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KIDO MEMBERSHIP ENROLLMENT

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  • Kido Membership Enrollment

Option A. Benefits Per Person (Waiting periods applicable)

Benefit Cover Type PLATINUM GOLD SILVER BRONZE COPPER MARBLE
Inpatient Per person 300,000,000 100,000,000 50,000,000 20,000,000 10,000,000 5,000,000
Maternity Per family 5,000,000 3,500,000 2,500,000 2,000,000 1,000,000 800,000
Last Expense Per person 3,000,000 2,500,000 2,000,000 1,000,000 1,000,000 500,000
Outpatient Per person 6,000,000 4,000,000 3,000,000 2,000,000 1,000,000 800,000
Optical Per person 800,000 500,000 400,000 200,000 150,000 100,000
Dental Per person 800,000 500,000 400,000 200,000 150,000 100,000

Applicable Premiums
Age Band Premium per life Premium per life Premium per life Premium per life Premium per life Premium per life
0-17 years 1,630,000 1,250,000 1,010,000 836,000 746,000 690,000
18-49 years 2,390,000 1,790,000 1,420,000 1,136,000 1,037,000 974,000
50-70 years 2,840,000 2,140,000 1,806,000 1,710,000 1,635,000 1,528,000

KIDO Subscription fee of UGX 50,000 per life MUST first be paid for you to join the cover.

Option B. Benefits Per Family(Waiting periods applicable)

Prudential HCP Network Enhanced list Standard List
Benefit Cover Type PLATINUM GOLD SILVER BRONZE COPPER MARBLE
Inpatient Per family 300,000,000 100,000,000 50,000,000 20,000,000 10,000,000 5,000,000
Maternity Per family 5,000,000 3,500,000 2,500,000 2,000,000 1,000,000 800,000
Last Expense Per family 3,000,000 2,500,000 2,000,000 1,000,000 1,000,000 500,000
Outpatient Per family 6,000,000 4,000,000 3,000,000 2,000,000 1,000,000 800,000
Optical Per family 800,000 500,000 400,000 200,000 150,000 100,000
Dental Per family 800,000 500,000 400,000 200,000 150,000 100,000

Applicable Premiums
Age Band Premium per family Premium per family Premium per family Premium per family Premium per family Premium per family
M 1,630,000 1,250,000 1,010,000 836,000 746,000 690,000
M+1 2,710,000 2,080,000 1,680,000 1,389,000 1,239,000 1,150,000
M+2 3,430,000 2,630,000 2,130,000 1,757,000 1,572,000 1,461,000
Additional Dependent 720,000 550,000 450,000 369,000 333,000 311,000

KIDO Subscription fee of UGX 50,000 per life MUST first be paid for you to join cover.

Option C. Benefits Per Person(Waiting periods waived on Outpatient Pre-existing and Chronic Benefit, and limited to 3 months on Inpatient Pre-exisiting, Chronic benefit)

Benefit Cover Table
Prudential HCP Network Enhanced list Standard List
Benefit Cover Type PLATINUM GOLD SILVER BRONZE COPPER MARBLE
Inpatient Per person 300,000,000 100,000,000 50,000,000 20,000,000 10,000,000 5,000,000
Maternity Per family 5,000,000 3,500,000 2,500,000 2,000,000 1,000,000 800,000
Last Expense Per person 3,000,000 2,500,000 2,000,000 1,000,000 1,000,000 500,000
Outpatient Per person 6,000,000 4,000,000 3,000,000 2,000,000 1,000,000 800,000
Optical Per person 800,000 500,000 400,000 200,000 150,000 100,000
Dental Per person 800,000 500,000 400,000 200,000 150,000 100,000

Applicable Premiums
Age Band Premium per life Premium per life Premium per life Premium per life Premium per life Premium per life
0-17 years 3,180,000 2,438,000 1,970,000 1,326,000 1,092,000 995,000
18-49 years 4,660,500 3,491,000 2,769,000 1,911,000 1,463,000 1,268,000
50-70 years 5,538,000 4,173,000 3,335,000 2,243,000 1,775,000 1,580,000

KIDO Subscription fee of UGX 50,000 per life MUST first be paid for you to join cover.

