What is Old Mutual Lady Anchor?

• Speak to your insurance agent or broker
• Call us on 0711 065 100 or;
• Email Medical Retail Retention at medicalretailretention@oldmutual.co.ke

1. A duly completed scheme application form by the scheme contact person or sponsor signed and stamped
2. A completed and signed application form by each employee
3. Certificate of Incorporation and KRA PIN certificate for the group
4. A letter of appointment for the insurance agent or broker, if applicable
5. A list of members and dependents (where applicable), including relevant details. Note: all employees or members of the organization must enroll
6. Proof of premium payment along with the quotation. Cover will commence only after premium payment

• Eligibility:
  • Main member, spouse, and domestic worker: Eligible from 18 to 50 years. Existing members can renew their coverage until their 60th birthday
• • Biological or adopted children: Eligible from 0 months to 18 years, or up to 25 years with proof of schooling
• Provider network: Access to a comprehensive network of service providers nationwide
• Waiting periods: Waived for inpatient, outpatient, dental, optical, and maternity benefits when the principal member and dependents are enrolled. A one-month waiting period applies for the Critical Illness benefit
• Pre-authorization:
  • All scheduled admissions must be pre-authorized at least 48 hours in advance
  • For emergency admissions, the hospital must contact Old Mutual within 48 hours of admission
• Hospital bills: All bills will be paid net of NHIF rebates as advised by Old Mutual
• Virtual smart cards: Members will use virtual smart cards at accredited providers for service access. A completed claim form is required for each service
• Emergency medical benefits abroad:
  • Members with limits of KES 1M or above traveling outside the country are eligible for emergency medical benefits for up to 6 weeks per visit
  • Expenses will be reimbursed within policy guidelines for reasonable charges. Travel and accommodation costs are not covered
• Hospital cash benefit: Payable once per admission lasting 5 days or more, up to 5 admissions per year

The policy does not cover:

• Expenses arising from withheld or misstated material information
• Fertility treatments
• Cosmetic surgery unless caused by an accident
• Weight management treatments and drugs
• Professional or hazardous sports participation (e.g., bungee jumping, paragliding)
• Treatment by unregistered medical practitioners
• Self-referred or self-prescribed treatments
• Nutritional supplements unless prescribed as part of medical treatment
• Alternative treatments (e.g., chiropractors, acupuncturists, herbalists)
• Expenses related to riots, strikes, or civil commotion
• Naval, military, or air force operations
• Expenses recoverable under other insurance covers (e.g., NHIF, GPA, WIBA)
• Beauty treatments or services in nature cure clinics or health hydros
• Diagnostic equipment (e.g., glucometers, BP machines)
• Experimental treatments
• Expenses related to contamination from radioactivity or nuclear waste
• Pandemics or epidemics, unless the policy includes a buy-back option with a specified sub-limit
• Benefits not purchased or indicated in the brochure