By Augustine Oduor

Teachers have negotiated a medical scheme with the National Hospital Insurance Fund (NHIF).

Under the new health scheme, all teachers who subscribe to the Kenya National Union of Teachers (Knut) will remit half their medical allowances to benefit from the services.
Knut has a membership of 250,000 teachers. Currently, teachers medical allowance range from about Sh750 to Sh4,200 per month.

The Government scheme also proposed to cover only the principal member, a spouse and two children.

But once the new negotiated health scheme is implemented, members will be covered together with their spouses and all their children.

Members will however be allowed to add spouses but at an additional premium of Sh210 per month.

A document seen by The Standard, The Proposed Teachers Medical Scheme, indicates in-patient cover will include hospital bed charges, doctors’ bills, anaesthetic fees, theatre fees, pharmacy and investigations reasonably incurred by an insured member.

"This will include dental and optical resulting from illness or accident.

The limit for in-patient cover is 180 hospitalisation days per year," read the document.

The outpatient cover will include doctor’s consultation, all the laboratory tests, imaging tests, prescriptions and dressing, all out patient procedures and pharmacy.

Out patient facilities shall however be choice based with an option of changing after every three months except where a member is transferred in cases of emergency.

Patients will only be required to pay out patient fee of Sh200 to private and mission hospitals and Sh100 to government hospitals.

The new scheme notes that the dental and optical cover for out patient will be available on referral basis and will be shared per family at a fee of up to Sh10,000 annually.

Interestingly, dependent children of up to 23 years will be covered under the scheme as long as they reside with their parents and are enrolled full-time in a recognised post-secondary institution.

The scheme also offers a post-retirement package to teachers that will also cover their spouses with one compulsory annual check-up.

The teachers will part with Sh767 for the lowest-paid, to Sh4,412 for the highest paid employee, if the proposal is approved.

Knut has locked horns with the government over the new Public Service Medical Scheme.

The union maintained that it would not allow its members medical allowances to be chopped and awarded to a group of insurers unknown to them.

Public Service minister Dalmas Otieno and his Permanent Secretary Titus Ndambuki are on record saying that teachers were free to join the scheme.