Option D. Benefits Per Family(Waiting periods waived on Outpatient Pre-existing and Chronic Benefit, and limited to 3 months on Inpatient Pre-exisiting, Chronic benefit)

Prudential HCP Network Enhanced list Standard List
Benefit Cover Type PLATINUM GOLD SILVER BRONZE COPPER MARBLE
Inpatient Per family 300,000,000 100,000,000 50,000,000 20,000,000 10,000,000 5,000,000
Maternity Per family 5,000,000 3,500,000 2,500,000 2,000,000 1,000,000 800,000
Last Expense Per family 3,000,000 2,500,000 2,000,000 1,000,000 1,000,000 500,000
Outpatient Per family 6,000,000 4,000,000 3,000,000 2,000,000 1,000,000 800,000
Optical Per family 800,000 500,000 400,000 200,000 150,000 100,000
Dental Per family 800,000 500,000 400,000 200,000 150,000 100,000
Age Band Premium per family Premium per family Premium per family Premium per family Premium per family Premium per family
M 3,179,000 2,438,000 1,970,000 1,326,000 1,092,000 995,000
M+1 5,285,000 4,056,000 3,276,000 2,204,000 1,814,000 1,658,000
M+2 6,689,000 5,129,000 4,154,000 2,789,000 2,301,000 2,106,000
Additional Dependent 1,404,000 1,073,000 878,000 585,000 488,000 449,000

Option E: Inpatient Cover only(Waiting periods waived on Outpatient Pre-existing and Chronic Benefit, and limited to 3 months on Inpatient Pre-exisiting, Chronic benefit)

Prudential HCP Network Standard list
Inpatient Medical Benefits Cover Limit
Inpatient Cover 2,500,000
Organ Transplant 1,500,000
Covid-19 Admissions 500,000
Pre-existing & Chronic Inpatient 500,000
Congenital 500,000
Gynaecological Surgery 500,000
Psychiatry & Psychological 500,000
Internal Surgical Appliances 500,000
Premium Per Family Size (0-70) Cover Limit
M 195,000
M+1 371,000
M+2 527,000
M+3 663,000
M+4 800,000
KIDO Subscription Fee per life 50,000

Option F: Senior Citizens Cover(No Waiting Periods)

Prudential HCP Network Standard list
Benefit Cover Type Senior Citizen
Inpatient per Person UGX 10,000,000
Last Expense per Person UGX 1,000,000
Outpatient per Person UGX 3,000,000
Optical per Person UGX 200,000
Dental per Person UGX 200,000
Age Band Premium per life
71-85 years 3,000,000

KIDO subscription fee per life.

Kido Membership form

APPLICATION TYPE (Check/tick appropriate box)

PRINCIPAL MEMBER'S DETAILS (Person who shall pay the insurance premium )

Contact Details

Residential Details

Current Residence

PARTICULARS OF FAMILY MEMBERS JOINING (This is applicable where a family scheme has been taken up )

NEXT OF KIN DETAILS

DETAILS OF PREVIOUS MEDICAL COVER

PREFERED PACKAGE

  • If No, choose one of options A or B (i.e for packages that have waiting periods)
  •  If Yes, choose one of options C to E (i.e for packages without/ with waived waiting periods)
  •  Applicants aged 71 to 85 years can only choose Option F

Please tick below the option you have chosen (TICK only one)

HEALTH QUESTIONNAIRE

Have you or any of your dependents ever had (been diagnosed and/or treated for) any of the following medical conditions? Kindly tick/circle YES (Y) or No (N) to all the questions below. Answers are required for each applicant. (Ask a doctor for assistance if needed). Note: If the answer is YES to any of the questions which follow, you will be required to provide details of the medical condition. Prudential may request you to provide a medical report, without which your application may be delayed.

MEDICAL CONDITION

1- Cancer, growths, or tumors whether benign or malignant

MEDICAL CONDITION

2 - Cardiovascular (heart and blood vessels) disorders including High Blood Pressure, heart Deep venous thrombosis, congenital heart disease, chest pain, coronary artery disease/ ischemic heart disease, valvular heart disease, and any other.

MEDICAL CONDITION

3 - Respiratory and Ear Nose and Throat (ENT) disorders including asthma, tuberculosis, hearing& speech impairment, adenoids, and any other.

MEDICAL CONDITION

4 - Endocrine disorders including high cholesterol, diabetes, thyroid abnormalities, obesity, hormonal imbalances, diabetic coma, and any other.

MEDICAL CONDITION

5 - Eye related disorders including glaucoma, blindness, cataracts, retinitis pigmentosa, lens implants, laser surgery, retinoblastoma and any other.

MEDICAL CONDITION

6 - Gastrointestinal disorders including peptic ulcer disease, pancreatitis, Liver disease hernias and any other.

MEDICAL CONDITION

7 - Gynecological & obstetric disorders including caesarian section, fibroids, ovarian cysts, infertility, pelvic inflammatory disease and any other.

MEDICAL CONDITION

8 - If pregnant indicate expected date of delivery.

MEDICAL CONDITION

9 - Genitourinary disorders including enlarged prostate, kidney failure, dialysis, kidney stones, bladder disorders or any STDs and any other.

MEDICAL CONDITION

10 - Musculoskeletal disorders including arthritis, gout, back problems, physical disabilities, joint problems and any other.

