Teachers’ Insurance Crisis: Unions Demand Urgent Review and Reform of Medical Scheme
The TSC, represented by Ayabei Chumo, explained that the commission relies on funds from the National Treasury to pay Minet, which then disburses the money to a consortium under Medical Administration Kenya Limited (MAKL) responsible for paying hospitals.
Teachers are covered by Minet Brokers Limited, which subcontracted a consortium of eight other insurance companies under MAKL to provide services across the 47 counties.
These companies include Bliss Healthcare Limited, Medical Administrators Kenya Limited, Old Mutual General Insurance Kenya Limited, Britam General Insurance Company (K) Limited, Star Discovery Insurance Limited, Pioneer Assurance Company Limited, and Star Discover Life Insurance Limited.
Medical Insurance Contract
Chumo detailed that TSC signed a three-year contract for the service with Minet Broker Limited for the medical insurance cover for teachers serving in public schools and employed by the commission, excluding the 46,000 serving on contract as interns.
The contract runs from December 1, 2022, to November 31, 2025, and was awarded to Minet after a competitive bidding process.
It covers all teachers employed by TSC, one spouse, four dependants up to 18 years, and 25 years for those who can prove they are in school or in college.
The contract provides up to Sh2 million for treatment in international hospitals and Sh2 million for travel costs for the patient and one accompanying family member.
The Senate Committee on Health, chaired by Uasin Gishu Senator Jackson Mandago, has expressed concern over the complaints and called for a resolution.
The medical scheme initially covered 416 health facilities, which has since expanded to 829, including public, faith-based, and private hospitals licensed by the Kenya Medical, Pharmacists, and Dentists Council (KMPDC).
Currently, there are 800 medical and healthcare service providers across the 47 counties cleared to offer treatment under the scheme.
Initially, 416 health facilities were cleared, but this number has now increased to 829. Public, county, and government referral hospitals have risen from 71 to 146; mission and faith-based hospitals from 29 to 133; and privately managed facilities from 316 to 550.
Knut and Kuppet urged the Treasury to expedite the release of funds to save teachers from suffering and humiliation while seeking medical attention.
The cover includes outpatient, in-patient, dental, optical, maternity, psychiatric, and counselling services, as well as road and air evacuation and funeral benefits.
Knut Secretary General Collins Oyuu emphasized the importance of timely fund releases to bring an end to the perennial challenges that have dogged the programme for several years.
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Flanked by first national vice chairman Malel Langat, Deputy Secretary General Hesbon Otieno, and second national Woman Representative Mercy Ndung’u, Oyuu suggested that the award of the tender by TSC to the providers under the capitation financing model instead of full insurance should be changed in the future.
Calls for Review and Improvement
Kuppet Secretary General Akello Misori added that the review of cover limits, particularly concerning maternity expenses, should be conducted on a need basis to ensure equitable support for all teachers, regardless of their job group.
Senator Mandago and other committee members expressed concern over the complaints from teachers regarding the medical cover and called for a resolution.
Expansion of Healthcare Facilities
The medical scheme initially covered 416 health facilities, which has since expanded to 829, including public, faith-based, and private hospitals licensed by the Kenya Medical, Pharmacists, and Dentists Council (KMPDC).
Before 2012, medical allowance was included in teachers’ pay slips, but the responsibility has since shifted to the TSC to engage a medical insurer.
In primary and secondary schools, 1,288,395 members are under insurance coverage, with 361,000 teachers as Principal Members with 233,568 spouses, 353,767 sons, and 339,967 daughters, according to available statistics.
The medical cover entitles teachers and their dependents to outpatient, in-patient, dental, optical, maternity, psychiatric and counselling services, road and air evacuation, funeral benefits, international referrals, and travel allocation benefits.
Teachers’ Insurance Crisis: Unions Demand Urgent Review and Reform of Medical Scheme
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