Britam Milele Health Plan Guide

Britam insurance has designed the Britam Milele Health Plan to offer individuals and families a strong health insurance solution. This plan caters to your healthcare needs throughout your life, ensuring financial security and access to quality medical care.

Britam Milele Health Plan Benefits

  • Lifetime Coverage: Unlike many insurance plans that expire at a certain age, Britam Milele Health plan provides coverage for your entire life, subject to annual renewals.
  • Pre-existing Condition Coverage: Britam Milele Health plan stands out by covering pre-existing, chronic, and congenital conditions up to the full inpatient limit.
  • Extensive Network Access: The Britam Milele Health plan grants you access to a vast network of hospitals, physicians, clinics, and other healthcare providers within the Britam panel. You’ll have a wide range of qualified medical professionals at your disposal.
  • Financial Safeguard during Critical Illness: Britam Milele Health plan offers critical illness cash benefits of up to Ksh 5 million or Ksh 10 million, significantly easing the burden during a critical illness.
  • Tailored Coverage Options: Britam Milele Health plan goes beyond basic inpatient coverage. You can choose to add maternity, outpatient, dental, and optical coverage to personalize the plan according to your specific needs.
  • Funeral Expense Coverage: Britam Milele Health plan offers an additional layer of security for your family by covering funeral expenses in the event of your passing.
  • Focus on Preventive Care: The Britam Milele Health plan includes free advice on healthy lifestyle choices and stress management support, empowering you to take charge of your well-being.
  • Annual Wellness Check-Ups: Free annual wellness check-ups are provided upon renewal to proactively monitor your health.

Britam Milele Health Plan Cover Features

  • Inpatient
  • Outpatient (optional)
  • Maternity (optional)
  • Dental (optional)
  • Optical (optional)
  • Funeral cover
  • Personal accident cover

Britam Milele Health Plan Inpatient Coverage

Britam Milele’s inpatient coverage is designed to address a wide range of medical expenses incurred during a hospital stay. This includes:

  • Doctor’s fees, including surgeons, physicians, and anesthetists
  • Nursing care, medication, and dressings
  • Surgical appliances and internal prosthetics
  • Charges for intensive care units (ICU) and high dependency units (HDU)
  • MRI and CT scans, pathology tests, and other diagnostic tests conducted while admitted
  • Daycare surgery under general anesthesia
  • Home nursing care subject to pre-authorization
  • Lodger fees for a parent or guardian accompanying a child under 10 years old
  • Internal and external surgical implants, appliances, joint replacements, and prostheses (excluding dental fixtures)

The Britam Milele health plan even covers emergency medical evacuation via ambulance and overseas referral treatment to a network of hospitals in India, subject to pre-authorization. Additionally, accidental related dental and optical treatment is included.

Britam Milele Health Plan Outpatient Coverage

An outpatient cover can be added to your Britam Milele health plan to cover various medical expenses outside of hospitalization. Britam Milele health outpatient coverage includes:

  • Consultations with general practitioners and referrals to specialists
  • Diagnostic tests such as X-rays, lab tests, ultrasounds, EEGs, ECGs, CT scans, and MRIs
  • Pre and postnatal hospital expenses, including two ultrasounds
  • Physiotherapy
  • Prescribed medication and dressings
  • Pre-existing, chronic, and recurring conditions, including congenital conditions and cancer
  • HIV/AIDS related conditions and prescribed ARVs
  • KEPI and baby-friendly vaccinations for children up to 18 months old
  • Counseling sessions with a psychiatrist (upon referral)
  • Co pay of Ksh 1,500 for Aga khan Hospital, AAR, The Nairobi Hospital, Gertrude’s Children’s hospital, The Karen Hospital, The Eldoret Hospital, Mediheal Hospital, St Luke Hospital and the satellite branches. Copay of Kshs 500 for all other providers.

Britam Milele Health Plan Sublimits

Inpatient

Maternity (Offered As Stand Alone)
  • The Milele Health Plan offers maternity cover, with limits ranging from Ksh 80,000 to Ksh 300,000.

Outpatient

Dental and Optical Plans (Optional)
  • The Milele Health plan offers outpatient cover with limits ranging from Kshs 50,000 to Kshs 200,000. In addition, you can get dental and optical covers ranging from 10,000 to 40,000.

Britam Milele Health Plan Eligibility

The Britam Milele Health Plan is designed to be accessible to a wide range of individuals. Newborns can be added after birth by filling an application form and attaching the birth notification. Maximum entry age is 75 years with no maximum exit age. Senior citizens i.e. 55 years are eligible subjected to satisfactory medical test for Britam appointed providers at applicant cost. Children can remain covered up to 25 years old if they are enrolled in school.

Britam Milele Health Plan Exclusions

  • Self-referred or self-prescribed treatment
  • Infertility & impotence
  • Intentional self-injury, chronic drunkenness, suicide or attempted suicide, drug and substance abuse
  • Hazardous pursuits (sports and hobbies)
  • Cosmetic and beauty treatment (unless accidental injury)
  • Experimental treatment or treatment subject to medical research
  • Weight management treatment and drugs
  • Diagnostic equipment (glucometers, BP machines, etc.)
  • External surgical appliances (crutches, wheelchairs, prostheses)
  • Dental prosthesis, crowns, dentures, bridges and braces
  • Alternative medicine (acupuncture, chiropractor, herbal medicine) unless GP referred
  • Expenses covered by other insurance or sources (e.g., NHIF)
  • Treatment outside approved service providers’ network
  • Nutritional supplements (unless prescribed for specific conditions)
  • Treatment related to menopause, andropause, aging, puberty, or pre-menstrual tension syndrome
  • Expenses incurred outside Kenya (except for up to 8 weeks)
  • Claims with misstated or withheld information (e.g., pre-existing conditions)
  • Treatment of obesity or slimming preparations
  • Cost of hearing aids
  • Expenses exceeding policy limits or sub-limits
  • Cost of organ donors and related transplant costs
  • Any other exclusions listed in the policy document

Britam Milele Health Plan Payment Option

Payments for Britam Milele health plan can be made through Mpesa Paybill Number 584065 using your full name as the account name.

How to Enroll in Britam Milele Health Plan

Here’s what you can do to get started with the Britam Milele Health plan:

  • Contact a Britam Agent: Britam has a network of qualified agents who can explain the plan details, answer your questions, and guide you through the enrollment process. You can call them via: (02) 2833027 / 0709 165 000.
  • Visit the Britam Website: Britam’s website provides comprehensive information about the Milele Health Plan, including brochures, FAQs, and contact details. You may even be able to initiate the enrollment process online.
  • Call Britam Customer Care: Britam’s customer care representatives are available to answer your questions and assist you with enrollment over the phone. The Britam customer care contacts are: (02) 2833027 / 0709 165 000.

 

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