• By Raymond Momanyi

How Much Does Medical Insurance Cost in Kenya?

At Imana, we know this is one of the most asked questions. The cost of medical insurance in Kenya isn't a one-size-fits-all; it depends on your age, number of dependents, pre-existing conditions, coverage type, and even the hospital tier you prefer. From the basic SHA cover to micro-insurance, management schemes to corporate group plans – we’ve unpacked it all for you. 

1. Social Health Authority (SHA) / NHIF Replacement 

• Monthly premium: ~KSh 3600 per year
• Covers inpatient and outpatient in public and some private facilities.
• Part of Kenya's move toward Universal Health Coverage (UHC).
• May need top-ups for tier 1 and 2 private hospitals.

2. Micro‑Insurance
 

• From as low as KSh 8500 per year
• Covers informal workers, gig economy, low-income earners. Access limited to tier 2&3 hospitals
• Providers: Britam, APA, Jubilee, Birdview, Star Discover, Pacis, CIC in partnership with Imana Insurance Agency Kenya Ltd
• Basic benefits can run up to 100k Outpatient and 500k Inpatient
• Ideal for starters, students, hustlers & SMEs in addition to SHA

3. Management Schemes / Chama Health Plans
 

• Group-based plans starting from KSh 15,000/year
• Affordable pooled risk options
• Offers IP, OP, maternity in public and mission hospitals
• Best for saccos, self-help groups & welfare associations

4. Corporate Medical Insurance (SMEs & Large Companies)
 

• Customised pricing for employee groups
• Premiums vary depending on benefits & network
• Includes IP, OP, dental, optical, chronic illness, maternity
• Better negotiated limits and wider hospital networks
• Perfect for employers looking to protect their teams

5. Retail (Individual & Family Plans)

a) Budget Plans

Offered by majority of medical insurance companies with prices starting from from Ksh 12,600/year for one person, if adding family members pricing goes up.

b) Mid-tier Plans

These are the not so low, not so high premium medical covers tailored for mid-level income individuals and families. Pricing starts from around Ksh.40,000 a year.

c) Premium Plans

These plans work well for high budget clientele who are looking for premium medical schemes with annual cost stretching to over Ksh.1Million

This also includes expatriates who’re seeking to buy international medical schemes like Cigna, Aetna, Now Health, AXA etc,

Key Factors That Affect Premiums
 

• Age of applicant(s)
• Number of dependents
• Scope: IP only vs. IP + OP + maternity
• Hospital category (tier 1 private costs more)
• Chronic/Pre-existing conditions
• Custom benefits (e.g. dental, optical, wellness)

Imana Insurance Agency Kenya Ltd

📍 4th Floor, Krishna Centre, Woodvale Grove, Westlands, Nairobi
🌐 www.imana.co.ke | www.mykava.co.ke
📱 Call/WhatsApp: +254 796 209 402 | +254 745 218 460 | +254 113 806 810

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