RUPHA360 Medical Insurance.
Affordable Healthcare Protection That Complements SHA
More healthcare protection. More value for your family. Greater peace of mind.
Access to quality healthcare should not be limited by financial constraints. As Kenya continues implementing healthcare reforms through the Social Health Authority (SHA), individuals, families and healthcare workers need additional options to strengthen their medical and financial protection.
Recognising this need, the Rural & Urban Private Hospitals Association of Kenya (RUPHA), through its RUPHA360 initiative, has partnered with Liaison Group to provide access to RUPHA360 Medical Insurance – an affordable medical insurance solution designed to complement SHA and provide additional healthcare benefits.
The product brings together a range of medical benefits, including inpatient, outpatient, maternity, surgical, dental, optical and last expense cover, offering individuals and families an opportunity to access broader healthcare protection.
Why RUPHA360 Medical Insurance?
While SHA provides an important foundation for healthcare financing, families may still require additional protection for different medical needs and unforeseen healthcare expenses.
RUPHA360 Medical Insurance offers complementary medical cover designed to provide additional financial protection while supporting access to healthcare services through participating RUPHA member facilities.
Whether it is a hospital admission, outpatient consultation, maternity care, dental treatment or an unexpected medical emergency, the product provides a range of benefits to support individuals and their families.
Affordable Family Medical Cover
One of the key attractions of RUPHA360 Medical Insurance is its affordable annual premium structure.
The available packages are designed to accommodate different family arrangements:
Package 1: Nuclear Family
KES 22,200 per year
- Principal member.
- One spouse.
- Up to three children.
- Additional child dependent: KES 3,000 annually.
Package 2: Extended Family
KES 24,700 per year
Includes the nuclear family package, with additional last expense protection extended to parents and parents-in-law, subject to the specified limits.
- Principal member.
- One spouse.
- Up to three children.
- Up to four parents or parents-in-law for last expense cover.
- Additional child dependent: KES 3,000 annually.
Both packages provide access to outpatient, inpatient, optical, dental, maternity and last expense benefits, subject to the applicable policy terms.
What Does the Cover Include?
RUPHA360 Medical Insurance provides a broad range of healthcare benefits to address different medical needs.
| Benefit | Cover limit |
|---|---|
| Inpatient | KES 250,000 per family |
| Outpatient | KES 50,000 per family |
| Surgical package | KES 200,000 per family annually |
| Chronic and pre-existing conditions | KES 100,000 per family annually |
| Maternity | KES 40,000 annually |
| Caesarean section | KES 50,000 annually |
| Psychological and wellbeing | KES 30,000 per family annually |
| Pandemics and related complications | KES 50,000 per family |
| Medical check-up | KES 10,000 per family |
| Dental | KES 10,000 per family |
| Optical | KES 10,000 per family |
Additional benefits include:
- Emergency road evacuation.
- Intensive Care Unit (ICU) cover of up to KES 28,000 per day, commencing after SHA cover.
- Acute admission support of KES 5,000 per day, for a maximum of three days.
- KEPi vaccines.
- HPV vaccination within the outpatient limit.
- Annual cervical cancer screening within the medical check-up limit.
- A maternity gift hamper for every birth.
- Last expense cover of KES 50,000 per eligible family member.
Outpatient, Dental and Optical Benefits
The package also provides access to routine and specialised healthcare services.
Outpatient consultations
The package provides outpatient consultations, medicines, basic laboratory tests and dressings, with the following limits per visit:
- Level 2 and 3 facilities: KES 1,500.
- Level 4 facilities: KES 2,500.
- Level 5 facilities: KES 3,000.
The stated access allowance is two cases per member per month.
Dental care
Covered services include extraction, filling, prescribed scaling and polishing, subject to the applicable limits.
Optical care
The package provides cover for frames and lenses, with frames covered up to KES 2,000 and replacement allowed once after every two years per member.
Specialised services listed in the package include MRI, CT scans, mammography, echocardiograms, electrocardiograms and specialised ultrasound services, among others.
Additional Protection Through Last Expense Cover
Medical emergencies are not the only unexpected events that can place financial pressure on families.
RUPHA360 Medical Insurance also includes last expense benefits to provide additional financial support to eligible family members.
Under the nuclear family arrangement, the principal member, one spouse and up to three children each have a last expense limit of KES 50,000.
The extended family option additionally includes parents and parents-in-law, up to a maximum of four, with a KES 50,000 limit per eligible member.
Key Features and Eligibility
The published package provides for:
- No waiting period.
- No accumulation of outpatient visits.
- Family cover for the principal member, one spouse and eligible children.
- Children below 18 years, with provision for continuation up to 25 years for qualifying full-time students.
- A provider panel restricted to participating RUPHA member facilities.
Applicable entry ages, continuity requirements, exclusions and other policy conditions apply.
Strengthening Healthcare Access Through RUPHA
RUPHA360 Medical Insurance is part of RUPHA’s broader commitment to promoting affordable healthcare financing and strengthening the private healthcare sector.
Through collaboration with Liaison Group, RUPHA seeks to connect individuals, families and healthcare workers to accessible insurance solutions while supporting healthcare service delivery through its member facilities.
For RUPHA member facilities, the initiative also presents an opportunity to support staff welfare by exploring additional medical protection for employees and their families.
How to Enrol
Getting started with RUPHA360 Medical Insurance is straightforward.
Interested individuals, families and healthcare facilities can:
- Visit the RUPHA360 platform.
- Explore the available medical insurance packages and benefits.
- Contact RUPHA for assistance and enrolment guidance.
- Review the applicable policy terms and complete the enrolment process.
Take a Step Towards Better Healthcare Protection
Healthcare needs are unpredictable, but preparing for them should be accessible and affordable.
With annual family premiums starting at KES 22,200, RUPHA360 Medical Insurance provides an opportunity to access additional medical protection that complements SHA.
Whether you are an individual, a parent, a healthcare professional or an employer looking to support your employees, explore how RUPHA360 can help strengthen your healthcare protection.
Explore RUPHA360 today.
Website: https://rupha360.com/
For enquiries and enrolment assistance:
Rural & Urban Private Hospitals Association of Kenya (RUPHA)
Email: info@rupha.co.ke
Phone: 0757 626 748 / 0794 673 821
