, NAIROBI, Kenya, Jan 31 – More than 255,000 teachers will benefit from a comprehensive medical scheme administered by the National Health Insurance Fund (NHIF).
The teachers become the second group after public servants to benefit from limitless outpatient and inpatient cover from the health scheme.
“We in government; we in NHIF must now invest heavily and adequately to improve our health facilities so that when these teachers go for health care they will find facilities that can deliver. Part of the improvement of these health facilities is not just equipment, doctors and nurses; part of the improvement is also management,” Medical Services Minister Anyang’ Nyong’o said.
In addition, the teachers will get a post-retirement package where members will access comprehensive medical cover for the principal member and one declared spouse after attaining the mandatory retirement age or retirement on medical grounds.
However, the post retirement comprehensive medical cover will only be accessed in government and mission facilities approved by NHIF and it will include a compulsory annual check-up.
“We will not be in a position to encourage referral hospitals to handle outpatient cases and in a very near future, NHIF will be allowing health providers to decide whether they are going to give outpatient services or inpatient services and the two may not be done at the same facility,” said NHIF Chief Executive Officer Richard Kerich.
The scheme will also include optical and dental cover of Sh10,000 each per family and a maternity cover.
Under reproductive health services there will be male circumcision, tubal ligation, vasectomy and family planning services.
However, the cover will exclude expenses incurred by a member as a result of cosmetic or beauty treatment and or surgery, except where certified as a necessary part of treatment, contingency arising whilst the member is outside the territorial limits of Kenya and expenses related to an accident or illness which may have occurred prior.
Other exclusions are fertility treatment relating to hormonal replacement and in vitro fertilisation as well as vaccines other than those of the Kenya Expanded Programme on Immunisation (KEPI).
“The list of accredited facilities that we have in NHIF will be able to suffice the tastes and demands that teachers have and we can assure you that this is a sustainable scheme,” NHIF Planning and Strategy Manager Chacha Marwa said.
It is estimated that 75 percent of Kenyans seek outpatient care while only 25 percent go for inpatient treatment.
The negotiations between the Kenya National Union of Teachers (KNUT) and NHIF began in November last year after the teachers rejected two previous government proposals to forfeit all their medical allowance in order to benefit from a comprehensive cover.
“We are here to assure you that we own this program, we want our teachers to get proper medical care because it is very expensive to finance treatment,” said KNUT Secretary General David Okuta.
The contract is for a period of four months from March 1, 2012 to June 30, 2012 both days inclusive and after that on an annual basis from July 1, 2012 to June 30, 2013 renewable.