Kenya: TSC Enhances Teachers' Medical Insurance

22 August 2019

The more than 318,000 teachers across the country have a reason to smile after their employer enhanced their medical cover.

The Teachers Service Commission, which has received an additional Sh3 billion from the government, has already invited bids for provision of the services which is in addition to Sh6 billion it has been collecting from teachers as their contribution to their medical cover.

In the new improved scheme, TSC has increased in-patient cover to between Sh750,000 and Sh2.5million from the current Sh500,000 to Sh1.5 million.

FRESH BIDS

Optical services will now be at Sh45,000 up from between Sh10,000 and Sh25,000, dental is at Sh35,000 up from between Sh10,000 and Sh25,000, while maternity will be between Sh100,000 to Sh200,000 up from a previous Sh75,000.

Group life cover will be between Sh450,000 to Sh1,000,050 while the last expense will be between Sh200,000 to Sh600,000.

Tender documents by TSC indicate that evacuation cover for teachers and their families will also be separate from in-patient, unlike in the past where it was within the in-patient cost.

Overseas evacuation has been given an extra Sh1 million while Sh200,000 will be provided to a relative accompanying the patient over above in-patient cost.

The move by TSC is a major boost to teachers across the country who have been pushing for a better medical cover.

Children eligible to benefits are aged zero to 18, while those in the 19 - 25 age bracket must prove evidence that they are in school to access the benefits.

At the moment, in-patient cover ranges from Sh500,000 to Sh1.5million, while maternity is Sh75,000.

Group life cover is between Sh300,000 and Sh700,000 while the last expense is Sh100,000.

The current deal with an insurance brokerage firm expires end of next month and the commission has already called for fresh bids from interested insurance firms.

TSC contracted AON Minet in July 1, 2015, to manage the multi-billion shilling medical scheme.

The commission had at first sought to have the National Hospital Insurance Fund (NHIF) run the teachers' scheme but it seems to have back-pedalled on the proposal, and opted to re-advertise.

DEPENDANTS

The teachers' medical scheme covers inpatient medical care, outpatient services, dental and optical medical care.

Data from the TSC shows that some 1,006,673 beneficiaries have been registered under the scheme, with 313,333 being teachers, 178,272 being their spouses and 515,068 being their children.

Kuppet in a proposal to TSC wants an improvement in medical scheme for teachers with in-patient cover being increased from Sh900,000 to Sh2.5 million. At the moment it ranges from Sh500,000 to Sh1.5 million.

Other benefits Kuppet wants are; an annual medical check which will entail examinations such as full haemogram, cholesterol, blood sugar, urinalysis, Pap smear for women, prostate specific antigen(PSA) for men, mammogram and family planning services.

Others are; exclusions for instance the treatment from non-accredited health facilities, vaccines such as Rota virus vaccine, anti-rabies, anti-venom, yellow fever and rehabilitation services for alcoholic teachers.

Teachers also want to participate in identification of health service providers through their representatives and the scheme to revise the number of dependants to five from the current four.

In-patient treatment to include government facilities such as referral hospitals and continuous sensitisation of teachers about the healthcare, group life and last expense incorporating the trade unions.

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