Britam Health Insurance is a Tier I health insurance in Kenya and the company has a number of superb health packages to cater to different medical needs, demographics, and budgets. Britam is one of the top insurers in Kenya, regulated by IRA, and has been leading consistently in various insurance segments including health insurance. This is according to the Association of Kenya Insurers (AKI).
The insurer offers different health packages, I shall discuss them later on in this article, ranging from individual to corporate covers. They are designed to suit different health needs, groups, age groups, and budget.
Britam’s most comprehensive medical cover includes the most prestigious hospitals in Kenya and covers a wide range of conditions including pre-existing and chronic conditions and substance and drug abuse rehabilitation.
The insurer also has budget-friendly medical packages for individuals, families, groups, and SMEs.
There are other Britam health insurance packages designed specifically for corporates/SMEs and groups.
Britam medical insurance covers integrate so well with the Social Health Authority (SHA/SHIF), complementing your public health cover.
In this write-up, I will take you through the most popular Britam Health Insurance packages for individuals, families, SMEs/corporates, and groups. I will also touch on age-bracket Britam health insurance covers.
I am a financial advisor at Britam and welcome to the guide.
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Which Britam Health Insurance Package Is Right for You?
Britam cover that fits you depends on your medical needs, family structure, and budget to say the least.
To guide you properly, here is a summary table showing profiles of health insurance seekers and where they fit in Britam health insurance packages.
| Profile/Requirements | Recommended Britam Cover | Core Highlights |
| Comprehensive coverage, high limits, pre-existing and chronic conditions, and substance abuse and rehabilitation covered | Britam Milele Health Plan | Up to KES 10M inpatient limits (shared or unshared) and lifetime renewal. This cover is suitable for individuals and families looking for a comprehensive cover with the most premium hospitals in Kenya. Read more about Milele Health Plan Here. |
| Micro-budget, basic inpatient/outpatient cover | Bima Ya Mwananchi (BYM) | Highly affordable and flexible tier options. BYM is suitable for individuals and families who are on budget. Read more about BYM here. |
| Seniors and elderly parents (65+ years) | Britam Milele Senior Medical Cover | A comprehensive, senior medical cover with entry up to the age of 80 years. One of the best in the market. Inpatient up to KES 10M, shared or unshared. |
| Children/Students without parents on cover | Milele Junior Medical Cover | This is designed specifically to cover minors and college students. |
| SMEs & Corporate, and Groups | Milele SME/Corporate Or Afya Tele | These two feature group rates and offer customized benefit structures. Afya Tele is a budget friendly health cover for SME and groups.Milele SME is comprehensive and designed for SME and corporates |
Overview of Britam Health Insurance Packages
Britam Milele Health Plan (Comprehensive Family and Individual Cover)
Milele Health Plan is one of the most comprehensive insurance covers in the market.
The health plan is suitable for individuals and families who want a cover that offers peace of mind. It has no discrimination against pre-existing and chronic conditions after waiting periods, high inpatient limits, wellness checks, and wide provider network.
The inpatient cover ranges for KES 300,000 to KES 10,000,000 which can be shared among the family members or unshared where each is allocated their own limit.
The outpatient cover ranges from KES 30,000 to KES 200,000.
Other covers include dental and optical covers of up to KES 40,000 each and maternity cover of up to KES 300,000.
Milele cover has five plans; platinum, gold, silver, bronze, and essential. Platinum, silver, and gold plans are the most comprehensive and include Tier I hospitals. Bronze and essential plans are the most affordable covers.
To learn more about the detailed limits, rates, and waiting periods? Read this complete guide on [Britam Milele Health Plan Review & Guide].
Britam Bima Ya Mwananchi (Affordable and Micro-Insurance Cover)
BYM health cover is purely designed for Individuals and families on a budget. The plan offers reasonably affordable rates for both inpatient and outpatient covers.
It also includes basic dental, optical, and maternity covers.
Its low entry premiums, essential inpatient/outpatient coverage, simple application process without rigorous medical checks make it so appealing to first-time insurance buyers, self-employed individuals, and those on a tight monthly budget.
