Teachers face delays in medical services as government owes Sh11.2 billion

Teachers across Kenya continue to face service delays under their medical scheme after the government failed to release Sh11.2 billion owed to the provider between December and March.

Teachers Service Commission (TSC) Chief Executive Officer Dr Nancy Macharia said the Commission has only paid the contract price up to November 30 for the second year of the Minet-managed policy.

She also noted that MPs have yet to allocate Sh1.5 billion for the teachers' Group Life insurance.

“With the implementation of the teachers’ medical scheme has been generally successful, the commission concedes that given the scheme’s size, the dynamics of implementation and fiscal constraints, some challenges have been experienced,” said Macharia.

Despite the delay, Minet continues to provide services. Macharia said teachers should visit the nearest hospital in the panel if turned away by a facility due to pending payments.

To mitigate disruptions, TSC has removed pre-authorisation requirements for outpatient and emergency cases and enhanced its call centre to manage high demand. It has also launched an ambulance and rescue service to support teachers countrywide.

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“The Commission has, through its contract implementation team, always endeavoured to hold the service provider to grant the necessary approvals within the prescribed timeline to ensure that teachers get services expeditiously,” said Macharia.

The scheme covers inpatient care ranging from Sh1 million to Sh3 million and outpatient services from Sh150,000 to Sh450,000. Teachers also receive dental and optical benefits between Sh45,000 and Sh60,000.

Maternity cover ranges from Sh120,000 to Sh300,000 and includes air evacuation for up to four dependents each year.

Macharia added that teachers are entitled to up to Sh2 million for international referrals and Sh200,000 for international travel annually.

She said the scheme includes high-cost procedures, chronic disease management and advanced medical treatment, promising that TSC will continue working with the provider to ensure access to care remains uninterrupted.