Liberty Health for Multinationals

Heritage Flexi for Corporates

Our Plans

Heritage Flexi Solutions offers a comprehensive Pan-African health insurance coverage designed to align with your corporate financial objectives. Flexi provides a range of modular plans for in-country employees with extensions to ensure that YOU our partner receives premium healthcare coverage.

We cater for health benefits to suit a range of income brackets, whilst ensuring access to quality health care benefits.

Our Inpatient cover is the only primary benefit for all other benefits while Outpatient is mandatory for Dental and Optical benefits to be insured. We offer unmatched levels of flexibility that allows you to vary your benefit coverage to fit the desired outlook of limit and budget.

Contact our Health Sales and Distribution team through [email protected] to get a quote.

Our Benefits

We have the following core benefits for your considerations.

Inpatient Coverage (hospitalization)

We cover the following medical treatment and services for acute illness or accidental hospitalization. This is a standalone benefit and a must have for all plans.

  • Hospital accommodation
  • In-patient fees for physicians, specialists, surgeons, anaesthetists, physiotherapists and other relevant specialist consultations in hospital
  • Operating theatre charges
  • Apparatus, material, and ward and theatre medicines used in hospital
  • Lodger fees for parents sharing room with their admitted dependant who is 12 years or younger. The treating doctor will need to advise us in writing that the parent should remain with the child. This benefit can be extended to adulthood for beneficiaries with specialized needs (PWD) hence must have a 24-hour guardian.

  • We provide benefits for a higher level of treatment, nursing vigilance and monitoring than is available in a high care unit when it is medically necessary.

We provide benefits for the cost of treatment for long-term conditions that incurred prior to enrolling on cover which may include old injuries, incurable conditions that need management, HIV/AIDS cancer care, organ transplants and renal (kidney) dialysis up to the specified sublimit and subject to clinical/treatment protocols.

Home Nursing Care on doctor recommendation is covered up to 30 days per annum subject to the applicable annual limit and pre-authorization.

COVID-19 hospitalization is also covered under this sublimit.

We cover for first-ever emergency caesarean section and maternity related complications are covered as a sublimit of the main Inpatient limit. These two are mutually exclusive benefits.

  • Confinement, the period of pregnancy when a woman is confined to a hospital bed (to reduce the risk of premature delivery).
  • A first ever non-elective caesarean section.
  • Maternity related complications (pre and post-delivery)
    • A separate pre-authorization is provided outside of the maternity benefit. This benefit does not cater for delivery charges.
    • This benefit cannot be used as a substitute for maternity if the maternity benefit is exhausted.

All congenital conditions are covered as a sublimit of the main Inpatient limit. The prematurity coverage applies under below conditions:

  • Child has not been discharged.
  • If discharged, not more than three (3) days after discharge.

We cover the cost of in-patient psychiatric treatment received at a psychiatric unit of a hospital. All treatment must be administered under the supervision of a registered psychiatrist. This is a preauthorized sublimit heavily monitored to ensure Data Protection compliance.

Rehabilitation on alcohol and drug addiction (employee only) is also considered at a lower defined limit within inpatient.

We cover for specialized dental and optical inpatient treatment. These must be considered when under full body anaesthesia hence must be pre-authorized and within the allocated sublimit.

Accidental dental and optical treatment is covered to the full inpatient limit.

We provide benefits for specialised radiology required in or out of hospital, such as CT and MRI scans.

We provide benefits for wheelchairs, corsets/walking frames, hearing aids, crutches & all assistive devices for PWDs.

We cover the cost of artificial limbs, and internal (surgically implanted) prostheses, such as:

  • Orthopaedic prostheses, including hip replacements, bone lengthening devices, spinal plates and screws.
  • End-vascular devices and devices for the central nervous system, cardiac system and ophthalmic system.

We provide benefits for transportation in the case of an emergency medical condition.

We pay for the transportation costs in-country where the emergency medical condition occurs to the nearest, appropriate medical facility within the member’s area of cover.

Overseas Evacuation is covered subject to:

  • Availability of applicable sublimit.
  • The condition has no local provider offering a sufficient solution.
  • Treatment abroad is more affordable than local facilities.
  • The purpose of evacuation will be to avoid death or serious impairment of the insured person’s immediate or long-term health.

This is an optional inpatient benefit designed to cater for hospitalization costs that exceed the primary inpatient limit up to a specified limit within the policy.

  • Excess of loss cover is subject to running concurrently with the primary cover.
  • Benefits under excess of loss are limited to admissions as a result of acute ailments and accidents only.
  • The cover excludes pre-existing chronic conditions, HIV/AIDS, congenital conditions, maternity related expenses, expenses recoverable from other insurers, psychiatric ailments, genetic defects, non-accidental dental and optical claims, and prematurity conditions.

