Britam Insurance has designed the Milele Health Plan to provide individuals and families with a strong health insurance solution. This plan caters to your healthcare needs throughout your life, ensuring financial security and access to quality medical care.
Britam Milele Health Plan Benefits
- Lifetime Coverage: Unlike many insurance plans that expire at a certain age, Britam Milele Health Plan provides coverage for your entire life, subject to annual renewals.
- Pre-existing Condition Coverage: Britam Milele Health Plan stands out by covering pre-existing, chronic, and congenital conditions up to the full inpatient limit.
- Extensive Network Access: The Britam Milele Health Plan grants you access to a vast network of hospitals, physicians, clinics, and other healthcare providers within the Britam panel. You’ll have a wide range of qualified medical professionals at your disposal.
- Financial Safeguard during Critical Illness: Britam Milele Health Plan offers critical illness cash benefits of up to Ksh 5 million or Ksh 10 million, significantly easing the burden during a critical illness.
- Tailored Coverage Options: Britam Milele Health Plan goes beyond basic inpatient coverage. You can choose to add maternity, outpatient, dental, and optical coverage to personalize the plan according to your specific needs.
- Funeral Expense Coverage: Britam Milele Health Plan offers an additional layer of security for your family by covering funeral expenses in the event of your passing.
- Focus on Preventive Care: The Britam Milele Health Plan includes free advice on healthy lifestyle choices and stress management support, empowering you to take charge of your well-being.
- Annual Wellness Check-Ups: Free annual wellness check-ups are provided upon renewal to proactively monitor your health.
Britam Milele Health Plan Cover Features
- Inpatient
- Outpatient (optional)
- Maternity (optional)
- Dental (optional)
- Optical (optional)
- Funeral cover
- Personal accident cover
Britam Milele Health Plan Inpatient Coverage
Britam Milele’s inpatient coverage includes:
- Doctor’s fees (surgeons, physicians, anesthetists)
- Nursing care, medications, dressings
- Surgical appliances, internal prosthetics
- ICU and HDU charges
- MRI, CT scans, pathology tests, and other diagnostics
- Daycare surgery under general anesthesia
- Home nursing care (subject to pre-authorization)
- Lodger fees for a parent/guardian accompanying a child under 10
- Surgical implants, joint replacements, prostheses (excluding dental fixtures)
Emergency medical evacuation and overseas referral treatment to India are also covered, subject to pre-authorization. Accidental dental and optical treatments are included.
Britam Milele Health Plan Outpatient Coverage
Britam Milele Health Outpatient cover includes:
- Consultations with GPs and specialists
- Diagnostic tests (X-rays, lab tests, ultrasounds, etc.)
- Pre and postnatal hospital expenses
- Physiotherapy
- Prescribed medications, dressings
- Coverage for pre-existing, chronic, congenital conditions, and cancer
- HIV/AIDS-related conditions and prescribed ARVs
- KEPI and baby-friendly vaccinations
- Counseling sessions with a psychiatrist (upon referral)
- Co-pay applicable for specified hospitals
Britam Milele Health Plan Sublimits
Inpatient
Maternity (Offered As Stand Alone)
- The Milele Health Plan offers maternity cover, with limits ranging from Ksh 80,000 to Ksh 300,000.
Outpatient
Dental and Optical Plans (Optional)
- The Milele Health plan offers outpatient cover with limits ranging from Kshs 50,000 to Kshs 200,000. In addition, you can get dental and optical covers ranging from 10,000 to 40,000.
Britam Milele Health Plan Eligibility
The Britam Milele Health Plan is accessible to:
- Newborns (added after birth with birth notification)
- Individuals up to 75 years old (no maximum exit age)
- Seniors (55 years, subject to medical test)
- Children covered up to 25 years old if enrolled in school.
Britam Milele Health Plan Exclusions
The Britam Milele Health Plan exclusions include:
- Self-referred or self-prescribed treatment
- Infertility & impotence
- Intentional self-injury, chronic drunkenness, suicide or attempted suicide, drug and substance abuse
- Hazardous pursuits (sports and hobbies)
- Cosmetic and beauty treatment (unless accidental injury)
- Experimental treatment or treatment subject to medical research
- Weight management treatment and drugs
- Diagnostic equipment (glucometers, BP machines, etc.)
- External surgical appliances (crutches, wheelchairs, prostheses)
- Dental prosthesis, crowns, dentures, bridges and braces
- Alternative medicine (acupuncture, chiropractor, herbal medicine) unless GP referred
- Expenses covered by other insurance or sources (e.g., NHIF)
- Treatment outside approved service providers’ network
- Nutritional supplements (unless prescribed for specific conditions)
- Treatment related to menopause, andropause, aging, puberty, or pre-menstrual tension syndrome
- Expenses incurred outside Kenya (except for up to 8 weeks)
- Claims with misstated or withheld information (e.g., pre-existing conditions)
- Treatment of obesity or slimming preparations
- Cost of hearing aids
- Expenses exceeding policy limits or sub-limits
- Cost of organ donors and related transplant costs
- Any other exclusions listed in the policy document
Britam Milele Health Plan Payment Option
Payments can be made through Mpesa Paybill Number 584065 using your full name as the account name.
How to Enroll in Britam Milele Health Plan
To enroll in the Britam Milele Health Plan:
- Contact a Britam Agent for detailed explanations and enrollment guidance.
- Visit Britam’s Website for comprehensive plan information and online enrollment.
- Call Britam Customer Care at (02) 2833027 / 0709 165 000 for assistance.
