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NPS & KPS Health Cover

This medical plan covers employees of the National Police Service and The Kenya Prisons Service including persons joining The National Police Service and The Kenya Prisons Service as uniform officers or as civilian staff during the contract period..


Detailed requirements include:

  • Principal member
  • Spouse
  • 5 Children

  • FEATURES & BENEFITS

    Outpatient Benefits

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  • Routine outpatient consultations
  • Diagnostic Laboratory investigations and radiology services (X-Ray, Ultrasound, Magnetic resonance imaging (MRI), and Computerized Tomography (CT) Scans)
  • Prescribed physiotherapy and rehabilitation services
  • Prescribed drugs and dressing
  • Prescribed routine laboratory tests
  • Spirometry (Lung Function Test)
  • HIV/AIDS-related conditions and prescribed ARVs.
  • KEPI /baby-friendly Vaccinations
  • Pap smear for ladies and PSA for men for both Principal and Spouse.
  • Antenatal and Post-natal care
  • Newly diagnosed chronic Conditions
  • Pre- existing and Chronic conditions (including Cancer)
  • Preventive care: including free Medical camps, Mobile Clinics for events, counseling on life style and wellness
  • Dental health care services
  • Nursing and midwifery services
  • Maternal child health/family planning
  • Minor surgical procedures
  • Optical care
  • Annual medical check-up
  • Referral for specialized services
  • Day care services such as Manual Vacuum Aspiration (MVA), circumcision, braces, surgery and other medical services deemed fit by the clinician e.g. cases whereby a clinician may use local anaesthesia to numb a particular part of the body which may include minor surgery like incision, drainage and suturing of wounds
  • Patients with pre-existing conditions would be allowed go directly to specialists without referrals subject to pre-authorization
  • Inpatient Benefits

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  • Hospital accommodation charges
  • Nursing care
  • Diagnostic, laboratory or other medically necessary facilities and services
  • Rehabilitation services
  • Operating theatre services
  • The cover include naval, military, air force and other security related operations.
  • Cover include war, invasion and civil war risk. Cover should include riots, strikes and civil commotions
  • Cover include Acts of terrorism
  • Cover include hazardous pursuit which include diving and riding in any kind of race
  • Cover include extreme and professional sports
  • Cover include Prosthetic device needed as part of treatment, which includes external artificial body part, such as a prosthetic limb or prosthetic ear
  • Cover should include transplant services - transplant of cornea, small bowel, kidney, kidney/pancreas, liver, heart, lung or heart/lung, bone marrow transplant bed entitlement (semi private or private): standard ward bed net of standard rebate per day hospital accommodation charges
  • Doctors (Physician, Surgeon & Anesthetist) fee
  • ICU/HDU Intensive Care, Intensive Therapy, Coronary care and High Dependency unit
  • Drugs/ Medicines, dressings and Internal Surgical appliance
  • Imaging, X-ray, Ultrasound, Electrocardiogram (ECG) and Computerized Tomography, MRI Scans
  • Radiotherapy and Chemotherapy
  • Emergency Road and Air Evacuation within East Africa led to admission using rotary and fixed-wing air rescue
  • Overseas and local evacuations where treatment is not locally available
  • Day care Surgery for minor surgical treatment that may not require admission
  • Hospital accommodation for accompanying parent and / or guardian for Hospitalized children
  • Post Hospitalization services
  • Congenital defects/ genetic disorders
  • Pre-existing and chronic conditions (including cancer) to be covered in full annual limit
  • Medical education and wellness program for members with pre-existing and chronic conditions
  • Repatriation of the mortal remains of principal member, dependants, caregiver accompanying the patient, donor of the organ where applicable or all
  • Cost for infertility
  • Renal dialysis
  • Child welfare
  • Occupational therapy
  • Mental illness including intentional self-injury and suicide
  • All Sexually Transmitted Infections (STD)
  • Illnesses resulting from alcohol and subsistence abuse intoxication
  • Laboratory Services/Investigation
  • Specialist consultations or visits
  • Drugs/medicine prescribed by treating clinician
  • Pre-hospitalization procedures such as laboratory, Maternity-related, x-ray or medical diagnostic procedures and tests
  • Normal delivery up to maternity limits
  • Caesarean section
  • Maternity related complications up to in-patients limits
  • Evacuation/rescue from the site of occurrence, the service provider will rescue both the injured and the deceased
  • Respiratory Illness - including but not limited to COVID-19
  • Dental Benefits

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  • Dental cover
  • Dental consultation an anaesthetists fees
  • Orthodontics
  • Dental X-ray
  • Root canal
  • Dental filling
  • Dental extractions including surgical extractions
  • Dentures
  • Hospital and operating theatre cost
  • Scaling
  • Dental Emergency
  • Dental care shall be family benefit
  • Optical Benefits

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  • All related expenses to the eye treatment.
  • Cost of lens and frames including replacements.
  • Replacement of damaged glasses/frames
  • Prescription for ophthalmic treatment and eye lenses
  • Optical cover shall be family benefit.
  • International and Domestic referrals
  • Referral to medical institutions that offer specialised services not available in the country.
  • Where the facility lacks a particular service, the facility shall refer a member or dependants to any other health provider where the service is available.
  • Medical Evacuation

