NAIROBI, KE: Over 318,000 teachers in Kenya have a reason to be happy after their employer improved their medical insurance cover.
The Teachers Service Commission received an additional s Sh3 billion (USD29 million) from the government, and now has invited bids for the provision of the services on top of Sh6 billion (USD58 million) it has collected from teachers as their total contribution to their medical cover.
In the new improved plan, the commission has increased in-patient cover to between Sh750,000 and Sh2.5 million from the existing Sh500,000 Sh500,000 to Sh1.5 million.
Optical services will now be offered at Sh45,000, a significant increase from between Sh10,000 and Sh25,000, while dental will now be at Sh35,000 up from between Sh10,000 and Sh25,000. Maternity coverage has seen an increase to between Sh100,000 to Sh200,000 up from Sh75,000.
Life insurance coverage is now between Sh450,000 to Sh1,000,050, whereas the last expense will be anywhere from Sh200,000 to Sh600,000.
Tender documents by the commission show that evacuation cover for teachers and their families will also be separate from in-patient, unlike previously where it was included in the in-patient cost.
Overseas evacuation has been awarded an additional Sh1 million while Sh200,000 will be given to a relative escorting the patient over above in-patient cost.
This move by TSC is a huge boost to teachers in the country who have been advocating for an improved medical cover.
Children eligible to benefits are aged 0 – 18, while those in the age bracket of 19 – 25 must provide evidence that they are still studying to access the benefits.
For now, in-patient coverage starts from Sh500,000 to Sh1.5 million, while maternity is Sh75,000.
Group life cover ranges from Sh300,000 to Sh700,000 while the last expense is Sh100,000.
The current contract with an insurance brokerage company expires end of next month and TSC has already called for fresh bids from interested insurance institutions. The commission had a deal with AON Minet since July 1, 2015.
At first, TSC had sought to have the National Hospital Insurance Fund (NHIF) to run the teacher’s scheme but it appears to have slowed down on the proposal and opted to re-advertise.
The teachers’ medical scheme offers coverage for inpatient medical care, outpatient services, optical and dental medical care.
TSC data shows that some 1,006,673 beneficiaries have been signed up for the scheme, with 313,333 being teachers, 178,272 and 515,068 being their spouses and children, respectively.
The Kenya Union of Post Primary Education (KUPPET) in a proposal to TSC wants a better medical scheme for teachers with in-patient cover being improved from Sh900,000 to Sh2.5 million. As of now, it varies from Sh500,000 to Sh1.5 million.
Kuppet also want an annual medical check which will include: examinations such as cholesterol, blood sugar, haemogram, urinalysis, prostate specific antigen (PSA) for men, Pap smear for women, mammogram and family planning services.
Bonuses include; exclusions for example the treatment from non-accredited health facilities, vaccines such as anti-venom, anti-rabies, yellow fever, and rehabilitation facilities for alcoholic teachers.
Teachers would additionally want to take part in finding health service providers through their representatives and the institution to increase the number of dependants to five from the current four.
Above all, they want inpatient treatment to constitute government services such as referral hospitals and regular sensitization of teachers about the healthcare, group life and last expense embodying the trade unions.