Healthcare is not only one of the most important services but also one of the most expensive and can quickly become a huge cost burden. The rise of certain diseases that require long-term treatment like cancer and diabetes and the ever-increasing cost of healthcare has left many families in a financially precarious position. Kenya is yet to have a functioning universal healthcare system but has made improvements over the last few years with free maternal healthcare available in public hospitals and NHIF cover working for many patients across the country. Still, there is a way to go to have Kenyans enjoying great healthcare without having to go broke and hold harambees. The Teachers’ Service Commission (TSC) medical scheme by Minet is a great example of what is possible in Kenya as far as healthcare is concerned.

CaptalWork acquired AON’s shareholding across 10 countries across Africa including Kenya and began operating as Minet Africa in 2017. Minet won the bid to run the Teachers’ Service Commission (TSC) medical scheme over other firms that had expressed interest. The scheme commenced on 1st July 2015 and saw more than 300,000 teachers covered. Before the scheme, teachers would receive a medical allowance of 700 to 4000 depending on their grade. This has now changed with this sum now going towards the medical scheme.

Who is eligible?

All teachers who are registered with TSC and are in active service are eligible. The registered teacher’s (principal member) cover extends to dependants – one spouse and 4 children (biological or legally adopted). The children are covered up to 20 years old if there is proof that the children are in a high school. There is no age limit for children with special needs.

What is the registration process?

Even though the teachers are in theory covered by being registered with TSC, they still must register with Minet to activate the cover. Registration is easy and is done through one’s mobile phone. The principal member only needs to dial *865# from their Safaricom or Airtel line and follow the prompts. They’ll be required to enter their ID number, TSC registration number, name, role and gender. The next prompt is to add dependents, though this can be done at a separate time by still dialling *865#. To register dependents, you need to have their full name, date of birth, I.D. number of birth certificate number. When they make a visit to the hospital, they will need to do a biometric registration for ease to access of services.

What is the scheme benefits structure?

The scheme benefits are graduated according to job groups, with inpatient cover ranging from Ksh 500,000 to Ksh 1,500,000 and are quite impressive as they cover things that even private insurance providers do not and do so without the pre-existing clause for chronic conditions such as cancer, diabetes, cardiac failure, schizophrenia, asthma, hypertension among others. The inpatient benefits include hospital accommodation, surgery, radiotherapy and chemotherapy, HIV/AIDS related conditions, dialysis, occupational therapy and In-Vitro Fertilization (IVF).  Other benefits include emergency road and air rescue including treatment abroad, maternity, dental, optical, psychiatric and counselling services and last expense of Ksh 100,000.

One must produce their NHIF card at the point of service as bills are paid net of NHIF. For primary outpatient care, a co-pay of Ksh 50 is payable by the member or dependent visiting the hospital.

How do you access the service?

To find out which clinics and hospitals are under the scheme, dial *340# and follow the prompts to access the list based on the kind of service you are seeking. The recommendations are based on outpatient, inpatient, optical, dental and maternity and direct and referral hospitals from the Sub County and County levels.

One of the other things that you can do when you dial *340# is rate the services of a hospital you’ve been to, which encourages service providers to provide good service and Minet information on any poor service providers.

All in all, the medical scheme is a good one and should be used as a blueprint for the kind of benefits that are possible for Kenyan citizens across the board.


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