Approximately 318,000 teachers around the country stand to reap benefits of a Ksh9 billion medical scheme secured by the Teachers Service Commission.
As per a circular by the TSC, the beneficiaries under the new scheme would be covered for both inpatient, outpatient, dental, optical, maternity, local and international medical emergency evacuation.
They would only be liable to pay Ksh 50 per visit while accessing outpatient, dental and optical doctors consultation services at certain hospitals.
The scheme has increased inpatient cover from the previous range of Ksh 500,000 - Ksh1.5 million to Ksh 750,000 - Ksh2.5 million.
For optical services, the beneficiaries will be covered up to Ksh 450, 000 while dental services will be covered up to Ksh 35,000.
The scheme will additionally provide group life covers between Ksh 450,000 and Ksh 1, 000,050.
The medical scheme came into effect in November 2019 when the TSC completed negotiations on a contract with Minet Kenya Insurance Brokers.
According to TSC CEO Nancy Macharia, the renegotiated benefits would only apply to those aged between 18 and 65 years and who are in active service.
A policyholder under the scheme would however only be limited to having four children under the cover.
"Four dependent biological or legally adopted children are eligible for the cover until they are 18 or 25 if still living with their parent(s) and enrolled in a recognised post-secondary institution,” stated Macharia in the circular.
Although the scheme also provides the beneficiaries with medical evacuation services, this has been limited to two trips per family annually.
“Medical emergency air and road evacuation allow for emergency transport and transfer of sick or injured members or dependants from the place of incident or facility with inadequate care to the appropriate facility using road, ambulance, fixed-wing plane and helicopter within East Africa. Air evacuation is limited to two per family per annum within the policy period,” clarified Macharia.
Kenya Union of Post Primary Education Teachers (Kuppet) had requested additional services under the medical cover.
These included an annual medical check that would entail examinations such as cholesterol, blood sugar, pap smear for women as well as family planning services.
The teachers had also asked to participate in selecting their preferred health service providers so that in-patient treatment to include government facilities such as referral hospitals.