Outpatient Coverage (day-to-day medical treatment)

Our out-patient health benefits cover day-to-day medical treatment that does not require hospitalisation. We provide benefits for the following treatment and services:

  • GP and specialist consultations
  • Prescribed laboratory tests/investigations
  • Prescribed drugs/medicines for acute and chronic case management
  • Outpatient procedures e.g. dressing & minor surgical services
  • Approved X-rays, Ultrasound and CT scans
  • Pre-existing conditions, chronic HIV/AIDS and cancer-related conditions
  • Congenital conditions
  • KEPI vaccinations and baby-friendly vaccines for children 5 years and below
  • Ambulance services
  • Treatment of gynaecological illnesses
  • Annual health check-ups (staff & spouses only)
  • Travel & private vaccines
  • Antenatal and postnatal care

These include:

  • Physiotherapy services
  • Occupational therapies including delayed milestones and speech therapies
  • Psychiatric treatment and psychiatric counselling services
  • Chiropractor services
  • Family planning and contraception

Maternity Coverage

This can be purchased as a standalone or sub-limit benefit under inpatient. We cover the following:

  • Cost of normal deliveries
  • Elective and subsequent caesarean section deliveries
  • Labor and recovery wards
  • Professional fees
  • Obstetric ultrasounds during theatre.
  • Midwives

Dental Coverage

Cost of dental consultation resulting in treatment expenses, inclusive of anaesthetists’ fees including theatre costs.

  • Dental x-rays
  • Dental fillings
  • Dental root canals
  • Dental extractions
  • Illness-related dental surgery and procedures

  • Dentures, inlay, bridges, orthodontics, and orthodontic treatment
  • Dental implants
  • Cosmetic dental treatment
  • Self-prescribed scaling
  • Repair or replacement of old dentures, bridges & plates

Optical Coverage

  • Cost of frames and lenses on prescription by an Ophthalmologist
  • Change of lenses covered on change of prescription, subject to pre-authorization and benefit availability
  • Frames are accessed once every 2 years with a 50% cap of the optical limit.

  • Coloured or disposable contact lenses
  • Plano lenses
  • Replacement or repair of lost, broken, or damaged spectacles
...

Useful Links

  1. How to contact us for pre-authorisation

    In the case of an emergency hospital admission, the Heritage Insurance approved healthcare provider should contact us for pre-authorisation, within 12 working hours of the event, to ensure that your claims are paid.

    Information we need:

    • Patient’s full name, membership/policy number and date of birth
    • Treating healthcare provider details: full name
    • Hospital details: full name of hospital
    • Reason for admission or emergency visit (medical and/or surgical condition)
    • Date of admission and proposed date of the procedure
    • Additional supporting documents where required
    • When a procedure is done out of hospital, for example, MRI (out-patient radiology), you need to supply the healthcare provider’s name

    Requirements:

    • Medical Report
    • A duly completed pre-authorization form by the doctor.
    • Any other relevant information e.g. Radiology results , evaluation results etc
    Notification for scheduled admissions:

    Members are required to notify us for any planned admission within 48 hours for review and advise.

    We will provide feedback to the Heritage approved provider within 12 hours upon receipt of full documentation.

  2. Continuous Care Program (CCP)

    The Continuous Care Program is designed to provide continuous and collaborative support for clients living with chronic health conditions. The goal is to improve health outcomes and enhance quality of life through personalized care and consistent engagement. The program supports the management of a wide range of conditions, including but not limited to Hypertension, Asthma, Cancer, Diabetes, Mental health illness, HIV/AIDS etc.

    Through strategic partnerships with various healthcare providers, we offer convenient, affordable, and tailored care to meet our clients' unique needs and promote overall well-being.

    • All-in-One Care: Unlimited consultations including Telemedicine and referrals to specialists
    • Affordable Pricing: Comprehensive services at a reduced cost to optimally manage your medical cover benefits.
    • Holistic Wellness: Ongoing support from doctors, nurses, counsellors, psychologists etc
    • Drug Deliveries at your convenience at no extra delivery cost
    • Nutrition reviews: Personalized meal and diet plans
    • Lab sample collections: At the convenience of your home/office
    • Home Based Care Services

    Your Privacy is Our Priority: Your personal and medical information will be treated with the utmost confidentiality and will be used solely for the purposes of your tailormade wellness program. By signing this form, you authorize the collection and use of your personal health information in accordance with our data privacy regulations.

    Register now for Continuous Care Program (CCP)

    Please contact your in-country office to pre-authorise any changes to your chronic treatment or medication. This will help us to ensure that claims are paid from your available benefits.

