DEFENCE FORCES MEDICAL INSURANCE SCHEME

Your Health care Partner in Retirement

Frequently Asked Questions

Find answers to common questions about DEFMIS membership, benefits, and services

Medical benefits are only accessible within the country unless on a referral basis for overseas treatment subject to approval by the Board of Trustees. Members must follow the proper overseas treatment authorization process.

DEFMIS covers treatment at accredited hospitals only. Members are required to visit General Practitioners (GP) at accredited facilities who will recommend further treatment if necessary. Treatment from personal doctors outside the accredited network is not covered.

The Trust Deed defines a child to include a posthumous child. Therefore, children born after the member's death are covered under the scheme.

Yes, adopted children are covered as dependants, provided they meet the eligibility criteria (single and under 21 years) and are declared during the nomination process upon retirement.

DEFMIS members enjoy equal benefits regardless of rank and access the same facilities. Coverage includes:
  • Inpatient cover: KES 2,000,000 per year (100% coverage)
  • Outpatient cover: KES 400,000 per year (75% coverage, 25% co-payment)
Members are treated regardless of their pre-existing medical conditions upon retirement.

Members can only benefit upon retirement and upon full payment of contributions. DEFMIS is designed as a retirement medical insurance scheme for KDF personnel.

Eligible beneficiaries:
  • Principal member (for life)
  • Spouse (for life)
  • Maximum of four children up to age 21 years
A member nominates their dependants through the DEFMIS declaration form upon retirement.

Currently No. The decision to either receive benefits or request a refund must be made before initiating the refund process. Once refunded, you cannot be issued with a membership card.

No. As per current regulations, a child is covered up to the age of 21 years regardless of whether they are still in school or their marital status.

Yes. Members can visit any of our accredited hospitals nationwide, including DEFMIS referral hospitals through a set out referral procedure. A list is provided upon issuance of membership cards and is available on our website at defmis.org.

No. Parents are not covered under the scheme. For the scheme to be sustainable, coverage is limited to the principal member, spouse, and children only.

No. Nomination of dependants is only done once upon retirement. The scheme covers only the dependants that you had at the time of retirement. Children born after retirement are not covered.

The correct and true account of your contribution status can be verified at DEFMIS headquarters, as the scheme has no control over payslip generation. Contact DEFMIS directly for accurate information.

Contribution towards the scheme is mandatory for all KDF members. This is also to ensure equity and to avoid disadvantaging members in case of divorce or separation.

Contribution periods:
  • Members who joined the scheme before July 2011: Contribute for 180 months (15 years)
  • Members who joined the scheme after July 2011: Contribute for 240 months (20 years)

You can check your contribution status through:
  • Contacting DEFMIS headquarters directly
  • Using the DEFMIS mobile application
  • Checking your monthly payslip
Stop orders are generated once your contributions have matured, and a maturity card is issued.

No. As per regulations, beneficiaries cannot be substituted to avoid abuse of the system.

No. Only one spouse is allowed for equity purposes and scheme sustainability.

No. Once a member is issued with a card, their contributions are transferred to equity and are no longer a liability to the scheme. The decision to receive benefits or request a refund must be made before being issued with a card.

Yes. Single parents can declare their children as beneficiaries, subject to the eligibility criteria (maximum of four children, single, and under 21 years).

Yes. Retirees must pay the balance within 6 months from retirement (policy from 2012 onwards).

Members can pay the balance through a determined lump sum rate calculation deducted from their gratuity upon retirement.

In case of death in service before completing contributions, your next of kin will be entitled to a refund of all contributions made. The scheme will process the refund to the beneficiaries as per the records on file.

At retirement, members will get 100% refund if they choose to withdraw instead of receiving medical benefits. However, the current policy encourages membership as part of pillar 5 (resettlement) for KDF personnel. The decision must be made before card issuance.

If your spouse dies, you (the principal member) continue to receive full medical benefits for yourself and any eligible children. However, you cannot substitute another spouse.

No. Contribution to DEFMIS is mandatory for all KDF personnel as part of resettlement benefits. Withdrawal is only possible upon retirement.

Still Have Questions?

Our team is ready to help you with any additional questions about DEFMIS membership and benefits.

Call Us

0798 999 444
0725 000 056/057

Email Us

info@defmis.org

Visit Us

19th Floor Nyayo House
Nairobi