Afya Poa Heath Insurance Scheme

AfyaPoa is a unique health-financing product that offers comprehensive health coverage for the whole family. The product is managed and distributed by Insurance for All (IFA) Insurance Agency Ltd. and underwritten by Sanlam Insurance Company Ltd.

Coverage at a glance

1. Outpatient- Covers cost of normal treatment including doctor costs, diagnostics and medication.

Limit per family Kes. 50,000

2. Inpatient- Covers costs admission including doctor costs, diagnostics, medication, ICU and HDU costs, and surgery.

Kes. 200,000

3. Martenity- Mainly covers the cost of child delivery including post and antenatal care

.Kes. 50,000

4. Dental- Covers outpatient dental procedures for the whole family.

Kes. 10,000

5. Funeral- Cover offers a cash benefit to cover funeral expenses in case of the death of a named family member. The cover is on a first death basis.

Kes. 10,000

Other unique benefits covered by the scheme
  • COVID-19 covered
  • Access to home visits and dial in consultations
  • Chronic disease management
  • Access to free nutrition advice
  • • Access to family planning services
  • Free wellness check-ups upon registration.
  • Access to the AfyaPoa app

Terms & Conditions

Premium

Sendy partners will be required to pay Ksh. 81/= per day for five working days per week.

Medical service providers

AfyaPoa has a wide panel of medical service providers where members can seek treatment. Members are restricted to getting medical services ONLY from these listed providers. A comprehensive list of the facilities is available on the Sendy website.

Eligibility

All Sendy Partners below the age of 70 years and their dependents who will include one spouse and 2 children below 18 years.

NHIF

Although not mandatory, we encourage our members to have an NHIF card as it compliments your AfyaPoa medical benefit.

What is the waiting period?

If you signup within 60 days for 28 April 2020, all parts of your insurance take effect immediately. After the 60 day grace period each part of the scheme will take effect subject to the waiting periods specified below.

  • No waiting period for accidents.
  • 30 day waiting period for general illnesses and treatment.
  • 120 day waiting period for non-accidental surgeries, elective gynecological and ENT admissions; admissions due to declared chronic or pre-existing illness; Funeral cover.
  • 9 month waiting period for maternity and first caesarian section.

How to signup

  1. Complete the application form & agree to terms and conditions.
  2. Provide a picture of your ID and your passport photo.
  3. Sign consent to have premiums deducted from your daily earnings

How to make a claim

Claiming medical benefits

Visit the nearest medical service provider listed as an AfyaPoa provider. Present your AfyaPoa card, hospital staff will confirm validity and proceed with treatment.Call the medical helpline in case you need any assistance.
Claiming funeral benefits
Complete the claim form and attach copies of: birth certificate of the children(of the deceased), burial permit or death certificate of the deceased, the beneficiaries ID copy and a police abstract for accidental deaths.

What is not covered

  • Nutritional supplements unless prescribed as part of medical treatment
  • Treatment outside the appointed panel of service provider
  • Self-prescribed treatment/medication
  • Beauty & cosmetic treatment or surgery
  • Weight management treatments and drugs
  • Beauty & cosmetic treatment or surgery
  • Diagnostic equipment (e.g. Glucometers, BP machines etc.) and hearing aids
  • Treatment other than by registered medical practitioner
  • Intentional self-injury, drunkenness, drug addiction
  • Experimental treatment
  • Overseas treatment
  • Infertility/Impotence treatment
  • Naval, Military or Air force operations

Here is the application form, https://share.hsforms.com/1_S4mv-DtSACk3DuT1o4mKw2y4yv

Did this answer your question? Thanks for the feedback There was a problem submitting your feedback. Please try again later.

Still need help? Contact Us Contact Us