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Jubilee Health Insurance – Coverage Details

1. Insurance Overview

Jubilee Health Insurance is one of Kenya’s leading medical cover providers, offering a range of health plans for individuals, families, and corporate groups. Their health cover includes both inpatient and outpatient medical services, wellness support, and chronic care.

2. What Jubilee Covers at This Hospital

Coverage status is based on Jubilee’s standard medical plans. Exact benefits may vary depending on the plan.

3. Coverage Limits

• Hospitalisation and surgical costs are covered up to the limit specified in your chosen plan.

• Outpatient and diagnostic expenses (labs, scans) are subject to plan limits or sub-limits.

• Drug prescriptions are reimbursed or covered up to the plan’s defined drug limit.

• Home nursing coverage is limited to a set number of days per policy period.

• International plans and very high-limit plans have higher coverage ceilings.

4. Pre-Authorization Requirements

• All inpatient hospital admissions generally require pre-authorization from Jubilee.

• Surgeries must often be approved in advance to ensure coverage.

• High-cost diagnostics (like MRI or CT scans) typically need authorization.

• Maternity admissions may require notification or approval ahead of the delivery date.

5. Co-Pay / Co-Insurance

• Depending on the plan, there may be a co-pay or percentage of cost you must pay for outpatient visits and diagnostics.

• Inpatient co-insurance might apply, especially for high-cost services.

• Specific co-pay rates vary by policy — check your schedule of benefits for your plan’s details.

6. Waiting Periods

• Pre-existing conditions usually have a waiting period before full coverage begins.

• Maternity benefits may have a waiting period (commonly 10-12 months depending on the plan).

• Dental or optical coverage (if included) could also involve a waiting period, depending on the plan.

7. How to Use Jubilee Cover at This Hospital

1. Present your insurance card or policy number at hospital registration.

2. Provide identification (e.g., national ID or passport).

3. Pay any required co-pay or deposit upfront (if your plan requires it).

4. Jubilee will verify your coverage with the hospital.

5. After treatment, the hospital bills Jubilee directly (for in-network services) or you submit a claim (depending on plan).

8. Required Documents

• Insurance card / policy number.

• National ID or valid identification document.

• For in-patient admissions: notes or letter of authorization (if required).

• For maternity: declaration or pre-authorization, if required by the plan.

9. Exclusions

Jubilee may not cover:

• Cosmetic, elective, or aesthetic procedures.

• Fertility / infertility treatments (unless explicitly included).

• Some pre-existing conditions may be limited or excluded in early policy years.

• Experimental treatments or unproven therapies.

• High-cost dental, optical or elective surgery may not be fully covered — check plan schedule.

10. Hospital & Insurer Contact Details

• Hospital Admissions / Billing: (Provide the hospital’s contact info)

• Jubilee Customer Care / Claims: +254 ___ (Insert contact) / email: ___@jubileeinsurance.com

• Pre-authorization Contact: Use the number or email provided in your policy schedule.

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11. Disclaimer

This information is based on publicly available details for Jubilee Health Insurance plans. Actual benefits may differ based on the specific policy you hold. Always confirm your coverage, limits, and pre-authorization requirements directly with Jubilee or through your policy schedule before seeking care.