Medical Insurance Juniors | Le'Risque Africa

Subject *

Email *

Name *

What is the number of children you want to cover? *

Do you have NHIF? *

Yes and up to date

Yes but not up to date

No

Have they had personal medical cover before? *

Yes

No

Let us know which one and overall experience:

What benefits are you looking into getting? *

Inpatient Only

Inpatient and Outpatient

Extra benefits your child will need: (you can only add dental and optical if you have outpatient cover) *

Optical

Dental

Other

Insurance premium budget range per child (0 - 18): Premium will determine the medical cover benefits (sum assured) *

12,000 - 32,000

32,001 - 50,000

50,001+

Other

Which hospitals do your kids frequent? *

If you have a personal/family doctor which medical covers does he/she take? *

Do your kid(s) have any congenital conditions? Congenital: A condition they were born with *

Other

Comments and/or questions that can help us better prepare for our meeting *

Other

Medical Insurance Questionnaire 2024 | Juniors (0 -18 years)