Healthcare facilities across the country yesterday began serving teachers under the Public Officers’ Medical Scheme Fund administered by the Social Health Authority (SHA), as the scheme officially took effect.
The Teachers Service Commission (TSC) said all the data for teachers had been successfully uploaded on the SHA system to ensure teachers have seamless access to healthcare.
TSC Director for Administrative Services Ibrahim Mumin said so far, the transition from Minet Kenya to the new scheme dubbed Mwalimu Cover has been smooth with no reported challenges.
“As at 10 am this morning, 249 inpatient cases had transitioned into the new scheme, out of these 48 are maternity cases,” he said during a tour by senior TSC officials at the Kenyatta National Hospital (KNH).
He noted that surveillance teams have been deployed across the country to monitor the transition in real time on the medical scheme and ensure that no teacher misses out on treatment.
KNH Chief Executive Officer Richard Lesiyampe said that so far, there have been no hitches in catering to inpatient and outpatient teachers who sought services.
“We want to confirm that 42 teachers transitioned into the new scheme and as at this morning, we received 15 teachers who came to seek treatment at KNH, and have been served under the new scheme,” said Dr Lesiyampe.
The TSC and SHA have launched sensitisation campaigns to ensure teachers understand how to access the services under the new scheme.
The comprehensive medical cover under SHA includes benefits such as inpatient and outpatient services, maternity care, chronic illness management, dental services, optical services and air evacuation, last expenses and overseas treatment.
“This morning, I brought to KNH from Langata Hospital a teacher who was in critical condition and it didn’t even take five minutes for the patient to be assisted,” said Mr Hanington Ochieng, the Kenya National Union of Teachers (Knut)-Nairobi Branch treasurer.
The Mwalimu Cover is designed with a tiered structure that matches benefits to the job groups with chief principals, enjoying the highest inpatient limit of up to Sh3 million, outpatient cover of Sh450,000 and maternity cover of Sh300,000.
Senior teachers in secondary schools have access to inpatient cover of Sh1.3 million and outpatient benefits of Sh200,000, while primary school teachers in the entry grade benefit from inpatient cover of Sh1 million and outpatient cover of Sh150,000, among other provisions.
The medical cover caters for the 415,000 teachers who are principal members, one declared spouse and up to five children from birth to the age of 21 years.
In September, when the TSC announced plans to migrate teachers to the new scheme under the SHA, legislators voiced reservations, fearing that teachers might lose some of their benefits. They were also concerned about the limited time available to develop a transition framework and to onboard the large number of teachers affected.
Union leaders similarly expressed misgivings about the new scheme, noting that they had not been adequately consulted on the migration. However, after several meetings, their concerns were eased.
President William Ruto, for his part, has promised teachers a superior medical cover under the new arrangement.
While the majority of Minet Kenya’s network hospitals remained operational, some facilities were temporarily suspended following investigations into fraudulent or unethical practices.
There were also complaints about delays in pre-authorisation for outpatient cases, which were later scrapped, mandatory referral from Bliss and inadequate qualified doctors in most empaneled hospitals.
Data from the TSC shows that so far, 8,148 healthcare facilities have been accredited to offer services under the Mwalimu Cover.
The facilities range from level 6 hospitals such as KNH to level 2 facilities, which are mostly dispensaries.
