Lets talk medical – Linda Jamii

Lets talk Medical Cover. We mostly ignore it yet we know we need it. We may predetermine alot of occurence but never medical emergencies. No one knows when we will fall sick or in an accident that requires medical attention. Many people assume medical insurance is for the sickly ….no, medical insurance should be made a basic need to all individuals. We have all somehow have found ourselves heading to see a ‘cheaper’ doc/clinic because at the time of our medical need, we didnt have the cash required for proper attention. Fine, you dont fall sick as often but it is always good to have a back-up…just in case…today we shall summarize Linda Jamii as we advance to more costlier options.

Wouldnt it be better to spend the 12,000.00 required over the payment period plan and get a cover than find yourself lying in hospital with a sum of money out of reach from you and your family needed before the doctor can attend to you?

Below are some of the facts from Linda Jamii..

ABOUT LINDA JAMII

Linda Jamii is a revolutionary family medical care product that has been developed by Britam in conjunction with Changamka Microinsurance and Safaricom. It is an inpatient and outpatient medical scheme with funeral expenses benefits built into it.

Subscribe to an e-card that enables you to save exclusively towards the purchase of health insurance for your family using MPESA.

CONTACTS

Call Center: 0708 525 525

Self Service: *525#

Email: lindajamii@britam.co.ke

COVERAGE

All payments for Linda Jamii are paid ONLY by using the Pay Bill Number: 525525. No cash transactions.

Waiting Periods

The policyholder and his/her nominated dependents will not be required to undergo any medical examination or test prior as an eligibility criterion. In consideration of this, the following waiting periods starting from the effective date, will apply to the following benefits;

  • Non-accidental injury and death       – 60 days  (or 2 months)
  • Inpatient maternity care                      – 60 days  (or 2 months)
  • Elective surgery                                   – 365 days (or 12 months)

 

For a new born child (or children) a mandatory one (1) month waiting period will apply for all medical insurance benefits.

  1. HEALTHCARE BENEFITS
DESCRIPTION BENEFITS FOR THE ANNUAL HEALTHCARE PLAN (12 MONTHS) BENEFITS UPON PAYMENT OF KSHS 6,000(PARTIAL BENEFITS FOR 6 MONTHS)
HOSPITALISATION CARE BENEFIT KShs. 200,000 Per family per year Maternity limit – KShs. 30,000 (within the hospitalisation limit) KShs. 75,000 per family for 6 months Maternity limit: 15,000/- (within the hospitalisation limit)
OUTPATIENT CARE BENEFIT KShs. 50,000 Per family per year. KShs.100/-payable per outpatient visit per person

Optical limit – KShs. 5,000 (within outpatient care limit)

Dental limit – KShs. 5,000

(within outpatient care limit)

KShs. 20,000 per family for 6 months

KShs. 100 payableper hospital visit per person

Optical limit – KShs. 2,000 (within outpatient care limit)

Dental limit – KShs. 2,000 (within outpatient care limit)

DAILY HOSPITAL CASH BENEFIT KShs. 500 (payable from day 3 of hospitalisation for principal or spouse) KShs. 500 (payable from day 3 of hospitalisation for principal or spouse)
FUNERAL ASSISTANCE BENEFIT KShs. 40,000 (Assistance applicable to principal and spouse)No waiting period for accidental death. KShs. 40,000 (Assistance applicable to principal and spouse)No waiting period for accidental death.
FAMILY SIZE COVERED Member / Spouse and all biological or legally adopted children under 18 years or 25 years, if in school or college. Member / Spouse and all biological or legally adopted children under 18 years or 25 years, if in school or college.
HEALTHCARE COST KShs. 12,000 per year. KShs. 6,000 for the 6 months period
LIMITS All limits shown are for the whole family and not individual limits. All limits shown are for the whole family and not individual limits.
HOSPITALS Britam approved hospitals. Britam approved hospitals
WAITING PERIOD 60 days from insurance commencement date. No waiting period for accident related hospitalisation or death (applicable to each individual) 60 days from insurance commencement date. No waiting period for accident related hospitalisation or death (applicable to each individual)

Out-patient cover

Members are expected to seek out-patient treatment in the accredited medical facilities. A member will be required to produce their Linda Jamii e-card or unique ID number and a national identification card. The out-patient cover includes amongst others these services: consultation, laboratory services, drugs administration and dispensing.

In-patient cover

Members are expected to seek in-patient treatment in the accredited medical facilities. A member will be required to produce their Linda Jamii e-card or unique ID number and a national identification card. The in-patient cover includes amongst others these services: consultation, laboratory services, drugs administration and dispensing, bed.

Dental cover

Dental treatment will include; dental consultation, cost of filling, x-rays and extractions including surgical extractions together with anesthetics fees hospital and operating theatre cost.

Optical cover

Optical treatment will include; cost of eye testing, cost of eye glasses, and frame.

 

HOSPITALS/DOCTORS

http://lindajamii.co.ke/hospitals/

Linda-Jamii-Panel-of-Hospitals-May-2015

ELIGIBILITY

  1. Kenyan Citizen with a valid ID or Kenyan passport
  2. The policyholder ( principal member) and nominated spouse member should both not be less than 18 years old
  3. The maximum entry age for this policy for both principal and spouse member is 75 years
  4. The minimum entry age under this policy for a child as a dependant is 1 month and the final applicable age is 18 years
  5. An adult child between 18 years and 25 years can be covered under this policy as a dependant subject to proof of enrollment in a school, college or university on a full time basis. This proof must be submitted annually

PAYMENT

The annual premium payable is kshs 12,000 per family per annum. This can be paid in full or in 2 equal instalments

How to Pay or Save for Linda Jamii via MPESA

  1. Access the SIM tool kit on your phone / Safaricom services option
    2. Go to M-pesa menu
    3. Select Lipa na M-pesa (also appears as payments services in some phones)
    4. Select Pay Bill and enter Business Number as 525525
    5. Enter Account Number (your unique Linda Jamii number) e.g 123456
    6. Enter amount you wish to pay Ksh (e.g 6000)
    7. Enter PIN number (your MPESA pin)
    8. Press OK. You will receive a confirmation message from MPESA.

EXCLUSIONS

General Exclusions
The cover shall exclude: expenses incurred by a member as a result of;

  • Cosmetic surgery
  • Treatment by chiropractors, acupunturists and herbalists, stays and/ or maintenance or treatment received in nature cure clinics or similar establishments or private beds registered within a nursing home, covalescent and / or rest homes.
  • Massage unless necessary for treatment i.e following accident.
  • Fertility treatment related to infertility and impotence
  • Vaccines
  • Investigations, treatment, surgery for obesity or its sequel, cosmetic or beauty treatment and/or surgery.
  • Period of stay at sanatoria, old age homes, places of rest etc.

 

share this:
About Wham 106 Articles
LindaAfya is our platform as warriors to create and raise awareness on health issues both chronic and invisible illnesses that affect us. #YourVoiceMatters #MyHealthMyResposibility

Be the first to comment

Leave a Reply