Teachers’ Healthcare Crisis: Unpaid Minet Insurance cover Leave Many Stranded
Teachers are facing challenges accessing medical services under the Minet Insurance cover.
Many teachers, who expected seamless treatment for themselves and their dependents, are being told to pay cash for services due to unresolved financial and technical issues with Minet.
Instances have been reported where preauthorization for treatment was not approved, forcing teachers to use the National Hospital Insurance Cover (NHIF) and pay additional amounts for medication and services.
This issue is not new, as similar challenges with the Minet cover were reported previously, with teachers being turned away due to alleged nonpayment of capitation by the insurer.
The problem is linked to the National Treasury’s delay in releasing Sh17.6 billion allocated for the annual medical scheme.
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So far, only Sh5.1 billion has been disbursed for the first quarter of the 2023/2024 financial year, leaving Sh12.5 billion outstanding. This shortfall has resulted in 406,635 teachers and tutors being unable to access necessary healthcare services.
During a Senate Committee on Health session, representatives from the Teachers Service Commission (TSC), the Kenya National Union of Teachers (Knut), and the Kenya Union of Post Primary Education Teachers (Kuppet) criticized the Treasury for the delays.
Out of the Sh316.7 billion allocated to TSC in the current financial year, Sh17.6 billion was intended for medical cover for teachers.
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There are 800 medical and healthcare service providers in the 47 counties – comprising levels two to six, managed by the government, faith-based, and private companies – cleared to offer treatment to teachers in the country under the scheme.
Available documents show that initially, 416 health facilities had been cleared, but it currently stands at 829 hospitals.
A total of 71 public, county, and government referral hospitals were listed in the tender list, but the numbers have since risen to 146.
Mission and faith-based hospitals in the tender list were originally 29 but rose to 133, while privately managed facilities were 316 but have since risen to 550.
Under the medical cover, the benefiting teachers and their family members registered as dependents are entitled to outpatient, in-patient, dental, optical, maternity, psychiatric and counselling services, road and air evacuation, funeral benefits, international referrals, and travel allocation benefits.
The medical scheme covers teachers through Minet Brokers Limited, which subcontracts a consortium of eight other insurance companies to provide services across the 47 counties.
The three-year contract between TSC and Minet Broker Limited, running from December 1, 2022, to November 31, 2025, was awarded after a competitive bidding process.
It covers all teachers employed by TSC, one spouse, and four dependants up to 18 years, and up to 25 years for those in school or college.
The contract also provides up to Sh2 million for treatment in international hospitals and travel costs for the patient and one accompanying family member.
Teachers’ Healthcare Crisis: Unpaid Minet Insurance cover Leave Many Stranded
