J CAREJUBILEE MEDICAL INSURANCEJ CARE is an individual and Family Medical Product from Jubilee Insurance – East Africa No. 1 Insurer.PRODUCTS

Inpatient Cover (Main & Compulsory) Outpatient Cover (Optional/Rider) Maternity Cover (Optional/Rider) Last Expense (Optional/Rider) Personal Accident (Optional/Rider)

Enhanced BenefitsWe offer enhanced cover options that cater for the following conditions after the first policy period (i.e. covered by the second year of continued coverage).

Cover pre-existing and chronic conditions Cover for HIV/AIDS and ARV therapy

Who is Eligible?

Adults between the age of 18 years and 60 years Children between the age of 3 months and 18 years

NB: Members above 50 years will be required to undergo a medical examination at specific providers before membership and eligibility of cover can be confirmed. Please note that this will be at the applicant’s expense.Maternity Cover

Normal delivery including professional fees, labour and recovery wards up to Kshs. 80,000 under the Royal Plan and Kshs. 60,000 under the Executive Plan.

Costs of delivery, and other related ailments and complications including ectopic pregnancies, miscarriage, etc

Caesarean section delivery including professional fees, labour and recovery wards up to Kshs. 150,000 under the Royal Plan and Kshs. 120,000 under the Executive Plan

Please note maternity has a 12 month waiting period of continued coverage with Jubilee Medical Insurance.

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BENEFITS SUMMARY OF JUBILEE MEDICAL INSURANCE’ – J CARE

Bed limit [1] (Standard Private Room for Royal and Executive plans, General ward for Advanced and Premier Plans)INPATIENT – MAIN BENEFITS

Prescription drugs and dressing upon discharge – maximum of 30 daysSurgical appliances and internal prosthesesNursing carePhysiotherapy as part of treatmentPhysician’s fees, Specialist fees, Procedure fees and anesthetist fees (paid according to the fees guidelines of the Kenya Medical Practitioners and Dentist Board)Gynecological illness and treatment [2]Pre-existing and Chronic conditions (Year 2)Cancer treatment (Year 2)HIV/AIDS treatment (Year 2)Organ transplant (Year 2)Theatre charges, ICU & HDULodger fee for parent accompanying child below 6 yearsDay surgery under general an aesthesia or heavy sedationHome nursing (Medically necessary subject to approval by Jubilee, Maximum 90 days)Local emergency road ambulance which is medically necessaryAir evacuation through AMREF membership at an additional fee (of Kshs. 1600 Available through AMREF/Flying Doctors Membership)Non elective (emergency) treatment outside Kenya – preauthorization compulsory (INDIA, PAKISTAN & SOUTH AFRICA)Airfare costs for non-elective treatment outside Kenya for the patient. Also, airfare for an accompanying guardian where patient is below 6 years (Economy Class)Psychiatric treatment (Year 2)Pathology, Radiology, and other necessary diagnostic testsAccidental related dental treatmentAccidental related optical treatment

OUTPATIENT – MAIN BENEFITSConsultation fees (Doctors on panel)Pathology, X-rays, MRI, CT scan, and other necessary diagnostic tests [3]Prescription drugs and dressing up to a maximum of 30 days dosageGynaecological illness and treatment[2]Pre-existing and chronic cover (Year 2)Cancer treatment (Year 3)HIV/AIDS treatment (Year 2)Psychiatric treatment (Year 2)Physiotherapy (Upon approval by Jubilee)

MATERNITY – MAIN BENEFITS (Only Applicable for Royal and Executive Plans)

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Normal DeliveryNormal delivery including all costs below shall not exceed limitCost of delivery and related complications of pregnancy resulting in admissionProfessional fees(paid according to the fees guidelines of the Kenya Medical Practitioners and Dentist Board)Labour and recovery wardCaesarean Section DeliveryCaesarean section delivery including all other costs above shall not exceed limitCost of delivery and related complications of pregnancy resulting in admissionProfessional fees(paid according to the fees guidelines of the Kenya Medical Practitioners and Dentist Board)Labour and recovery ward

LAST EXPENCEProvision of a burial permit and death certificate will allow the insurer to make payment to the nominated beneficiary

PERSONAL ACCIDENT (18 Years and above – FREE for principal member)Accident reimbursement up to specified limit (Kshs. 500,000)

NB 2.1 All inpatient hospital bills shall be paid net of National Hospital Insurance Fund (NHIF).2 Fibroids, Adenoidectomy, Hemorrhoidectomy& Tonsillectomy procedures shall have a waiting period of 24 months.3 MRI, CT Scan on pre-authorization.NB 2. There are different specifications in each plan selected. Feel free to inquire for details

IMPORTANT NOTES

All inpatient hospital bills shall be paid net of National Hospital Insurance Fund (NHIF). Fibroids, Adenoidectomy, Hemorrhoidectomy& Tonsillectomy procedures shall have a

waiting period of 24 months. MRI, CT Scan on pre-authorization. All scheduled admissions must be reported to Jubilee at least 48 hours prior to admission.

Members must seek Jubilee authorization before proceeding. For emergency admissions, the hospital will contact us within 48 hours for authorization. All plans are subject to a 60 day’s waiting period. Members must bring their medical cards to obtain treatment on credit at the accredited

panel of providers. Each member will also be required to complete and sign a claim form available at the service provider.

In case of a medical emergency, members can reach us on the 24 hours emergency lines. A member on travel outside the country will be eligible for emergency medical benefits

up to a period of six (6) weeks in any one visit. All medical expenses will be on reimbursement basis and will be within the acceptable guidelines of the Kenya Medical Practitioners and Dentists Board.

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For details on how to get yourself covered, contact John Ithoka 0707,264,569, Email: johnjubileeinsurance@gmail.com

Mr. John Ithoka

Medical Insurance Consultant

FOR JUBILEE INSURANCE COMPANY OF KENYA

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