Afya Imara Junior Medical Cover

GET COMPREHENSIVE MEDICAL COVER FOR YOUR CHILD WHEN IT REALLY COUNTS!

Afya Imara Junior is a comprehensive medical cover underwritten by UAP Old Mutual that provides insurance for children from birth up to 21 years.

It includes both inpatient and outpatient options at the Gertrude’s Children’s Hospital that provide our clients with the choice to exclusively access services from the main hospital and any of the satellite clinics.

There are four (4) options on this cover to choose from:

Benefits of the Gertrude’s Children’s Hospital solution:

Details Additional information
Age of Child This solution covers children from birth (after discharge from hospital) up to the age of 18. -It extends to those above 18 years but up to a maximum of 21 years, provided evidence of schooling is provided.
Inpatient Benefit This ranges from Kes 500,000 to Kes 5million
  • Hospitalization expenses including surgeon, physician, theatre, ICU & HDU fees
  • Diagnostics and physiotherapists fees, prescribed drugs, dressings, surgical appliances
  • Accommodation costs for parent/guardian accompanying child of 12 years and below.
Outpatient Benefit This ranges from Kes 50,000 to Kes 150,000
  • Routine outpatient services, consultations, diagnostics, drugs and dressings.
  • Routine dental and optical services, including cost of frames, lenses.
  • Well baby Clinics.
Provider Gertrude’s Children’s Hospital
  • Exclusive services at Gertrude’s Children’s Hospital
  • Discounted rate on the Gertrude’s Children’s Hospital option
  • Access to all UAP panel of providers

Should you require any additional information on this enhanced solution, kindly email us on:info@gerties.org
or call us on:020 720 6000 or 020 720 6534

Frequently Asked Questions

Eligibility Information

Question: Is my child eligible for the Afya-Imara Junior Medical cover?

Answer:

Children up to 21years are eligible for Afya-Imara Junior Medical cover. However, children above 18 years will require proof of schooling.

Question: Are teenagers eligible for coverage?
Answer:

Yes, children from birth until their 21st birthday are eligible for coverage. However, children above 18 years will require proof of schooling.

Question: I have a job. Can my children and teens still qualify?
Answer:

Yes, many children who are eligible for Afya-Imara Junior Medical cover are in families where one or both parents are working. Working parents may not have health coverage through their jobs or the health plans they’re offered may not cover their children.

Question: Who can apply for Afya-Imara Junior Medical cover for a child?
Answer:

A parent, grandparent, guardian or other authorized representative can apply on behalf of a child.

Question: What if my children and teens are covered by Afya-Imara Junior Medical cover already?
Answer:

That’s great! They already have comprehensive Inpatient health insurance. You can choose to add the Outpatient benefit.

Question: Is there a limit on the amount of time my child or teen can remain enrolled in Afya-Imara Junior Medical cover?

Answer:

Children and teens can stay covered as long as they qualify. You’ll need to renew their coverage once a year. Cover can be extended to those above 18 years but up to a maximum of 21 years, provided evidence of schooling is availed

Question: How do I know when to renew Afya-Imara Junior Medical coverage for my child or teen?

Answer:

UAPOM will contact you to let you know that it is time to renew your child’s coverage. Cover is not renewable after the 18th birthday, except on the exemption above, and children are moved automatically to Afya-Imara.

Covered Services

Question: What does Afya-Imara Junior Medical solution cover?

Answer:

The product provides comprehensive coverage for children, including:

  • Routine check-ups
  • Immunizations
  • Doctor visits
  • Prescriptions
  • Routine dental and optical services
  • Inpatient and outpatient hospital care
  • Laboratory and X-ray services
  • Emergency services
  • Mental health services

For a detailed benefit schedule refer to the brochure.

Question: How do I find a Gertrude’s Hospital clinic in my area?
Answer:

Services provided under this product can be accessed on the Gertrude’s Hospital network specified under each option

  • Gertrude’s Children’s Hospital at Muthaiga and its Satellite clinics.
  • Call Gertrude’s Children’s Hospital on 020 720 6000 or your insurance agent for help in locating the nearest service provider.

Question: What do families pay for coverage under Afya-Imara Junior Medical cover?
Answer:

Depending on the number of children as well as benefits & limits chosen the premiums will vary. Refer to the brochure for benefits, limits and rates schedule.

Application Process

Question: When can I apply for Afya-Imara Junior Medical cover? Is there a certain time of year I should apply?
Answer:

You can enroll any time. There’s no special open enrollment period. Call Gertrude’s Children’s Hospital or visit any

Question: How do I apply for Afya-Imara Junior Medical cover?
Answer:
You can apply online, by phone, by mail or in person.

Visit our website

www.gerties.org for online application or call 020 720 6000 or 020 720 6534 or visit any of our outpatient clinics.

To get more information and help call us on or email us on:

info@gerties.org