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Senate queries Sh5.9b medical cover contract for teachers

By Hillary Mageka
Monday, October 5th, 2020
Nominated Senator Rose Nyamunga.
In summary

Senators have raised concerns over a contract signed by Teachers Service Commission (TSC) with AoN Minet to manage Sh5.9 billion medical cover for teachers.

The contract was signed in May 2015 as a milestone in enhancing teachers’ health cover.

However, lawmakers allege, teachers are reporting that the services offered by AON Minet are not only poor in terms of quality, but also too restrictive to benefit them.

In addition, despite the significant deduction both for National Hospital Insurance Fund (NHIF) and AON MINET on their pay slips, there are no commensurate services.

Led by Nominated Senator Rose Nyamunga, the legislators held that though the decision to introduce a medical cover for teachers was very good, there appears, however, to be glaring gaps and challenges that must be addressed by the employer.

Low capitation

According to Ms Nyamunga, the scheme has very low capitation on outpatient services, with some capped at as low as Sh90 inclusive of doctors’ consultations, tests and drugs.

There are also restrictions on the hospitals teachers are allowed to visit for treatment, some of which are ill-equipped and lack qualified personnel.

“Delays in approvals, which sometimes can take up to one month. This is really absurd, considering that at times, it might be that the life of a teacher might be at stake,” she said in a statement dubbed status of teachers’ medical cover under AON Minet Kenya.

“There have been instances where hospitals have turned away teachers insured by AON Minet because of the challenges they face while lodging claims with the company,” the statement adds.

Some health facilities, such as Bliss, the statement disclosed operate only between 8.00am and 5.00pm, thus making it difficult for teachers who fall ill at night to get the help they need.

On dental services, the nominated senator noted only tooth extraction is catered for by teachers’ insurer.

Other essential services like cleaning, refilling, root canal treatment and tooth replacement or dentures are not covered, she held.