Afya Takaful
Introducing the first sharia’h compliant medical scheme for corporate organizations.

Afya Takaful is a medical scheme for corporates that caters for medical expenses arising out of illness and accidental injuries.It is a health insurance plan that is based on moral and ethical fundamentals and social welfare, and is open for the whole Kenyan corporate market.

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Corporate Eligibility
1. Be registered by State Law office & Kenya Revenue Authority
2. Engaged in occupation/business that is in line with moral and ethical principles
3. Minimum of 10 employees can obtain cover.

Age Eligibility
• Adults:18-65years
• Children covered from birth (38weeks to 18 years, this can be extended up to 25 years subject to proof of full time learning)
• Maximum joining age is 65 yearsAccommodation
• General ward bed for benefits below Ksh 1 Million
• Standard private room for benefits above Ksh 1 MillionAccess to services
• Treatment will be on credit basis in TIA appointed Medical ServiceProviders (MSPs)
• Members will present a TIA smartcard for identification

Accommodation
• General ward bed for benefits below Ksh 1 Million
• Standard private room for benefits above Ksh 1 Million

Access to services
• Treatment will be on credit basis in TIA appointed Medical Service Providers (MSPs)
• Members will present a TIA smartcard for identification

1. Corporate Insured Schemes.

• Annual contribution paid to TIA advance and no additional payments done except for new members added to the scheme
• Inpatient Per person/family (Minimum limit Ksh 200,000)
• Outpatient Per person/family (Minimum limit Ksh 30,000)
• Dental Per person/family (Minimum limit Ksh 10,000)
• Optical Per person/family (Minimum limit Ksh 10,000)
• Maternity Per person/family (Minimum limit Ksh 30,000)
• Funeral Expenses Per person/family (Minimum limit Ksh 30,000)

2. Corporate Self-funded Schemes

• Client deposits an agreed amount with TIA
• TIA arranges for credit facilities and pays the providers
• The client reviews the scope of cover as well as the exclusions
• Upon depletion of the fund (before end of cover period), the client isrequired to replenish. In case the fund is not depleted, the
remainder is returned to the client or utilized in the subsequent year
• An administration fee is charged per person per annum

3. Hybrid of Corporate Insured and Self-funded Schemes

• This is a combination of both corporate insured and self-funded schemes by a corporate within a policy period
• Inpatient covers will be insured whereas Outpatient, Maternity, optical & Dental covers shall be on self-fund

The following are covered under inpatient cover

• Pre-existing, Chronic, Cancer and HIV AIDS covered within theinpatient limit
• Congenital defects or related illnesses (conditions that a person is born with)
• Prematurity conditions
• Psychiatric conditions
• First emergency caesarean Section within inpatient
• Maternity and related complications (e.g. ectopic pregnancy, miscarriage etc)
• Road and air evacuation in case of an emergency
• Lodger Fee for children below 7 years of age
• Cover outside Kenya on holiday & business for a period of six weeks from date of travel
• Evacuation abroad for treatment not locally available.
• Qualified and dedicated personnel with ability to address customer queries
• Antiretroviral drugs are covered
• Inpatient illness related optical cover per family within inpatient
• Inpatient illness related dental cover per family within inpatient

The following are covered under outpatient cover

• Consultation with a general practitioner
• Consultation with a specialist upon referral by a general practitioner up to the specialists charges
• Laboratory investigations and tests
• X-Rays
• Prescription medicines
• Outpatient procedures e.g. Dressings
• Physiotherapists fees
• KEPI vaccinations up to 1.5 years.
• Day care procedures
• Pre-existing, Chronic, Cancer and HIV AIDS covered to the full outpatient limit
• Congenital defects or related illnesses (conditions that a person is born with)
• Prematurity conditions
• Psychiatric conditions

What are the policy exclusions under Afya Medical Cover

• Any expenses which are payable by any other Insurance e.g. NHIF, Group Personal Accident etc for Group Personal Accident (GPA) e.t.c.
• Any expenses for medical examinations done for check-up purposes not arising out of sickness or accident
• Family planning and fertility treatment
• Intentional self-injury, suicide or attempted suicide, intoxication, drunkenness
• Cosmetic surgery, massage or beauty treatment, weight management treatment and drugs
• Naval, Military and Air force operations
• Riding or driving in any kind of race
• Participation in extreme sports
• Stays at sanatoria, old age homes, places of rest, etc
• Nervous breakdown general debility, psychoneurosis
• General health check-ups, vaccinations
• War, invasion, civil war, riots or act of terrorism
• Chiropractors, acupuncturists or herbalists treatment

What is it Unique about Afya Takaful?

• An ethical and morally principled Insurance Scheme
• Cover available for more than one female spouse
• Surplus sharing (if any) from the Risk Fund is payable annually for participants with a loss ratio of less than 60%
• No waiting period
• Re-imbursement up to 100%
• Quality Healthcare