TSC Minet Teachers’ Medical Scheme- Benefits per job group

By Editorial Team

TSC MINET MEDICAL SCHEME BENEFITS’ STRUCTURE

Job Group Outpatient Inpatient Dental Optical Maternity Group life Last Expense Ambulance Services International Referral International Travel
B5 100,000 750,000 35,000 45,000 100,000 450,000 200,000  

 

 

 

 

Air fix wing and Helicopter 2(two) per family per Annum

 1,000,000 200,000
C1 100,000 750,000 35,000 45,000 100,000 450,000 200,000 1,000,000 200,000
C2 100,000 750,000 35,000 45,000 100,000 450,000 200,000 1,000,000 200,000
C3 100,000 850,000 35,000 45,000 100,000 550,000 200,000 1,000,000 200,000
C4 150,000 1,000,000 35,000 45,000 100,000 550,000 200,000 1,000,000 200,000
C5 175,000 1,250,000 35,000 45,000 100,000 650,000 200,000 1,000,000 200,000
D1 225,000 1,500,000 35,000 45,000 150,000 650,000 300,000 1,000,000 200,000
D2 250,000 1,800,000 35,000 45,000 150,000 1,050,000 400,000 1,000,000 200,000
D3 275,000 2,000,000 35,000 45,000 200,000 1,050,000 500,000 1,000,000 200,000
D4 375,000 2,500,000 35,000 45,000 200,000 1,050,000 600,000 1,000,000 200,000
D5 375,000 2,500,000 35,000 45,000 200,000 1,050,000 600,000 1,000,000 200,000

 

TSC MINET MEDICAL SCHEME INPATIENT BENEFIT

This is treatment which requires admission in a hospital or day care surgery/procedure. The benefits (paid net of NHIF rebates) under this cover include but are not limited to:

TSC MINET MEDICAL SCHEME OUTPATIENT BENEFIT

This is treatment that does not require admission or daycare surgery in a hospital. The outpatient cover caters for all routine outpatient services which include but are not limited to:

TSC MINET MEDICAL SCHEME MATERNITY BENEFIT

The benefits under this cover include but are not limited to:

NB: The maternity benefit is available to principal members and/or their spouse only.

 

TSC MINET MEDICAL SCHEME DENTAL BENEFIT

The benefits under this cover include but are not limited to:

TSC MINET MEDICAL SCHEME OPTICAL BENEFIT

This benefit caters for expenses related to eye treatment which includes but not limited to:

TSC MINET MEDICAL SCHEME CO-PAY

There shall be a co-pay chargeable of Kenya Shillings Fifty (Kshs 50) per outpatient visit per individual for dental, optical and outpatient doctor consultation services.

The co-pay shall not be charged in the following cases:

MEDICAL EMERGENCY: ROAD AND AIR EVACUATION

This benefit is for emergency transportation and transfer of sick or injured members or dependants from a place of incident or facility with inadequate care to the appropriate facility using road ambulance, fix-wing or helicopter services within East Africa (Kenya, Uganda, Rwanda and Tanzania). Air evacuation will be limited to two (2) per family per annum within the policy period.

TSC MINET MEDICAL SCHEME INTERNATIONAL REFERRAL & TRAVEL ALLOCATIONS BENEFIT

This is payment that shall be made exclusively for members and the person accompanying the patient. This will be paid out where authorisation has been granted for the member to travel to another country for specialised treatment which is not available locally. A medical refferal report shall be required to facilitate overseas treatment.

*All requests for specialized treatment outside Kenya shall require approval from the Director, Medical Services in the Ministry of Health.

TSC MINET MEDICAL SCHEME GROUP LIFE BENEFIT

This benefit is payable to the next of kin upon the demise of a principal member. To access the group life benefit, the following information should be availed to Minet at the earliest possible convenience:

NB: *Payment will be made to a valid account number held in a registered commercial bank.

TSC MINET MEDICAL SCHEME LAST EXPENSE BENEFIT

This benefit is payable to the next of kin upon the demise of a principal member mainly to cater for funeral expenses. It is payable within 48 hours subject to confirmation of the Next of Kin and upon provision of the following documents:

Chief’s letter in case the deceased had not declared their next of kin.

NB: * Submission of Group Life and Last Expense Claims must be done within 12 months after which it will not be payable.

TSC MINET MEDICAL SCHEME Psychiatric and Counselling Services

Provision of Psycho-social support programs for employees for conditions such as chemical dependency, stress, post-traumatic counselling, relationship difficulties, anxiety and depression, parenting, legal or financial distress etc. services will include but not limited to:

TSC MINET MEDICAL SCHEME EXCLUSIONS

Expenses for the following will not be covered under the scheme:

ELIGIBILITY

REGISTRATION

Unstructured Supplementary Service Data (USSD) registration

Ensure you have the below mandatory details:

PRINCIPAL REGISTRATION

Step 1:

Dial *865# from your Safaricom or Airtel mobile phone number.

Step 2:

Key in your TSC and National ID Numbers when prompted. The details will be verified against our database.

Step 3:

If successful, you will be prompted to enter your name (surname and other name), role and gender.

*Once done, you will receive a message confirming your successful registration onto the

scheme and a prompt to register dependants.

 

DEPENDANT REGISTRATION

Step 1:

Dial *865# from your Safaricom or Airtel mobile phone number

Step 2:

Select the dependant you wish to register i.e spouse or child

Step 3:

Enter Relation, full names, Disability status, Date of birth, ID number if you are over 18 years.

After successful registration the member will recieve a link to complete the registration process: https://collaborationkenya.minet.com/TSC

If not successful, kindly contact us on our call centre hotline number 1528 for further assistance.

 

Procedure for access to medical cover under the scheme

Members of the Teachers’ Medical Scheme can access any of the service providers on our panel countrywide. This list is accessible via USSD code *340# or Minet/TSC Website.

Step 1:

Present yourself at the service provider on our active panel.

Step 2:

Identify yourself or your dependant with the TSC number

Step 3:

The service provider will generate an SMS that contains a One-Time-Pin (OTP), sent to the principal member’s registered mobile number.

Step 4:

You will present this OTP to the service provider representative to register the fingerprints.

Step 5:

You will be requested to place a finger on the biometric device and the impressions will be saved against your membership record.

On successful registration the member or dependant can access medical services.

NB: Children under 5 years of age will be registered under either the parent or an appointed guardian.

 Medical Facilities

Direct facilities

These are primary care facilities that members can access directly without the need of a referral letter.

Referral facilities

These are facilities that offer medical services for cases that require specialised treatment. A Referral letter from a direct facility is required to access medical services in these facilities.

MEMBER EDUCATION

Scheme member education is a continuous process to sensitise members on the operation of the medical scheme.

We encourage that you keep this document safe and refer to it often.

To learn more about the Teachers’ Medical Scheme, you are encouraged to get in touch with us through the channels below:

Telephone: 0730 604 000                                  Hotline: 1528

Email:         mmc.customerservice@Minet.co.ke       Website: www.minet.com/kenya

Twitter:      @Minet_Kenya                           Facebook: MinetKe

Telegram: Teachers’ Medical Scheme

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