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Updated AON Minet Medical-Healthcare Cover For Teachers And Their Dependants And Benefits

Here are the latest updated details for the Teachers Service Commission concerning AON Minet Medical-Healthcare cover for teachers and their dependants, beneficiaries, and the group life insurance (including last expense).

TSC contracted the AON Minet Kenya Insurance Brokers to provide Medical cover for all teachers and their dependants from the 1st of November, 2019.

Updated AON Minet Membership Eligibility

The following are the conditions necessary for one to be an eligible member under the AON Minet insurance cover:

  1. legible for teachers employed by teacher’s service commission aging from 18 to 65 years old
  2. The AON cover insures the legal spouse of a teacher employed under TSC
  3. A maximum of 4 biological children for the AON registered member are beneficiaries of the AON cover
  4. Children with disabilities who are beneficiaries for AON cover their age is considered.i.e no age limit.

The AON minute insurance cover contains the insured member and five beneficiaries.

AON MINET MEDICAL COVER CHARGES

Charges of Kenyan shillings (50) per person for outpatient, dental and optical doctors consultation services are paid on visit.

AON cover considers maternity and other related conditions that does not require the doctors’ consultation

AON MINET BENEFITS STRUCTURE

The AON minute benefit structure benefits the following grades as indicated below;

Updated AON Minet Benefit Structure
Updated AON Minet Benefit Structure.
Grade
Outpatient
Inpatient
Maternity
Optical
Dental
B5 100,000 750 000 100,000 45,000 35,000
C1
100,000 750,000 100,000 45,000 35,000
C2 100,000 750,000 100,000 45,000 35,000
C3 100,000 850,000 100,000 45,000 35,000
C4 150,000  1,000,000 100,000 45,000 35,000
C5 175,000  1,250,000 100,000 45,000 35,000
D1
225,000  1,500,000 150,000 45,000 35,000
D2 250,000 1, 800,000 150,000 45,000 35,000
D3 275,000  2,000,000 200,000 45,000 35,000
D4 375,000  2,500,000 200,000 45,000 35,000
D5 375,000  2,500,000 200,000 45,000 35,000

Grade
Group Life
Last
Expense
Air Evacuation Air fixing and Helicopter At two (2) per family Per annum
Int.
Referral
Int. Travel
B5 450,000 200,000  1,000,000 200,000
C1
450,000 200,000  1,000,000 200,000
C2 450,000 200,000  1,000,000 200,000
C3  550,000 200,000 1,000,000 200,000
C4 550,000 200,000 1,000,000 200,000
C5 650,000 200,000 1,000,000 200,000
D1
650,000 300,00 1,000,000 200,000
D2  1,050,000 400,00 1,000,000 200,000
D3  1,050,000 500,000 1,000,000 200,000
D4  1,050,000 600,000 1,000,000 200,000
D5  1,050,000 600,000 1,000,000 200,000

AON MINET COVER RANGE

The patient is covered in the following areas; outpatient, inpatient, dental, optical, maternity conditions, and any medical evacuation.

a) Inpatient Benefits

It deals with admissions and staying in the hospital for persons insured to receive medical services related to the conditions stated above. The impatient benefits as follows;

Hospital accommodation for accompanying parent and [or guardian for hospitalized children below seven (7) years

  • Bed entitlement: Job Group B5 to D2 — standard ward bed and Job Group D3 to D5 — Standard Private Wing

Doctor’s (Physician, Surgeon Anesthetists) Fee.

  • Theatre and critical care charges (ICU).
  • Internal surgical dressings, drugs, and medicines
  • Laboratory tests.
  • X-ray, Ultrasound, ECG and Computerized Tomography, MRI Scans
  • Radiotherapy and Chemotherapy
  • In-Patient Physiotherapy, Hydrotherapy
  • Occupational therapy
  • Hospital accommodation for accompanying parent and [or guardian for hospitalized children below seven (7) years.
  • In-Patient Physiotherapy, Hydrotherapy
  • Medical education and wellness program for members with pre-existing and chronic conditions
  • Medical Emergency Road evacuation services leading to admission
  • Congenital defects/genetic disorders

Post- Hospitalization benefit of up to two (2) weeks for other sicknesses and six

(6) Weeks for accident cases after discharge.

  • Daycare Surgery for minor surgical treatment that may not require admission In-vitro Fertilization (IVF)
  • Renal dialysis Cancer Treatment and related procedures and tests

b) Outpatient

A treatment that does not require one to stay at the hospital. Areas for outpatient treatment:

  • Regular consultations by outpatients
  • Prescribed Diagnostic Laboratory and Radiology services (X-ray, ultrasound, MRI, and CT Scans).
  • Prescribed physiotherapy
  • Giving a prescription of drugs and mode of dressing.
  • Directing outpatients to different specialist for proper guidance.
  • HIV/AIDS related conditions and prescribed ARV’s to the full cover limit per family per annum.
  • Helping outpatients to understand newly diagnosed with chronic conditions
  • Existence of chronic diseases e.g. chronic diseases( cancer)
  • Rehabilitation service as per limits
  • Ensures that prevention care are well implemented i.e. mobile clinics, camps to address lifestyle issues and wellness of the outpatients
  • Prescribed preventive and curative drugs/care
  • Prescribed Diagnostic Laboratory and Radiology services (X-ray, ultrasound, MRI, and CT Scans).
  • Pap smear for ladies and PSA for men- (for principal members only)
  • Medical Emergency for Road ambulance evacuation service.
  • Members are not restricted on where to receive medical services.
  • Members are free to visit any medical service within the country to receive medical services.