To learn more about this plan, check out this step-by-step breakdown of [Britam Bima Ya Mwananchi Premiums & Benefits].
Britam Senior Medical Cover and Junior Covers
Britam health insurance also caters to special demographics; seniors entering retirement where standard covers lapse or spike in cost, and standalone covers for children and dependants.
Both the junior and senior medical covers are comprehensive and are derived from the famous Milele Health Plan, only now sharply focused on the needs of these demographics.
Both minors and seniors enjoy comprehensive coverages with high inpatient and outpatient limits. However, seniors at an advanced age may be exempt from outpatient coverage, but will still enjoy high inpatient limits.
The entry age of Britam Senior Medical Cover is 80 years and once enrolled, it is up to life as long as you renew it. No exit age.
Britam Corporate/SME and Group Medical Covers (Afya Tele and Milele SME)
We start with Afya Tele. Afya Tele is a comprehensive medical cover tailored to cater to the needs of groups and small companies.
The cover group rates are budget-friendly and start at KES 13,000 per group member.
The inpatient limit ranges from KES 200,000 to KES 750,000 while the outpatient cover ranges for KES 30,000 to KES 75,000.
Afya Tele covers both pre-existing and chronic conditions in both inpatient and outpatient, and also psychiatric cases.
Other covers include dental and optical covers up to KES 10,000 each and maternity cover.
Milele SME Health Plan is more advanced to attend to the most comprehensive needs of big SMEs and corporations.
Milele SME is customised according to the needs of these organisations and their rates are negotiated most of the times.
To learn more about Afya Tele read this guide on [Britam Afya Tele Medical Cover: Benefits, Limits, Eligibility & How to Apply]
General Rules and Policy Mechanics
Many first time medical insurance buyers are not aware of certain terms and limitations that are standard in health insurance.
Most of these terms and limitations are designed to prevent medical covers from being abused.
Let us discuss them briefly.
Waiting Periods
When you enroll in a medical cover, you will be subjected to a one month waiting period for general illnesses. There is no waiting period for accident cases.
Maternity cover is subject to a 10-12 months waiting period. Chronic and pre-existing conditions are subject to a 12 months waiting period.
For organ transplant, it is 24 months. If you request a Britam quote from me, I will include all those details in your document.
Standard Policy Exclusions
There are certain exclusions you should note before enrolling in the health cover of your choice.
Certain conditions are entirely not covered, unless recommended by a qualified, professional doctor.
Such conditions and cases include cosmetic procedures, unprescribed supplements, teeth braces, self-inflicted injuries, among others.
Your policy document will list all the exclusions.
Hospital Panel and Claim Process
Each plan has its own hospital panel. If you need to see the hospital list, you can just request me here by chatting with me or calling.
You can access the Milele Health Plan hospital panel here.
When you visit a doctor in one of Britam’s authorised hospitals, you just produce your smart card or show your coverage app.
Sometimes during emergencies, you might visit a hospital that is not in the Britam panel. In such cases, you pay from your pockets, keep the receipts and later on fill the claim form and submit it to Britam with the receipts attached. If the bill is too huge, it is advisable to call the emergency contact numbers in your app or smart card.
Actually, whenever you are in a dilemma on what to do when visiting a doctor, always call the contact numbers on your smart card or app. You will be guided accordingly on what to do.
How to Select and Apply for Britam Health Insurance
- Before doing anything, assess your family medical needs. If you are an individual, access your medical needs. This will help come with inpatient and outpatient figures that will adequately cover you and your family for the whole year without going back to your pockets.
- As you assess your family medical needs, determine your budget. Most medical cover premiums are annual. Have a figure in mind you can afford.
- Ensure also that the hospitals you prefer to seek treatment are included in the Britam panel. For Milele Health Plan, almost all major hospitals are in the panel.
- When applying, the following documents will be required: National ID, KRA PIN, and birth certificates for children.
If you have any questions about any of Britam health insurance packages, or any questions that involve Britam, let us meet in WhatsApp or comment section below.
Thank you for being here.
