Will my pre-existing condition be covered?

It depends on disclosure and the insurer. Most plans either (a) cover declared pre-existing conditions after a 12-month waiting period, (b) cover them at an additional premium, or (c) exclude them outright. Honest disclosure on the application form is critical. Undisclosed conditions void claims.

Up to what age are children covered?

Standard family policies cover children up to age 18, or up to age 23 if in full-time tertiary education with a school letter. Above that, children move to their own individual policy. We handle the transition.

What is the minimum number of staff for a group scheme?

Most insurers accept group medical from 5 lives. Below that, you can either combine with another SME under a small-group facility, or buy individual policies for each staff member.

How is the renewal premium calculated for a corporate scheme?

Above 50 lives, insurers use a loss ratio model: total claims paid divided by total premium charged for the prior year. Loss ratios under 70% typically attract favourable renewals; above 90% trigger increases. We provide loss ratio analysis at every renewal so the discussion is on the numbers, not the insurer's narrative.

How much is outpatient insurance in Kenya?

Standalone outpatient-only cover is priced against the annual outpatient limit you choose (typically KES 50,000 to KES 150,000), your age, and whether optical and dental are added. We confirm your exact premium on WhatsApp before you commit.

Can I pay for medical insurance monthly in Kenya?

Not as instalment billing: like all Vike products (other than highly customised covers), medical insurance is paid as a single premium upfront for the year. What we can do is show you the annual premium broken down to a monthly-equivalent figure, from about KES 1,800/month (around KES 21,600/year), so it is easier to plan for and budget against your salary.

Health & Medical Insurance Kenya | Vike Insurance Brokers

What We Cover

6 types of health & medical insurance cover. Each one has its own page with the full policy detail, pricing and claims process.

