TSC Faces Suit Over Sh35 Billion Teachers’ Medical Cover, AON Minet
The Teachers Service Commission (TSC) is facing new legal action in connection with the award of a Sh35 billion medical insurance tender for teachers, which a lawmaker claims was designed to favor the present insurance provider.
Senator Okiya Omtatah of Busia has asked the TSC to reject the tender given to AON Minet, which has been delivering the services since 2019.
AON Minet is now running the expiring Sh35.22 billion teachers’ medical scheme, which provides full medical insurance coverage to 341,837 public school teachers.
According to Mr Omtatah, the TSC imposed excessive requirements to eliminate competition in the multibillion-shilling tender and assure Minet’s retention of the lucrative business.
“I demand the immediate cancellation of this rigged tender and that the procurement of a comprehensive teachers’ medical insurance cover must be done in accordance with the provisions of Article 227(1) of the Constitution and Kenya’s procurement laws,” said Mr Omtatah.
TSC AON Minet medical scheme requirements and eligibility
To be eligible for the coverage, you must be a TSC-employed teacher on active duty.
Dependents are also eligible, although only one legal spouse and up to four unmarried biological or legally adopted children are allowed.
Children from birth to 25 years old are also covered if they attend a reputable post-secondary institution.
There is no upper age limit for disabled children.
DETAILS ABOUT CHANGE OF DEPENDENTS
Once enrolled, you cannot modify your dependents, although you may do so at the end of the policy if your spouse dies or gets divorced.
Additionally, at the beginning of each insurance period, you will have the opportunity to review your coverage and modify your dependents as you see fit.
Every year, the policy year concludes in September.
Premature babies born before 38 weeks are covered under the policy’s maternity coverage. It also includes the dependent’s lawful spouse up to age 70.
The coverage does not provide for the medical needs of the major member’s relatives.
ENROLLMENT IN THE MINET INSURANCE TSC COVER
The registration process is uncomplicated for the chief member (teacher) and their family. A USSD registration and a biometric registration at the hospital are required.
Principal members need only dial *865# on their Safaricom or Airtel line and enter their TSC and National I.D. numbers.
If registration is successful, you must input your name, role, and gender, after which you will receive a confirmation message and a request to register your dependents.
To register dependents, follow the identical steps.
HOW TO ACCESS MINET’S MEDICAL SERVICES
As a Teachers’ Minet medical scheme member, you have nationwide access to all AON Minet service providers via the organization’s online platform.
You can access the list by dialing *340# from your Safaricom or Airtel phone. Follow the on-screen instructions to obtain the required service.
BENEFITS OF MINET INSURANCE TSC MEDICAL COVER FOR MEMBERS
Members’ benefits can be separated into inpatient and outpatient categories.
–> Inpatient services:
As part of the inpatient coverage, the primary member and dependents may:
- Evacuation by road and air within East Africa in response to an urgent situation, leading to admittance
- Charges for hospital accommodations:
- NHIF rebate standard ward bed fee for Groups G-N
- Standard private ward bed charge for Groups P-R, net of NHIF rebate per day
- ICU/HDU hospital expenses
- Physician or surgeon compensation
- Medicine, dressings, and equipment for internal surgical procedures
- Radiotherapy, hydrotherapy, chemotherapy, and physiotherapy for hospitalized patients
- Pathology, electrocardiogram, magnetic resonance imaging, x-ray, ultrasound, and computed tomography
- Following hospitalization care (within 21 days after discharge from the hospital)
- Hospital lodging for accompanying parent or guardian of hospitalized children under seven (7) years of age.
- Home health care, physiotherapy, and occupational therapy are examples of rehabilitation services.
- Ophthalmologic and dental inpatient procedures
- Treatment for congenital impairments and genital diseases
- HIV/AIDS-related disease treatment Cancer and other pre-existing and chronic illnesses
–> The TSC medical coverage will also encompass outpatient services, which will include the following benefits:
- Regular outpatient consultations
- Day surgery for simple procedures that do not require hospitalization
- Diagnostic laboratory and radiological services consisting of x-rays, ultrasounds, MRI, and CT scans.
- Regularly prescribed laboratory tests
- suggested physiotherapy, Medications and dressings
- HIV/AIDS-related diseases and ARV prescriptions up to the annual maximum per family
- PSA for men and Pap smear for women (for the principal member-only)
- Dialysis Regular prenatal check-ups
KEPI vaccines and routine immunizations
–> Pregnancy services:
The coverage is limited to the primary member and his or her legal spouse. Upon delivery, newborns must be registered immediately.
Among the features offered in this bundle are the following:
- Routine prenatal examinations
- KEPI vaccines or routine immunizations
- Delivering compensations
- Urgent and elective cesarean delivery
- Six weeks of postpartum care.
- Prematurity expenses Congenital disorders.
–> Dental services:
The plan’s dental coverage includes, but is not limited to:
- Root canal therapy
- Dental extractions
- Expenses for dental consultations and anesthesia
- Scaling necessitated by a current medical condition and authorized by a dentist
–> Offering optical services:
The optical coverage includes all eye treatments. It includes, but is not limited to, the followin benefits:
Lenses Spectacle frames
–> Evacuation services:
In the event of an emergency, you must immediately contact Minet via their call centre’s emergency number.
The coverage includes the following ground and air evacuation and ambulance services:
- Services of emergency road ambulance evacuation in East Africa
- Services of emergency air ambulance evacuation in East Africa
- Overseas evacuation/treatment overseas in India if treatment is unavailable locally and falls within the policy’s parameters.
- If a member has a medical emergency, they will utilize the service providers indicated for their region of residency.
The Minet Kenya insurance broker response team will accept requests and handle the evacuation process.
–> Last expense benefits:
The Last Expense cover is a benefit payable to the principle member’s next of kin in the event of the principal member’s death to assist with funeral expenditures.
It is due within 48 hours by mobile money transfer, providing Minet has all the required details.
The benefit is Kshs 100,000 for all employment categories.
To gain access, you must send Minet Kenya an email telling them of the death. Additionally, you must include a burial permission and a letter from the TSC.
The email must also contain:
- Number of the deceased TSC
- Date of passing
- Name and relationship of next of kin (spouse and children)
- Next of kin’s identification number
- The mobile phone number of the next of kin
–> Benefits for group life:
The Group Life insurance is payable to the deceased’s family to assist them in reconstructing their lives following the loss of the primary member.
The benefit increases with time across employment groups and is only applicable following the principal member’s passing.
To get the group life insurance benefit, you must provide the following information to Minet Kenya:
- The decedent’s
- Certificate of decedent’s death
- Permission to bury
- Vorlage de l’original or d’une copie de la carte d’identité du défunt
- Name of the bank, its branch, the name and number of the account
MINET INSURANCE FOR TEACHERS’ CONTACTS
If you require additional information or assistance with the AON Minet TSC medical plan, you can reach them at the following numbers:
Call center emergency line: 1528 from any mobile network (Safaricom or Airtel)
Call center general lines: 0719-044-799/0719-044-999/0703-604-000
Daily emergence of infectious diseases and other medical issues necessitates acquiring medical coverage.