    Chronic conditions covered by the chronic medicine benefit:

    • Acne
    • Addison’s disease
    • Allergic rhinitis
    • Alzheimer’s disease
    • Anaemia
    • Ankylosing spondylitis
    • Anorexia nervosa
    • Arrythmias and conduction disorders
    • Asthma
    • Attention deficit hyperactivity disorder (ADHD)
    • Barrett’s oesophagitis
    • Benign prostatic hypertrophy
    • Bipolar mood disorder
    • Bronchiectasis
    • Bulimia nervosa
    • Cardiac failure
    • Cardiomyopathy
    • Chronic obstructive pulmonary disorder (COPD)
    • Chronic renal disease
    • Conn’s syndrome
    • Cor pulmonale
    • Coronary artery disease/Ischemic heart disease
    • Crohn’s disease
    • Cushing’s disease
    • Cystic fibrosis
    • Deep vein thrombosis
    • Depression
    • Dermatitis/eczema
    • Dermatomyositis
    • Diabetes insipidus
    • Diabetes mellitus type 1
    • Diabetes mellitus type 2
    • Diverticular disease
    • Dysrhythmias
    • Dystonia
    • Endometriosis
    • Epilepsy
    • Gastro-oesophageal reflux disorder (GORD)
    • Generalised anxiety disorder (GAD)
    • Glaucoma
    • Gout
    • Haemophilia
    • Hepatitis B
    • Hepatitis C
    • HIV/AIDS
    • Hyperlipidaemia
    • Hyperparathyroidism
    • Hypertension
    • Hyperthyroidism
    • Hypoparathyroidism
    • Hypopituitarism
    • Hypothyroidism
    • Malabsorption syndrome
    • Male hypogonadism
    • Meniere’s disease
    • Menopausal and perimenopausal disorders
    • Menorrhagia
    • Motor neuron disease
    • Multiple sclerosis
    • Muscular dystrophy
    • Myasthenia gravis
    • Neuropathy
    • Obsessive compulsive disorder (OCD)
    • Osteoarthritis
    • Osteoporosis
    • Paget’s disease
    • Paralytic syndromes and associated complications
    • Parkinson’s disease
    • Pemphigus
    • Polyarteritis nodosa
    • Polycystic ovarian syndrome
    • Polymyalgia rheumatica
    • Post-traumatic stress disorders
    • Primary/idiopathic thrombocytopaenic purpura
    • Psoriasis
    • Psoriatic arthritis
    • Pulmonary interstitial fibrosis
    • Rheumatoid arthritis
    • Rosacae
    • Sarcoidosis
    • Schizophrenia
    • Scleroderma and systemic sclerosis
    • Sicca syndrome
    • Stroke
    • Systemic lupus erythromatosus
    • Thrombosis and embolism
    • Tourette’s syndrome
    • Transient ischaemic attacks
    • Trigeminal neuralgia
    • Tuberculosis
    • Ulcerative colitis
    • Urinary incontinence
    • Urinary tract infection (chronic)
    • Valvular heart disease
    • Zollinger-ellison syndrome

  3. How to Submit a reimbursement claim.

    Please ensure that your original hard copy claim documents are submitted through [email protected] by your relevant medical scheme administrator or intermediary(human resource manager (employer), insurance agent or insurance broker).

    Below find the reimbursement check list:

    Outpatient Claims
    1. A duly completed claim form including laboratory and prescriptions requests.
    2. An itemised invoice
    3. E-tims receipts including proof of M-Pesa ETR payments etc
    4. A duly completed accounts details form
    Inpatient Claims
    1. A duly completed pre-authorization form by the doctor
    2. An itemised invoice
    3. A medical report
    4. Discharge summary
    5. E-tims receipts including proof of M-Pesa ETR payments etc
    6. A duly completed accounts details form

    Kindly note upon receipt of claim full documentation , Heritage Insurance shall review and process the reimbursement within 10 business days as per the policy terms and conditions.

    We have made the claims process as simple as possible for you and your treating provider. The list below provides all the details required when submitting a claim to us either by you or your treating provider.

    Information that must be on the claim:
    • Membership/policy number
    • Patient’s name and surname
    • Patient’s date of birth
    • Principal member’s name and surname
    • Employer/scheme name
    • Diagnosis
    • Date of service (include admission & discharge dates for hospitalisation)
    • A detailed description, per item, of the treatment or service received/provided
    • Quantity (i.e. 30 Disprin, 3 days in General Ward)
    • Tariff code (if available)
    • Amount charged per service or treatment
    • Name of the treating healthcare professional
    • Facility name
    • Total charged
    • Proof of payment (receipt or EFT proof)
    • Signature of the insured person or principal member if a minor
    • Signature of the provider
    • Invoice (for credit claims)
    • Provider stamp
    • Insured’s cell phone number
    What to remember

    Please ensure that the original, hard copy claims are clear, detailed and easy to read as this will speed up the time it takes to process the claims.

  4. Contact Us

    Operations Medical Contact center

    Email: [email protected]

    WhatsApp: 0768 661 492

    Phone: 0711 076 333

Get a quote

Relevant Documents and Forms

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