MEDICAL CONDITION

11 - Neurological & psychological disorders including epilepsy, mental disabilities, paralysis, schizophrenia, depression, bipolar disorder, Addiction and any other.

MEDICAL CONDITION

12 - Blood & connective tissue disorders including leukemia, HIV/AIDS, systemic lupus erythematous (SLE) and any other.

MEDICAL CONDITION

13 - Congenital/inherited/hereditary disorders including birth defects, sickle cell disease, hernia and any other.

MEDICAL CONDITION

14 - Skin disorders including eczema, keloids, warts, acne, moles, melanoma, skin cancer, hypertrophic scars, burns and any other.

MEDICAL CONDITION

15 - Has any close blood relative (excluding dependents) ever been diagnosed with heart disease, high cholesterol, diabetes or any other hereditary disease.

If answered YES to any of the questions above, please supply full details below:

INSURANCE PREMIUM PAYMENT DETAILS

Please attach the following documents

Attach a photocopy of valid Identification Card (National ID or Passport or Birth certificate or Driving permit) or copies of birth certificates for biological children 4 months-17 year and Discharge report for 0-3 months.
Attach a current medical report for any condition declared in the health questionnaire.

DECLARATION

Prudential Assurance Uganda Limited (PAUL) reserves the right to terminate your membership if the above information given is proved to be false. No premium will be refunded in this regard.

I hereby declare that to the best of my knowledge and belief the information given in the application is true and complete. I agree that the exclusions and restrictions of the Scheme will be binding on me and all eligible dependants included in the membership.

POLICY EXCLUSIONS (PE)

Under this agreement, the Provider shall not provide any health care services to an insured whose ailment is directly or indirectly attributed to the following:
PE1: Abuse of alcohol, drug, any other intoxicating substance, or any addictive condition of any kind and any medical condition arising directly or indirectly from any such abuse or addiction not limited to Admissions for rehabilitation.
PE2: Any type of infertility treatment, contraception, sterilization or fertilization, treatment for sexual problems (including impotence, whatever the cause), sex changes, assisted reproduction (E.g., IVF treatment) and any pregnancy, including surrogacy, resulting from such treatment.
PE3: Experimental or unproven treatment unless the Company has given specific pre-authorization.
PE4: Cryopreservation, implantation, or re-implantation of living cells or living tissue, whether autologous or provided by a donor.
PE5: Injury or Illness caused by, contributed to, or resulting from self-infliction, or willful exposure to danger.
PE6: Medical conditions sustained by military, naval or air force personnel resulting from participation in any military, naval or air force operation or exercise, participation in war, riots, strikes, lockouts, civil commotion, rebellion, revolution, insurrection, terrorism, military or usurped power or any illegal/criminal act, including resulting Imprisonment.
PE7: The release of weapon(s) of mass destruction (nuclear, biological, or chemical) whether such involves an explosive sequence(s) or not.
PE8: Contamination from chemical, biological, and nuclear materials, including waste products from the combustion of nuclear fuel.
PE9: Treatment by chiropractors, acupuncturists, and herbalists, stays and/or maintenance or treatment received in nature cure clinics or similar establishments, or private beds registered within a nursing home, sanatoria, convalescent and/or rest homes or ‘cures ’ attached to such establishments.
PE10: Medical Conditions due to the participation in professional and hazardous sports including but not limited to scuba diving, sky diving, parachuting, paragliding, mountaineering and martial arts, or use of weapons or firearms.
PE11: Learning difficulties and/or disorders, developmental disorders, and speech/or voice problems.
PE12: Cosmetic, reconstructive, or remedial disorders, whether or not for psychological reasons, and/or any complications arising thereafter including and not limited to removal of fat from any part of the body, keloid, scars and birthmark removal, breast reduction or breast enlargement, ear or body piercing and tattooing, and any treatment required following these.
PE13: Routine medical examinations and regular check-ups, unless explicitly included as part of the scheme agreed by the member’s
employer.
PE14: Circumcision unless medically necessary for the treatment of disease/injury not excluded in the Policy.
PE15: *Vaccinations.
PE16: Sex hormone replacement therapy, use of steroids, organic preparations and their derivatives except in management of non- hormonal conditions e.g. Cancers and related conditions.
PE17: Treatment in any quarantine/isolation or rest home, spa, hydro-clinic, health resort, massage centre and chiropractic treatment,
sanatorium or long-term care facility that is not a hospital.
PE18: Abortion due to voluntary, psychological, or social reasons, and its consequences. PE19: Sunglasses and Plano lenses.
PE20: Natural or non-medical degenerative defects but not limited to sight, hearing and bone.
PE21: Preventative dental examinations, prophylaxis treatment, dentures, false teeth, dental implants and/or orthodontic treatment.
PE22: Obesity, special diet, or weight control, compulsive or addictive eating disorders and/or homesickness.
PE23: Children’s food, baby supplies, vitamin, mineral or organic supplements, de-wormers, products that can be purchased without a
doctor’s prescription such as, but not limited to, mouthwash, toothpaste, antiseptic lozenges or sprays, shampoo, sunscreen, etc.
PE24: *Supplying, maintaining, or fitting any external prostheses or appliances, rental or purchase of crutches, wheelchairs, or oth er equipment, medical or otherwise. The Company will pay for spinal support, knee brace, collar brace, etc. if it is part of a surgical operation and/or integral to the treatment of a covered medical condition.
PE25: Charges or fees incurred for the completion of medical claim forms and any provider registration fees and medical repor t charges unless requested by the Company.
PE26: *Any treatment relating to a condition that the insured person was aware of (ought to have known) at the commencement date, which was not disclosed to us, and accepted by us.
PE27: Medication, drugs, and dressings which are not recognized by the National Drug Authority of Uganda or are available without
prescription from a medical practitioner, specialist/consultant, registered nurse, or therapist. PE28: Treatment as a result of proven medical negligence or malpractice.
PE29: Medical certificates and examinations for residence, employment, or travel.
PE30: Treatment for national disasters, pandemics, and epidemics.