c) Maternity

AON cover insures the following maternal issues:

  • Delivery/ Doctors Fees
  • Postnatal care up to six (6) weeks post-delivery
  • Routine Immunizations (KEPI) and Baby-Friendly Vaccines
  • Genital conditions
  • Insures conditions dealing with normal delivery, Emergencies resulting from the caesarian section, and elective CS
  • Routine Antenatal check-up

The maternity benefit is available to principal members and/or their spouses only.

d) Dental

The cover insures persons with the following dental problems:

  • Dental Consultation and Anesthetist’s fees
  • Tooth Extraction accompanied by medical conditions and prescription by a dentist
  • Dental deformation resulting from accidents or injuries
  • Surgeries resulting from dental deformation

Dental X-rays and Root canal treatment.

e) Optical

It deals with optical problems such as:

  • Ophthalmic ultrasound if prescribed by the Ophthalmologist
  • Deals with the issuance of Lenses and frames are issued once a year unless under a medical condition and either prescribed by an ophthalmologist.
  • Prescription for eye treatment and eye lenses

f) Insures Medical Emergency Road and Air Evacuation

Insures emergency transportation and easy transfer of sick or injured person or dependents to a facility with appropriate care using road ambulance, fix-wing, and helicopter services within East Africa (Kenya, Uganda, Rwanda, and Tanzania). Air evacuation is limited to two (2) per family within a policy period.

g) AON Minet cover insures International Travel and Referral Allocations

It insures a member referred overseas for quality specialized treatment than it is locally, pays the air ticket and their accommodation. This should be accompanied by a medical report.

Specialized treatment outside the country are approved by the Director of Medical Services in the Ministry of Health

h)  AON Counselling Psychiatric and Services

AON minet cover provides psycho-social support programs for employees for conditions such as dependency, stress, -traumatic counseling relationship discomforts, anxiety, and depression, parental guidance financial distress, etc. These services are not limited.

  • AON minet promotes tele-counseling services through Tele-counseling center.
  • Online counselling services in many instances
  • Refers members to face-to-face counselling sessions.

AON MINET MEDICAL COVER EXCLUSIONS

  • It excludes problems resulting due to active participation in war, riots, and terrorisms
  • Difficulties resulting from the use of cosmetics
  • Cases dealing with massage unless were approved as medically correct
  • Nutritional supplements unless prescribed by a medical doctor as a treatment of a given deficiency
  • It doesn’t cover dependents with maternity difficulties
  • Whenever drugs that are not prescribed are used.
  • Treatment other than by a registered medical practitioner
  • Payment of sh.50 by outpatients, dental and optical patients.
  • Reimbursement of costs incurred outside the appointed panel of providers unless for emergency cases, accident cases and
  • Private vaccines and travel vaccines
  • Alcohol-related rehabilitation child dependents
  • Cost of lenses and frames not prescribed by an Ophthalmology
  • Excludes spectacles replaced in the same year by a cover
  • Does not issue antiglare and/ Photochromatic lenses unless prescribed by a doctor
  • It excludes cosmetic dental care unless resulting from accidents like caps, bridges, teeth whitening, and cleaning.
  • Excludes infertility resulting from family planning methods
  • Replacement or repair of old dentures bridges and plates unless damage to dentures, bridges, and plates becomes necessary as a result of an accident
  • Any treatment covered with NHIF

AON MINET COVER BENEFITS ON GROUP LIFE AND LAST EXPENSE (FUNERAL)

a) Funeral Benefits

The cover provides a certain amount set according to grades and is paid only in the event of death of the principal member to support in arising funeral expenses.

b) Group Life Benefit

A certain amount to be paid to the principal member under the AON medical scheme as shown in the table given above.

AON MINET INSURANCE COVER SERVICE PROVIDERS

The AON Minet Service providers either by direct access or by referrals is enclosed.

Members may also view a full list of medical service providers through: –

  1. TSC and MINET Kenya websites
  2. use of Mobile phone USSD code — dial *340#

The AON MINET COVER insures the teachers and dependents who have received services only from appointed panel of service providers .There is no refund of funds incurred outside the appointed panel on service providers except on emergence issues,

How to Upload Membership Documents for AON Minet Insurance Cover for Teachers

Below is the video showing the procedure  on how a member can upload the  required membership documents through the online AON minet portal.

CONTACTS FOR ENQUIRIES

Members may direct their inquiries to Minet Kenya through:

  • Tel: 0730 604000
  • Hotline: 1 528
  • Email: mmc.customerservice@minet.co.ke
  • Website: www.minet.com/kenya
  • Twitter: Minet_Kenya
  • Facebook: MinetKe
  • Telegram: Teachers’ Medical Scheme

NB; Teachers are advised not to involve them in fraud activities that may hinder them, from being members of the medical cover

This circular is very important because it analyses the provisions of the AON medical scheme to all teachers.


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