Uncertainty for teachers as Medical Scheme nears expiry

Uncertainty for teachers as Medical Scheme nears expiry

Thousands of teachers under the Teachers Service Commission (TSC) are staring at fresh uncertainty over access to comprehensive medical cover, as their current insurance contract nears expiry in November, with no clear alternative under the new Social Health Authority (SHA) scheme.

Documents tabled in Parliament by the Commission suggest the existing private insurer arrangement will not transition into the new framework, raising fears of disrupted healthcare access for teachers nationwide.

It is now emerging that the unravelling of the TSC’s comprehensive medical cover began as early as last year.

TSC is said to have raised concerns with the National Treasury and the Social Health Authority (SHA) over the fate of its contract with Minet, the lead insurer in the teachers’ medical consortium.

In a letter dated December 18th and addressed to the then-Principal Secretary Harry Kimtai, the TSC sought clarity from the ministry on what mechanisms SHA had put in place to onboard teachers into a new comprehensive medical scheme starting January this year.

The letter outlined the scope of the existing Minet cover, which included inpatient and outpatient services, dental, optical, maternity care, local air and road evacuations, international travel coverage, and last expense benefits — a package that had shielded teachers from out-of-pocket expenses for over a decade.

This inquiry came in the wake of a directive from the National Treasury to terminate the current medical cover — a move that, if implemented without a proper alternative, would leave thousands of teachers vulnerable and uninsured.

In response, the then-acting CEO of SHA Robert Ingasira informed the TSC that it was not possible to onboard the teachers at such short notice. He also noted that the proposed budget of Ksh.10.3 billion was out of reach for SHA.

A letter from Treasury addressed to the TSC further sealed the deal for the teachers’ comprehensive health insurance.

Treasury PS Chris Kiptoo told the teachers’ commission that aside from limited resources, structures to operationalise the Public Officers Medical Scheme Fund were not yet established, making it impossible to onboard teachers into a comprehensive insurance cover.

The comprehensive insurance cover for teachers has been in effect for nearly ten years and is part of the teachers’ CBA from 2017 to 2021.

Teachers forfeited their medical allowance for the comprehensive health insurance cover. The three-year contract expires in November this year.

SHA has maintained that the teachers will be catered for under the three SHA funds based on their 2.75% contributions.