Covid-19 – Healthcare FAQ

Does my international private medical policy cover me for Covid-19?

All the insurers we work with have confirmed that they will cover Covid-19. However, there may be specific scenarios that may limit your coverage. This will depend on your policy benefits, the area of cover on your policy, your location and any personal medical exclusions on your policy.

I am on an inpatient plan and do not have any outpatient benefits on my plan, would I be covered for Covid-19 tests?

Some insurers will cover testing for Covid-19 regardless whether you have outpatient benefits on your policy. Please get in touch with us if you do not have a copy of your policy benefits.

The area of cover on my policy is “Africa” but I am stuck in a country outside Africa, would I still be covered for Covid-19?

If you find yourself outside your policy’s area of cover and your policy benefits have an “out-of-area” cover, you may be able to claim for treatment relating to Covid-19 as part of this benefit. To see whether you have this benefit, please refer to your membership guide.

There is a travel restriction on the country I am departing to, are there any limitations on my coverage?

Insurers will typically not cover treatment if members voluntarily choose to travel to a destination after a travel restriction has been applied. With this said, exceptions may be made on a case-by-case basis (for example, if the destination country is your country of residence, if you have been sent for a work assignment or your close family lives in that destination). If this is a concern of yours, please let us know so we can assist you in seeking clarifications from the insurer.

I have exclusions on my policy, could these affect my coverage for Covid-19?

Certain personal medical exclusions may have been applied to your policy based on your health declaration when you first joined. Depending on your exclusion, there may be restrictions to your coverage. For example, if you have an exclusion on respiratory conditions, it might mean you will not be able to claim for Covid-19.

As the rules differ per insurer, if you are concerned about your exclusions, please let us know and we’ll be happy to check with your insurer on your behalf. To see which exclusions apply to your policy, please refer to your membership certificate or let us know and we will send this to you.

My country has implemented restrictions on movement, and I cannot easily access a doctor. Can you help?

Many doctors are now providing telephone consultations. We have also provided details of telehealth services on our Covid-19 portal.

If your policy has outpatient benefits, eligible claims for telephone consultations can be submitted to the insurer for reimbursement. Please let us know if you need any assistance with your claim submissions.

I will likely get treated for Covid-19 at a government facility, at no cost to myself or my insurer.

Some policies offer a “hospital cash benefit” that would apply if you are treated in a public hospital free-of-charge. This cash benefit would apply in the context of Covid-19. Your membership guide will indicate whether you have this benefit.

What additional support services can I expect from my insurer?

  • Most insurers have a 24×7 medical advice line for members to access
  • Some insurers have assistance programmes that offer 24×7 confidential short-term counselling support – we find that this is a very useful service for our customers

Details on the additional support services per insurer can be found on our Covid-19 portal. 

Where in Kenya can I get treated and tested for Covid -19?

The response to COVID19 is being organised and managed by each country’s respective government and health authorities. At this time, understandably, governments want to control 100% of Covid-19 cases to ensure they contain the outbreak and testing and treatment will be done in a government facility of their choice.

I don´t want to be admitted to a government hospital, can I get treated at a private hospital such as Aga Khan or Nairobi Hospital?

The insurers have no influence over which hospital you will be admitted to and must adhere to the government´s guidelines. We have seen that some clients have been admitted to the Aga Khan however this is upon the government´s discretion and the insurer cannot guarantee this will be the case for all members.

In the instance that we cannot be treated here in Kenya for Covid-19 can we be evacuated to a country of our choice and will the insurance company cover the costs of treatment in another country?

This will depend on the benefits, limits and terms & conditions of your policy. If it has been established that treatment is not available locally:

    • If you have an evacuation benefit, you would not necessarily be taken to a country of your choice, but to the nearest suitable hospital from your location.
    • If you have a repatriation benefit – you would be repatriated back to your home country.

Your insurer will do everything they can to support you with this.

Further, as Covid-19 is considered an infectious disease evacuation or repatriation would be subject to availability of the air ambulance aircrafts outfitted with a special “Bubble” to transport an infected member.

It would also be subject to government authorisations at location, and the receiving country as they will have to give permission for an infected person to enter their country. Evacuations will therefore be managed by insurers on a case-by-case basis.

What do I do If I am showing symptoms for Covid-19?

If you are showing symptoms you should self- isolate for 14 days. If you are very sick and need to see a doctor you should call the Ministry of Health hotline -719 – and they will take you through the necessary steps. Please see advised protocol on the JW Seagon Covid-19 Information Portal?

 Alternatively, you can call the hotline of a hospital of your choice and they will advise you on the next steps. You can also call Dial Daktari for a consultation with a doctor. All these contacts and more can be found on the  JW Seagon Covid-19 Information Portal

Is there any action that we should be taking?  If someone is diagnosed with the virus, will my insurer cover the cost of quarantine and/or treatment?

If you have International Private Medical Insurance your insurer will cover you for Covid-19 in line with your policy benefits.

Local Medical Insurers have advised their current position allows for all medically necessary treatment and testing for Covid-19 to be covered as per your policy benefits and limits. However, cases must be diagnosed and treated in a medical facility or public hospital that has been authorised by the Kenyan government.

Can you find out for me if the insurer will provide a reduction in the premium paid seeing as the region for cover is reduced to Kenya only due to the Covid-19 outbreak?

Restrictions have been placed on treatment for Covid-19 by all governments in the efforts to contain the pandemic. This however does not mean the region of cover on your insurance policy has reduced. If you are on a Worldwide, excluding USA policy, the region still applies and can be accessed once the restrictions are lifted.

Regardless, we are actively engaging with all our insurers to ascertain how best to assist our clients with premium payments and will provide updates as soon as possible.

In the instance of a serious illness or injury unrelated to Covid-19 would evacuation still be possible, if the case was serious enough and local solutions were not appropriate?

If you have an evacuation benefit as part of your policy the insurer would engage with their local partners to work on an evacuation plan. The insurer will offer evacuation if treatment is medically necessary and is unavailable locally (subject to approval). All evacuations will therefore be managed on a case-by-case basis.

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