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Medical cover guide

HeriAfya Standard — limits, benefits and options

HeriAfya Standard is Heritage's core individual and family plan, with inpatient limits from KSh 500,000 and optional outpatient, maternity, dental and optical benefits.

Cover typeIndividual and family
Inpatient limitsKSh 500,000 to KSh 10,000,000
Plans available10
Medical examinationApplicants aged 56 and above

HeriAfya Standard — inpatient limits

Inpatient limitBed entitlementPlan
KSh 500,000General wardHeriAfya Standard · 500,000
KSh 750,000General wardHeriAfya Standard · 750,000
KSh 1,000,000Private room subject to plan scheduleHeriAfya Standard · 1,000,000
KSh 1,500,000Private room subject to plan scheduleHeriAfya Standard · 1,500,000
KSh 2,000,000Private room subject to plan scheduleHeriAfya Standard · 2,000,000
KSh 2,500,000Private room subject to plan scheduleHeriAfya Standard · 2,500,000
KSh 3,000,000Private room subject to plan scheduleHeriAfya Standard · 3,000,000
KSh 5,000,000Private room subject to plan scheduleHeriAfya Standard · 5,000,000
KSh 7,500,000Private room subject to plan scheduleHeriAfya Standard · 7,500,000
KSh 10,000,000Private room subject to plan scheduleHeriAfya Standard · 10,000,000

Premiums depend on the members covered and their ages, so the price for a limit is confirmed in your quotation.

Optional benefits you can add

Depending on the plan you choose, the following can be added to the inpatient cover:

  • Outpatient: KSh 50,000, KSh 75,000, KSh 100,000, KSh 150,000, KSh 200,000, KSh 250,000, KSh 300,000, KSh 350,000
  • Maternity: KSh 50,000, KSh 60,000, KSh 75,000, KSh 80,000, KSh 100,000, KSh 120,000, KSh 150,000, KSh 175,000, KSh 200,000, KSh 250,000, KSh 300,000
  • Dental: KSh 5,000, KSh 7,500, KSh 10,000, KSh 15,000, KSh 20,000, KSh 30,000, KSh 40,000, KSh 50,000
  • Optical: KSh 5,000, KSh 7,500, KSh 10,000, KSh 15,000, KSh 20,000, KSh 30,000, KSh 40,000, KSh 50,000

What the cover includes

  • HeriAfya Junior, Senior, Standard and Corporate medical cover options
  • Published 2026 plan limits and rate schedules

Benefit sub-limits (pre-existing conditions, chronic conditions, maternity, psychiatric care, last expense and so on) are printed on every quotation we issue and are listed in the insurer's brochure.

Waiting periods

  • Waiting periods vary by HeriAfya product schedule

Co-payment, where it applies

  • KSh 1,000 at Aga Khan Nairobi, Kisumu & Mombasa, Nairobi Hospital, Gertrude’s, MP Shah, Mater and Karen Hospital
  • KSh 500 at all other providers

HeriAfya Standard — frequently asked questions

What inpatient limits are available on HeriAfya Standard?
The limits we quote are KSh 500,000 to KSh 10,000,000 per year. Each limit is a separate plan with its own benefits schedule, so the premium and the sub-limits change with the limit you pick.
Can I add outpatient, maternity, dental or optical cover?
Yes. Depending on the plan, optional benefits can be added at the amounts listed above. Outpatient cover is normally required before dental or optical benefits can be selected.
Who can be covered?
This product covers a principal member, and can include a spouse and children on the same policy.
How is the premium paid?
Premiums are paid directly to Heritage using the payment details printed on your quotation. Now Insurance Agency does not receive or handle client payments.
How long does cover take to start?
Cover is typically confirmed within 1 to 5 working days after payment or IPF settlement and receipt of complete documents, subject to the insurer's underwriting and acceptance.

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