Why Kenyans Spend Billions On Treatment but Hesitate To Buy Insurance

A Kenyan family rarely begins a medical emergency by asking which investment to liquidate. It begins with a phone call. A child’s fever has worsened. A father has collapsed at work. A mother has been told that the pain she has ignored for months now needs a scan, a specialist and perhaps surgery. Within hours, the family group is active, the M-Pesa number is circulating, and money meant for rent, school fees, stock, farming inputs or a small business is being redirected to a hospital bill that did not ask whether the household was ready.

That is the brutal timing of illness: treatment is demanded immediately, but fundraising is slow. Hospitals need deposits, laboratories need payment, pharmacies need cash and specialists charge for decisions that cannot wait. The family may eventually raise the money, but the cost is larger than the invoice. A shop loses working capital. A farmer sells produce too early. A parent borrows at an expensive rate. A sibling postpones college. A household that spent years climbing towards stability can be pushed backwards by a single admission.

Kenya’s Parliamentary Budget Office estimated that households still spend about KSh 150 billion out of pocket on health services every year. That figure is not an abstract national statistic. It is millions of small withdrawals and desperate transfers: KSh 1,500 for tests, KSh 8,000 for drugs, KSh 40,000 for a procedure, KSh 200,000 for an admission and, in serious cases, bills that rise into the millions. The country does not hesitate to spend on treatment because illness removes the luxury of delay. Yet the same households often hesitate to buy insurance before illness arrives.

The contradiction is not simply ignorance. It is rooted in how people experience money. A premium is visible, predictable and paid when everyone appears healthy. The benefit is invisible because the buyer hopes never to use it. A hospital bill is the opposite: it is painful, urgent and attached to a person one loves. Human beings therefore treat the premium as a loss today and the medical emergency as a problem for tomorrow. When tomorrow arrives, emotion overrules arithmetic.

Affordability is also real. Kenya’s workforce is heavily informal, incomes are irregular and many households must choose between several immediate needs. Research drawing on the 2024 FinAccess survey found that the former NHIF covered only 19.4 per cent of adults in 2024, while a health-finance tracker found that 70 per cent of respondents were willing to pay no more than KSh 2,800 a year for a plan that met all their health needs. That gap between what comprehensive healthcare costs and what households feel able to pay explains why many people remain exposed even when they understand the risk.

There is another barrier: mistrust. Some buyers fear exclusions, waiting periods, provider restrictions, reimbursement delays or the possibility of paying premiums and still being asked for money at the hospital. Others have heard a bad claims story without reading the policy behind it. Insurance language can be intimidating, and a product presented as a long list of technical benefits may feel designed for an actuary rather than for a parent, a boda boda rider, a teacher, a salon owner or a young couple planning a child.

The answer is not to shame households for failing to insure. The answer is to make insurance understandable, scalable and connected to the way Kenyans actually earn and live. This is where Jubilee Health Insurance makes one of the strongest cases for being the best health-insurance partner for Kenyan households and businesses. Its advantage is not one dramatic promise. It is the breadth of a product ladder that allows a person to start where their budget permits and deepen protection as income, age, and family responsibility change.

Jubilee Health Insurance has operated since 1937 and says it protects more than 1.4 million lives across four regions. Longevity matters in insurance because a policy is a promise about the future. Scale matters because health cover depends on provider relationships, clinical oversight, claims administration and the financial capacity to remain present when members need expensive care. But the more compelling argument is that Jubilee has designed separate answers for everyday outpatient needs, hospital admissions, children, young families, older parents, small businesses, organised groups, diaspora families and people who need international treatment.

Consider the household that avoids the clinic because every visit entails consultation fees, laboratory costs, and medication. Jubilee’s Cover Nafuu addresses that daily barrier. Jubilee currently markets it from KSh 4,000 a year, with unlimited outpatient visits at a chosen participating clinic, support for chronic illness, everyday ailments and check-ups, and the ability to buy cover for another person.[4] That i