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  • Road evacuation
  • Air evacuation
  • Water evacuation
  • Railway evacuation
  • Maternity and reproductive healthcare

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  • Consultation and treatment for both mother and child
  • Routine antenatal check-up
  • Delivery fees
  • Post-natal care
  • Routine immunization (KEPI) and baby-friendly vaccines
  • Cost of childbirth including caesarean section deliveries.
  • Maternity benefits available to the principal member and their spouse only
  • Congenital conditions
  • Pre-maturity
  • Family planning services
  • REGISTRATION PROCESS

    If you are a member of NPS/KPS, follow the below prompts to register.
    Registration is through NPS Website or by USSD as shown below

    DEPENDENTS REGISTRATION

    FREQUENTLY ASKED QUESTIONS

    Who is eligible for this cover

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  • Principal Member
  • Spouse
  • 5 Children
  • How do I register for the medical scheme?

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    Step 1: Dial *202*05# from your Safaricom line or *204*05# from Airtel LINE and follow the prompts
    Step 2: Click on Registration then select Self-Registration
    Step 3: You will be required to enter your Payroll number and National ID Number which will be verified against the database
  • If successful, you will be asked to enter your DOB, Gender and Workstation County and finally you will be required to confirm registration details the submit the details
  • If not successful, you will need to contact the call center for further assistance
  • Step 4: If successful, you will be prompted to enter your name (surname and other name), role and gender. Once done, you will receive a message confirming your successful registration onto the scheme and a prompt to register dependants.

    How do I register via the web?

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  • Log in to the web portal via https://npskps.com/p_reg
  • For self-registration, enter your mobile number
  • Click on Send OTP, a One Time Pin will be sent to that mobile number to allow you log in access Follow the prompts and complete self-registration
  • For dependents registration, you will be required to enter your Payroll number which will be verified against the database
  • An OTP will be sent to the registered mobile number under that PF Number
  • How do I register my dependent?

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    Step 1: Dial *202*05# from your Safaricom line or *204*05# from Airtel LINE and follow the prompts
    Step 2: Click on Registration and select Dependant Registration
    Step 3: Confirm if dependant is disabled or not
    Step 4: Select the dependant you wish to register, i.e. spouse or child
    Step 5:  
  • Enter Surname (Optional- You can type O to skip this)
  •  
  • Enter First Name
  •  
  • Enter Middle Name
  • Step 6: Provide Child Date of birth (YYYY/MM/DD)
    Step 7: Gender Click Submit when done Once done, you will receive a message confirming your successful registration onto the scheme and a link to upload supporting documents for the dependants. Link to upload dependant documents is https://npskps.com/nps_kps

    How do I access medical cover?

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  • After registration of dependants via the USSD, supporting documents must be provided for verification. Upon verification of dependant's documents, member will be notified via an SMS, if wrong documents are provided, the dependants will be suspended and member will be notified on the same
  • The member or a dependant presents themselves at an accredited service provider on the active panel (the list of active service providers can be accessed by dialing *202*05#)
  • For job group M-T, the member or the dependant identifies themselves with the Virtual card bearing their names and principal members details OR the Principal member No i.e PF number. The service provider keys in the member number (PF Number) on the smart system. The registered member and verified dependants shall be displayed on the system
  • For first time visit, registration of Biometrics will be done once for each registered member at any of the accredited service providers. After fingerprints registration, the service provider initiates the visit on the system for access of medical services. The member can also initiate the visit on the Smart application which is downloadable via Google Playstore.
  • For job group A-K, the member or the dependant identifies themselves with the Principal Member National ID number
  • The service provider will generate an SMS that contains the One-Time-Pin (OTP), sent to the principal member's registered mobile number. For first time visit, registration of Biometrics will be done once for each registered member at any of the accredited service providers. After fingerprints registration, the service provider initiates the process for access of medical services
  • Does the cover have emergency evacuation?

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  • Yes, the cover has both road, air, water and railway evacuation).
  • How many dependents are covered?

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  • 6 Dependants.
  • What is Funeral cover?

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  • The scheme provides a Last Expense benefit of Kes 200,000 for the principal member and Kes 50,000 for one declared dependent.
  • If both the husband and wife are principal members under the cover, each will enjoy the benefit separately.
  • The benefit is payable within 72 working hours from the time of reporting.
  • What happens when my benefits are exhausted?

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  • The benefits under Job Group A-K have unlimited benefits on Inpatient & Outpa-tient but capped limits on Maternity, Dental & Optical, which upon depletion then the member seeks treatment out of pocket for the remaining policy term. For Job Group L- T , all benefits are capped to specified limits in the year.
  • Who should I reach out to for assistance in case of an emergency?

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  • Call CenterL-T - 020 4974666, 0719 044 666, 0730 674 666. Call Center A-K- 0730 730 000
  • Do I require NHIF for accessing healthcare services?

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  • To access care, members need to be compliant with the NHIF, now SHIF, which is a law-regulated scheme.
  • Is there co-pay? (what is co-pay?)

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  • The scheme is not guided to a co-pay model but the negotiated reasonable & customary rates by the administrative parties of the Joint Venture apply.