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BY MERCY GITAU

Last year announced the enhancement of medical cover schemes for its members, spouses and children.

Teachers employed by the Teachers Service Commission (TSC) and their families have access to healthcare facilities from 832 service providers countrywide, within the East African region and worldwide according to a schedule unveiled by Minet Kenya.

This comes after Minet Kenya, an Insurance and risk management solutions provider, last year announced the enhancement of medical cover schemes for its members, spouses and children.

Minet Kenya General Manager in charge of medical managed care Mr Edwin Kegode says that the services range from outpatient, inpatient, maternity, dental and optical.

This, Mr Kegode says, is part of the measures taken by Minet Kenya to cushion the teachers “so as to make them focus more in imparting knowledge to learners.”

For instance teachers and their families seeking outpatient services have 762 service providers at their disposal, inpatient 595 service providers, maternity 558, dental 364 and optical from 245 service providers.

Of the service providers, 593 are private, representing 71 percent of the service share, 124, which is 15 percent of the service share, are Government of Kenya owned while 115, about 14 percent, are mission facilities.

The TSC medical scheme has 2,524 service points distributed in all the 47 counties across the country.

“The list of medical service providers on our panel can be accessed by the members through the short code service by dialling 340 for both Safaricom and Airtel service providers,” says Mr Kegode.

Alternatively, Mr Kegode says, the members may access the service providers via the link; https://collaborationkenya.minet.com/MinetKe/Teachersmedicalscheme/

The cover takes care of 360,000 teachers out of the 406,000 teachers on the Teachers Service Commission (TSC) payroll.

The cover also includes about 230,000 spouses and 677,000 children, meaning that at least 1.3 million lives are covered by Minet- Kenya.

The distribution of the service providers per hospital level is such that level 4 hospitals are 294 representing 35 percent of the market share, level 3B are 177, which is 21 percent of the distribution, level 2 are 163, about 20 percent of the entire share and level and level 3A 118, which is 14 percent.

The others are level 5 hospitals that are 72, which is 9 percent of the global share, level 6B which are 5 hospitals accounting for 1 percent, 2 level 6A facilities and 1 level 4B both accounting for zero percent of the distribution.

The enhanced cover benefits provided by Minet allows a couple, who are both teachers employed by TSC, to insure up to eight children in the scheme compared to the previous arrangement that limited a maximum of four children.

In the current limits under Capitation Model, Unlimited benefits for both Inpatient and Outpatient for Job Group B5- C3 shall apply on government hospitals, faith-based hospitals- missionary hospitals and private hospitals owned by the Capitation Provider.

Teachers who wish to seek medical services from alternative empaneled hospitals shall be free to do so but within the limits provided and that the co-pay previously charged at Sh50 for outpatient visits has been removed.

The inpatient benefits range from Sh1 million for teachers in job group B5 to Sh3 million for those in job group D5.

Previously inpatient cover for the job group B5 was limited to Sh750,000 with teachers in job group D5 allowed a maximum of Sh2.5 million.

The outpatient benefit for the teachers in job group B5 has been enhanced to Sh150,000 from Sh100,000 with those in job group D5 up to Sh450,000 from Sh375,000.

The enhanced benefits for dental and optical covers have been increased uniformly across the job groups.

The current dental benefits for the teachers is Sh45,000 across the job group from Sh35,000 with optical increasing to Sh60,000 from Sh45,000 across the job groups.

The maternity benefit for teachers in job groups B5, C1, C2 and C3 has been increased to Sh120,000 from Sh100,000.

Teachers in job groups B5, C1, C2, C3, C4, C5 have last expense benefits increased from Sh200,000 to Sh300,000.

The other benefits include the inpatient post hospitalization from the two weeks to five weeks, post hospitalization attendant therapy that was not covered for up to three months.

Laser surgery was previously not covered but is now part of the enhanced inpatient cover.

The overseas treatment has a standalone cover of Sh2 million from Sh1 million and Sh200,000 in air ticket and accommodation for the caregiver, which remains unchanged.

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