CIC AfyaBora Family Medical Cover

Hospital cover for the whole family, from KES 6,804 a year.

Afya Bora covers you, your spouse and your children for admission, surgery, maternity and everyday clinic visits. Pick one of six plan options and pay only KES 100 per outpatient visit at any panel hospital.

Price my family's cover Find a panel hospital
KES 1MHighest inpatient limit
KES 100Outpatient co-pay
47Counties on the panel
Up to 80Joining age
AfyaBoraFamily Plan · Option 3
M + 3  ·  500K / 60K
Inpatient per familyKES 500,000
Co-payKES 100

Six plan options

Choose how much cover your family needs

Each option sets the yearly limit for the whole family. Inpatient cover is the core; outpatient is an add-on that also unlocks dental and optical. Tap an option to price it below.

Premium calculator

See your yearly premium

Rates come from the CIC AfyaBora rate card and depend on the principal member's age, the number of dependants and the option you choose.

Principal member's age
Use age next birthday. Members joining at 50 and above need a medical examination report at their own cost.
Dependants (spouse and children)
3 M+3: you and 3 dependants
Type of cover

Benefit schedule

What every option pays, in KES per family per year

Sub-limits sit inside the overall inpatient or outpatient limit. The option you picked above is highlighted.

KES 100

is all you pay at the counter for each outpatient visit at a panel provider. The rest of a covered visit is billed straight to CIC.

Waiting periods

When each benefit starts after you join

Day 1Accident-related admissions. No waiting period.
30 daysAcute illness, outpatient visits, dental and optical.
9 monthsPre-existing and chronic conditions, specialised surgeries, hernia repair.
10 monthsMaternity, including pre-natal and post-natal care.

Included at no extra cost

Support beyond the hospital bill

Chronic disease programme

Ongoing care for chronic conditions, with drugs delivered to your home or office through CIC Pharmacy and Dawa Mlangoni.

CIC Mom's Club

Expectant mothers get physical, mental and social support through pregnancy and the post-natal months, plus training on child nutrition and first aid.

Mental wellness

Tele-health consultations, mental health talks and toll-free counselling.

Health talks and camps

Wellness check-ups and talks for your group, aimed at catching conditions early.

24-hour help line

A 24/7 call centre and a dedicated relationship manager for your scheme.

Overseas referral

Treatment in India when it is not available locally, after a second opinion from a CIC-appointed specialist.

Provider panel

Find an Afya Bora hospital near you

Treatment is only covered at panel providers. Search by county, town or hospital name.

Terms and exclusions

Read this before you join

Who can be covered
  • Principal member and spouse up to 80 years (age next birthday).
  • Children from birth (full term, 37 weeks, and discharged from hospital) to 18 years; up to 25 years if in full-time education.
  • Children over 18 not in school join as principal members.
  • Members aged 60 and above can cover one dependant (M+1).
  • Medical examination report required for joiners aged 50 and above, at the member's cost.
How cover works
  • Cover applies in Kenya, at designated panel providers only.
  • No reimbursement claims, except emergencies while travelling outside Kenya.
  • KES 100 co-pay per outpatient visit.
  • Dental and optical only apply when outpatient cover is bought. Frames up to KES 1,500, replaced once every 2 years.
  • Hospital accommodation is a general ward bed, net of SHIF rebate.
  • Premiums are paid upfront before cover starts (Insurance Act No. 11 of 2019).
Main exclusions
  • Cosmetic surgery, unless caused by an accident.
  • Weight management, family planning and infertility treatment.
  • Hazardous sports, active participation in war, riot or civil commotion.
  • Self-referred or self-prescribed treatment; alternative medicine.
  • Specialist fees without a GP referral (except gynaecologists and paediatricians).
  • Bills from providers outside the CIC panel; costs covered by SHIF, GPA or WIBA.
  • Pandemics and epidemics declared by WHO or the Ministry of Health.
Dental and optical exclusions
  • Dental: crowns, braces, dentures, bridges, plates, bleaching, polishing and scaling, unless caused by accidental injury.
  • Optical: plano prescriptions, photochromic lenses, anti-glare coatings, ±0.25 prescriptions, frames above KES 1,500.
  • Laser eyesight correction; diagnostic equipment such as glucometers and BP machines.

This is a summary. The CIC policy document lists the full terms and exclusions.

How to join

Enrol your family or your whole group

  1. Get your quoteUse the calculator above or call us for a group quotation for your SACCO, chama or welfare.
  2. Fill in the proposal form onlineOne form per principal member, listing all dependants, their medical history and your next of kin.
  3. Pay the premiumCover starts once the premium is received, as the Insurance Act requires.
  4. Get treatedWalk into any panel hospital with your ID and pay KES 100 per outpatient visit.
Call or WhatsApp AfyaSure+254 722 460 390
Websiteafyasure.org
OfficeP.O. Box 7132–00100, Nairobi
CIC 24-hour call centre+254 020 282 3000
Chat on WhatsApp Start your application

Proposal form

Apply for AfyaBora Family Medical Cover

This is the CIC AfyaBora Family Member Proposal Form. It takes about 10 minutes. Have ID numbers and dates of birth for everyone you are covering. Cover starts only after CIC accepts your application in writing and the full annual premium is paid.

A. Cover arrangement

Who is this cover for?

Family size

Include your spouse?
You are applying for
M+0You only

The form will only ask for the people you choose here.

Benefits