GDC ShwAARi
GDC ShwAARi is a comprehensive health insurance product with a single limit. It covers inpatient, including maternity, and outpatient services. Additionally, it offers bonus benefits for dental and optical services within each coverage limit.
Eligibility
- Eligible for the primary member and their dependents from birth (provided it is a term baby of 38 weeks) to 100 years.
- Children above 18 but below 24 years will be included in the parent's cover if they are still in school.
- Members joining the scheme above the age of 65 will not be required to take a Medical examination, but they will be required to declare any pre-existing conditions.
Bonus Benefit:
- GDC ShwAARi, 100K – up to a limit of Ksh. 5,000
- GDC ShwAARi, 250K – up to a limit of Ksh. 5,000
- GDC ShwAARi, 500K – up to a limit of Ksh. 5,000
- GDC ShwAARi, 750K – up to a limit of Ksh. 7,500
- GDC ShwAARi, 1M – up to a limit of Ksh. 10,000
Cover Plans
The cover has five plans; clients can choose depending on their needs and affordability.
| Plan Type | Overall Limit |
|---|---|
| Plan 1 | 100,000 |
| Plan 2 | 250,000 |
| Plan 3 | 500,000 |
| Plan 4 | 750,000 |
| Plan 5 | 1,000,000 |
Cover Plans
Annual Rates (0 – 65 Years)
b) Annual Rates (Above 65 Years)
| Plan Type | 100,000 | 250,000 | 500,000 | 750,000 | 1,000,000 |
|---|---|---|---|---|---|
| M | 13,494 | 18,356 | 27,535 | 38,548 | 55,895 |
| M+1 | 19,567 | 34,000 | 51,000 | 71,401 | 103,531 |
| M+2 | 26,415 | 47,684 | 71,526 | 100,137 | 145,199 |
| M+3 | 31,698 | 58,436 | 87,653 | 122,715 | 177,937 |
| M+4 | 37,087 | 67,201 | 100,802 | 141,122 | 204,627 |
| Plan Type | 100,000 | 250,000 | 500,000 | 750,000 | 1,000,000 |
|---|---|---|---|---|---|
| M | 18,868 | 28,199 | 41,048 | 56,468 | 83,548 |
| M+1 | 34,906 | 60,100 | 73,901 | 102,461 | 152,620 |
| M+2 | 50,700 | 69,258 | 102,637 | 142,692 | 213,038 |
Terms & Conditions
Waiting Period
Exclusions
Provider Panel
- The benefits stated above are annual limits and will depend on the plan chosen by the clients.
- For Inpatient treatments, the hospital room type will be a general ward bed (Maximum of 5k).
- No refunds for deletion in groups.
- There will be no pro-ration of premiums. Add-on joining the scheme mid-cover will pay full premiums.
- The geographical limit is Kenya only. Access will be strictly within the designated provider panel.
- There is a ten-month (10-month) waiting period for all Inpatient medical expenses related to pre-existing and/or chronic conditions, non-accident related surgeries, pregnancy and childbirth.
- Outpatient cases relating to pre-existing and/or chronic condition’s will be subject to 3 months waiting periods.
- There is a week waiting period for both illness admissions and visits.
- No waiting periods for groups with members above 15.
The following exclusions will apply:
- Only indicated medical expenses which are as per ethical/practice guidelines of the practice and medical board
- Cosmetic Treatments
- Infertility treatment
- Hearing Aids
- Treatment that is considered experimental/investigative according to accepted professional medical standards
Members will access services from our wide panel of providers comprising of select government, private, mission & faith-based facilities.
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