Individual Medical Insurance
Inpatient and outpatient cover for individuals: hospital stays, surgery, specialist consultations, and chronic condition management.
From KES 25,000 a year
Typical rate
What it covers
- Inpatient: hospital admission, surgery, ICU, theatre fees, drugs, and consumables
- Outpatient: GP and specialist consultations, diagnostics, and prescribed drugs
- Pre- and post-hospitalisation expenses (typically 30–90 days each side)
See prices for Individual Medical Insurance Details about Individual Medical Insurance
More about Individual Medical Insurance
Since the transition from NHIF to the Social Health Authority (SHA) in October 2024, private medical cover has become more important than ever for Kenyans who want predictable access to quality healthcare. Individual medical insurance fills the gap between SHIF's public-scheme limits and the actual cost of care at Aga Khan, Nairobi Hospital, MP Shah, Karen Hospital, Avenue, and the country's other leading private facilities.
Also covers
Day-care procedures: minor surgeries not requiring overnight admission
Emergency local and overseas evacuation on most schemes
Who it's for
Self-employed Kenyans and freelancers without employer medical cover
Retirees and pre-retirees wanting predictable private healthcare access
Spouses of employed members topping up corporate cover with personal extras
Family Medical Insurance
One plan covering you, your spouse, and your children, with maternity, paediatric, and dental options under a shared limit.
From KES 80,000 a year
Typical rate
What it covers
- Inpatient: admission, surgery, ICU, and maternity for the whole family
- Outpatient: GP, specialist, diagnostics, and pharmacy
- Maternity: antenatal, normal delivery, C-section, and post-natal care
See prices for Family Medical Insurance Details about Family Medical Insurance
More about Family Medical Insurance
Family medical insurance covers a principal member, their spouse, and dependants, typically children up to age 18 (or 23 if in full-time tertiary education): under a single contract. The benefits, limits, and excess are usually shared across the family, though some insurers offer per-member limits for higher-tier plans.
Also covers
Paediatric: congenital conditions (disclosed), routine immunisations, child consultations
Dental: routine cleanings, fillings, extractions; major work as a rider
Who it's for
Young families planning children or with children under 18
Self-employed parents without employer medical cover
Single-parent households consolidating cover for self and children
SME Group Medical Insurance
Affordable group medical schemes for small and medium businesses, covering 5 to 50 employees with optional dependant cover.
What it covers
- Inpatient: admission, surgery, ICU, maternity per employee (and dependants if added)
- Outpatient: consultations, diagnostics, prescribed drugs
- Maternity: for principal members and spouses
Request a quote for SME Group Medical Insurance Details about SME Group Medical Insurance
More about SME Group Medical Insurance
Group medical cover is the single most valued benefit Kenyan SMEs can offer their staff. It is also one of the most cost-effective: from five lives upward, insurers price group medical 20–40% below the equivalent individual cover, because risk is pooled across the group and the underwriting overhead is lower per member.
Also covers
Dental and optical (typically standard on most SME schemes)
Annual wellness check-up for senior staff (premium tier)
Who it's for
Kenyan SMEs with 5 or more employees
Founders wanting to attract and retain talent in competitive sectors
Family businesses formalising staff benefits
Corporate Medical Insurance
Bespoke medical schemes for corporates above 50 lives: banded benefits, broad hospital panels, and a dedicated relationship manager.
What it covers
- Inpatient: multi-tier limits across staff bands, including overseas treatment for executives
- Outpatient: flat or tiered limits with chronic condition management built in
- Maternity: full antenatal, delivery, post-natal, and neonatal cover
Request a quote for Corporate Medical Insurance Details about Corporate Medical Insurance
More about Corporate Medical Insurance
At 50+ lives, group medical pricing transitions from book rates to experience-rated underwriting: your scheme's own claims history starts to drive the premium at renewal. That is an opportunity: well-managed schemes reward employers with better terms each year, but it also requires the right broker to structure benefits, monitor utilisation, and challenge insurer renewal proposals on the numbers.
Also covers
Dental and optical: included by default on most corporate schemes
Pre-employment and annual medical examinations
Who it's for
Kenyan corporates and multinationals with 50+ employees
HR and benefits leaders managing schemes across multiple staff bands
Listed companies needing ESG-aligned employee health reporting
Outpatient-Only Medical Insurance
Standalone outpatient cover for Kenya: GP and specialist consultations, lab tests, and prescribed drugs, without inpatient.
What it covers
- GP and general-practitioner consultations at panel clinics
- Specialist consultations on referral (e.g. dermatology, ENT, paediatrics)
- Laboratory tests and diagnostics: bloodwork, urinalysis, basic imaging
Request a quote for Outpatient-Only Medical Insurance Details about Outpatient-Only Medical Insurance
More about Outpatient-Only Medical Insurance
Outpatient-only medical insurance covers the everyday healthcare you use without being admitted to hospital, seeing a GP or specialist, having lab tests and scans, and collecting prescribed medication. In Kenya these visits are where most households actually spend on health: a consultation and a course of drugs can run KES 3,000–8,000 each time, several times a year, and none of it touches an inpatient policy. A standalone outpatient plan turns those unpredictable cash payments into one predictable annual premium.
Also covers
Prescribed drugs and common medication dispensed at panel pharmacies
Routine outpatient procedures not requiring admission
Who it's for
Young, single, or generally healthy adults whose main health spend is consultations and drugs
Freelancers, gig workers, and the self-employed without any employer medical cover
Employees whose company scheme covers inpatient only, leaving outpatient out of pocket
Monthly Medical Cover: Health Insurance Priced Per Month
Vike medical insurance is paid as one premium upfront each year, not in monthly instalments. This plan's annual premium works out to about KES 1,800 a month, so it is easy to budget against inpatient and outpatient health cover.
From KES 21,600 a year
Typical rate
What it covers
- Inpatient: hospital admission, surgery, and ICU up to the plan's annual limit
- Outpatient: consultations, diagnostics, and prescribed drugs where included
- Maternity, dental, and optical on plans and tiers that offer them
See prices for Monthly Medical Cover: Health Insurance Priced Per Month Details about Monthly Medical Cover: Health Insurance Priced Per Month
More about Monthly Medical Cover: Health Insurance Priced Per Month
Some Kenyans search for "monthly medical cover" hoping to pay for health insurance in small instalments. Vike does not offer instalment billing: like our other products, medical cover is paid as a single premium upfront for the year. What we do offer is the cost shown broken down by the month, so it is easy to budget against a salary: from about KES 1,800 a month, which works out to roughly KES 21,600 for the full year. The benefits are the same as a standard medical plan: inpatient admission and surgery, plus outpatient consultations, tests, and drugs where the plan includes them.
Also covers
Cashless admission and treatment at the insurer's panel facilities
A clear monthly-equivalent figure for budgeting, even though the premium is paid upfront
Who it's for
Salaried earners who want to budget against a monthly-equivalent cost before paying the annual premium
Freelancers and small-business owners planning their annual premium around steady monthly income
Young families budgeting for their first private medical plan using a clear monthly-equivalent figure

Comprehensive Health Cover for Individuals, Families & Businesses

What We Cover

Individual Medical Insurance

Family Medical Insurance

SME Group Medical Insurance

Corporate Medical Insurance

Outpatient-Only Medical Insurance

Monthly Medical Cover: Health Insurance Priced Per Month

Why Choose Vike?

Health & Medical Insurance FAQs

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