Imana Afya Medical Insurance – Apply Now

Woodvale Grove, Krishna Centre, 4th Floor Westlands
insurance@imana.co.ke
0796209402
0113619635

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Get a quote 0113619635

Imana Afya Medical Insurance
Afya Bora, Maisha Bora

ABOUT IMANA AFYA MEDICAL

Imana Afya Medical Insurance is an affordable and flexible health cover designed to provide reliable protection for individuals, families, and groups. It ensures you and your loved ones have access to quality healthcare without financial stress.

Why You Need This Cover.

Affordable premiums tailored to fit your budget

Comprehensive inpatient and outpatient medical cover

Covers Maternity

Covers Last expense

Dental and optical benefits included with outpatient

IMANA AFYA – Annual Benefits & Premiums (KES)

INPATIENT · incl. MATERNITY

Inpatient	Maternity	M	M+1	M+2	M+3	M+4	M+5
500,000	75,000	8,230	12,345	13,826	15,308	16,789	18,271

OPTIONAL OUTPATIENT · incl. DENTAL / OPTICAL

Outpatient	Dental / Optical	M	M+1	M+2	M+3	M+4	M+5
75,000	10,000 Dental 10,000 Optical	12,190	21,940	21,940	21,940	21,940	21,940

M = Principal member only · M+1 = Principal + 1 person · M+2 = Principal + 2 … up to M+5 (Principal + 5).

⚠ Disclaimer: Applicants aged 55 years and above will be considered after assessment and acceptance of their application. Thank you.

Imana Afya Medical Application Form

To be filled in block letters · Fields marked * are required

Personal

Dependants

Plan

Health

Declare

Step 1 of 5

Applicant Details

Title *

Mr Mrs Miss Dr Other

First Name *

Surname *

Date of Birth *

Occupation *

Mobile Number *

Email Address *

ID Number *

KRA PIN *

P.O. Box

Postal Code

Physical Address

City / Town *

Step 2 of 5

Dependants & Next of Kin

Choose who is covered under this policy.

* Attach Birth Certificate for children under 18 years. This cover prices up to M+5 (up to 6 members).

Principal Member Include the principal member on this medical cover Tick if the applicant named in Step 1 will be covered under this policy

Dependants

Maximum of 5 dependants (M+5) reached. For larger families, please contact us for a custom quote.

Next of Kin / Beneficiary

Full Name *

Phone Number *

ID / Passport

Email Address

Step 3 of 5

Plan Details – Imana Afya Medical

Inpatient Cover *

KES 500,000 Inpatient (included)

Maternity cover of KES 75,000 is included with your inpatient benefit.

Optional Outpatient Cover Outpatient – KES 75,000 Includes Dental (KES 10,000) & Optical (KES 10,000) at no extra cost

Family Size: —

No members selected yet

Premium Estimate

Inpatient (incl. Maternity)—

Outpatient (incl. Dental & Optical)—

Gross Premium—

Levies (0.45%)—

Stamp DutyKES 40

Total Premium (KES)—

* Annual premium based on your family size. Final premium confirmed by our team.

Step 4 of 5

Health Declaration

Please answer to the best of your knowledge and belief.

Do you or your dependants have any deformity, impairment or loss of hearing, vision or limbs?

Yes No

Q3a

Ever been admitted into a hospital or had a surgical operation?

Yes No

Q3b

Ever been advised to have a surgical operation which has not been performed?

Yes No

Q4a

Skin, ears, nose, throat, eyes — e.g. sinusitis, cataracts, glaucoma?

Yes No

Q4b

Stomach, intestines, liver, kidneys, bladder — e.g. hernia, diabetes, piles?

Yes No

Q4c

Lungs, bones, joints — e.g. asthma, bronchitis, tuberculosis, arthritis?

Yes No

Q4d

Heart, brain, nervous disorder — e.g. blood pressure, stroke, paralysis?

Yes No

Q4e

Lymphatic system — e.g. goitre, gout, thyroid?

Yes No

Q4f

Cancer, tumour, cyst or growth of any kind?

Yes No

Q4g

Female reproductive system — e.g. fibroids, cysts, fallopian tubes?

Yes No

Q4h

Any other conditions not listed above?

Yes No

In the past 5 years, consulted a physician for any reason not previously noted?

Yes No

Currently taking any medication or treatment regularly?

Yes No

Currently suffering from any symptoms not yet consulted a doctor for?

Yes No

Currently insured under any other medical, hospitalisation, accident or life insurance?

Yes No

Ever had a medical insurance application rejected, cancelled or subject to special terms?

Yes No

Q8 — If Yes, please provide insurer details

If any answer is Yes, provide details (question, diagnosis, dates, physician)

Step 5 of 5

Member's Declaration

I confirm that all the above statements are true and complete to the best of my knowledge and belief. The Company will rely on them for acceptance of this application.

I consent to Imana Insurance seeking health information from any physician or healthcare provider on my behalf.

Important: This policy is only effective after acceptance and full premium payment. Pre-existing conditions are not covered for the first 10 months.

Date of Signing *

I, the above-named principal member, confirm that all statements in this application are true and complete. *

Application Summary

Name—

Date of Birth—

Occupation—

Family Size—

Mobile—

Email—

Inpatient Limit—

Outpatient Limit—

Dependants—

Total Premium—

Insurance that reflects the way you live your life.

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Contact Info.

Woodvale Grove, Krishna Centre, 4th Floor Westlands

+254 796209402
+254 113806810
Insurance@imana.co.ke

Imana Afya Medical Insurance Afya Bora, Maisha Bora

Why You Need This Cover.

Imana Afya Medical Application Form

Applicant Details

Dependants & Next of Kin

Next of Kin / Beneficiary

Plan Details – Imana Afya Medical

Health Declaration

Member's Declaration

Imana Afya Medical Insurance
Afya Bora, Maisha Bora