PE31: Permanent family planning methods such as tubal ligation, vasectomy, or the reversal of such procedures.
PE32: Prophylactic treatments and Allergic tests.
PE33: All transportation costs occurring during trips specifically made for the purpose of obtaining Treatment, any other non -medical items
that are not required for treatment will not be catered for by the Company e.g. phone calls, DVDs, airtime, internet, newspapers, diapers.
PE34: All costs relating to appointments not kept or cancelled by the Insured or Insured dependents.
PE35: All costs relating to interest charged and legal fees arising out of overdue medical expenses.
PE36: Any costs incurred in the pursuit of any legal action against us.

All costs relating to appointments not kept or cancelled by the Insured or Insured dependants. All costs relating to interest charged and legal fees arising out of overdue medical expenses. Any costs incurred in the pursuit of any legal action against us.

*These may be covered in individual schemes, categories, or special cases at which point they will be displayed on the biometric reader. Please feel free to contact us if in doubt.

WAITING PERIODS
1) Inpatient (Hospitalization) Services will be provided under this scheme after three (3) months from the commencement date.
2) Outpatient Services will be provided under this scheme from the commencement date.
3) Maternity Services, Elective surgeries, Pre-existing and Chronic cover will be provided under this scheme after twelve (8) months from the commencement date.
4) Organ transplant will be provided under this scheme after twenty-four (24) months from the commencement date.


DECLARATION
I, the undersigned member/applicant:
1) Hereby apply for myself and my dependants to be registered on the Prudential Assurance Uganda Limited Medical Scheme (the
“Scheme”) and have read, understood and agree to abide by the Rules of the Scheme.
2) Warrant that the contents of this application and any other documents which may be required in support thereof are true,
correct and complete, whether recorded in writing by me or by my agent/broker/intermediary on my behalf and, sh ould there be any change in the state of health or illness suffered by myself or any of my dependants from the date of signing this application form and the date of acceptance of the risk by the Scheme, notification of such change will be provided to the Scheme in writing with full details of such condition/ailment.
3) Understand that the statements and answers provided form the basis of the contracts and any breach of my warranty or non –
disclosure of any information material to the assessment of this application shall render any contracts to which this application relates null and void and all premiums paid shall be forfeited.
4) Understand and accept that no benefit will be payable by the Scheme unless they are satisfied as to the validity of a claim and have received all requirements which they may deem necessary including the results of such medical examinations and tests that they may require me or my dependants to undertake.
5) Consent to the Scheme addressing any requests for information, tests or examinations directly to any dependant of mine over the age of 23, with the same legal consequences as if the request had been addressed to me in my capacity as a member.
6) Acknowledge and accept that the Scheme reserves the right to, without notice, cancel, suspend and or terminate membership to the
Scheme if any due premium is not paid on the due date.
7) Do hereby undertake to repay the scheme any amounts paid under circumstances where no benefits were payable under the terms a nd conditions of the scheme and acknowledge that such amounts are recoverable from me.
8) Undertake to inform the Scheme within 30 days should material changes occur.
9) Undertake to provide an adoption order or social proof that my adopted/foster child is legally placed in my custody

Give Us A Call

0800-200-052

Send Us A Message

customercare@prudential.ug

Office Location

10th Floor, Zebra Plaza, Plot 23 Kampala Road, Kampala

Prudential Uganda is regulated by the Insurance Regulatory Authority of Uganda, whose main responsibility among others, is to ensure that insurance companies honour claims. Furthermore, Prudential Uganda is a subsidiary of Prudential plc, UK, a company that has been honouring claims for over 175 years.

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