The renewal means that Teachers and their dependents can now continue to access healthcare services in both public and private facilities under the Teachers Service Commission (TSC) medical scheme.
In the contract, the lowest teacher in the Job Grade B5 which comprise primary teacher II are entitled to an in patient cover of Ksh1 million while outpatient was adjusted to Ksh150,000.
Continue reading: TSC Minet Medical Scheme For Teachers 2025-2026 (Full information)
The highest job group in the teaching service which is D5 which comprise Chief Principals are entitled to an in-patient cover of Ksh3 million while the outpatient is Ksh450,000.
However, teachers will continue enjoying the dental and optical covers on a flat rate of Ksh45,000 and Ksh 60,000 respectively across all the job grades while Maternity cover will range from Ksh120,000 for Job Group B5 to Ksh300,000 for Job Group D5 (Chief Principals), with the last expenses for all the teachers from B5 to D5 being pegged at Ksh300,000.
All employed teachers aged 18 years to 65 years, with only one spouse, will benefit from the cover, and will include four dependent children (both biological and adopted); which will cover them from birth until they reach 18 years, 25 years for those who will be residing with their parents and have enrolled in a recognized post-secondary institutions, with no maximum age limit for children with proven disability status.
The medical cover will entail Inpatient Benefits such as Doctor’s (Physician, Surgeon and Anesthetic) fee, ICU/HDU/Critical Care and theatre charges; Drugs/Medicines, dressings and internal surgical appliance, Pathology/Laboratory, X-ray, Ultrasound, Electrocardiogram, and Computerized Tomography, MRI Scans; Radiotherapy and Chemotherapy, In-patient Physiotherapy, Hydrotherapy, Occupational therapy among others.
Outpatient Benefits will entail Routine outpatient consultations, Prescribed Diagnostic Laboratory and Radiology services (x-ray, ultrasound, MRI and CT scans), Prescribed Physiotherapy, Prescribed drugs and dressing, Referral outpatient to specialists, HIV/AIDS related conditions and prescribed ARV’s to the full cover limit per family per annum and newly diagnosed chronic conditions among others.
Maternity benefits for Principal members and/or their spouses only entail Delivery/Doctors Fees, Routine Antenatal check-up, Postnatal care, Routine immunization (KEPI) and baby Friendly vaccines, First emergency caesarean section, subsequent elective CS and normal Delivery among other benefits.
Dental benefits are Dental consultations and Anesthetist’s, Dental X-rays and Root canal treatment, Tooth Extraction, Scalling necessitated by a prevailing medical condition and prescribed by a dentist, Dentures necessitated by an accident/injury, Deformation surgery, and Dental crowns. Optical benefits are Cost of lenses and frames, Prescription by an Ophthalmic treatment and eye lenses, Ophthalmic ultrasound if prescribed by the Ophthalmologist, and Surgery.
On the other hand, the cover also entails Medical Emergency Road and Air Evacuation, International Travel and Referral Allocation, Chronic, Critical and terminal disease management which includes Cancer, Kidney failure, hypertension, arthritis, diabetes, HIV/AIDS, liver disease among others, Drug and substance abuse including alcoholism and associated rehabilitation, Work related trauma among other benefits.
Minet registers about 7,000 outpatient visits daily, 300 new admissions per day, 400 dental cases daily, and 400 optical cases in a day. The scheme also boasts a fully automated system for registration, approvals, claiming, and settlement.
