Teachers Blame TSC for Failing to Remit NHIF Deductions
Some teachers have vented their frustrations by criticizing the Teachers Service Commission (TSC) after it emerged that the commission has not been remitting funds despite making monthly deductions on the salaries of teachers.
Teachers and other TSC employees have two insurance covers. These insurance covers are AON Minet, their primary health insurance cover, and the National Hospital Insurance Fund (NHIF). They pay these through monthly deductions on their payslips.
For teachers, NHIF cover is paid via an amount the NHIF sees fit while AON Minet is covered via the teachers’ medical allowance.
Unfortunately, teachers prefer to use their NHIF cover for treatment or seek treatment for their dependants.
Some teachers were not allowed to use the NHIF insurance cover by hospitals as their accounts were in arrears.
On the issue, TSC has not responded and teachers depending on NHIF to access treatment in hospitals may have to use money from their pockets instead.
Teachers can use either AON Minet or NHIF insurance covers. However, NHIF is preferred in most cases when a TSC teacher’s benefit limit is reached under AON Minet.
TSC defends AON Minet Cover
At the beginning of the last month, TSC defended AON Minet medical scheme for its employees, saying that it is the best around of its kind in the region. Allegations of humiliations by service providers were termed baseless.
TSC’s chief executive Nancy Macharia claims of teachers being humiliated in service provided by the medical scheme are not true.
The Commission’s chief also ruled out claims of there being a daily limit on outpatient services.
“The only capping for the outpatient component is the annual allocation for members,” Dr. Nancy Macharia addressed the Senate Committee on Education in November. The Senate Committee on Education is chaired by Dr. Alice Milgo.
She revealed that analysis done on the benefits shows the teachers’ medical scheme is better than what most public workers enjoy in Kenya and the Region at large.
Dr. Macharia said the scheme papers over a variety of services and the annual allocations for every component are enough to cover the principal member and five dependants.
“it is one of the most comprehensive schemes,” added Dr. Nancy.
Besides, the Commission boss said that the scheme provides accessible health services to teachers in all the 47 counties.
The TSC Chief was responding to Senator Rose Nyamunga’s statement who said that teachers are being humiliated under the AON Minet Insurance Scheme.
Ms. Nyamunga revealed that teachers had complained that they are being restricted on where they should seek medical treatment.
She said some of the hospitals are poorly equipped and lacked staff that is qualified to do the job.
“Delays in approval sometimes take up to one month,” Ms. Nyamunga added.
Other challenges the teachers and their dependants face include limited access due to the rigid operating hours at some hospitals and dental services that are limited. AON Minet only covers tooth extraction.
Senator Nyamunga also revealed that teachers face a hard time lodging claims with AON Minet.
However, TSC in defense said that the scheme has more than 500 providers who offer a variety of services, including inpatient, outpatient, optical, dental, maternity, medical emergency evacuation, and specialized referrals locally and internationally. Group excess of loss cover, last expense cover, and group life cover is also among the services provided by the medical scheme.
The medical scheme covers more than 1,036,000 lives. Of these, 332,000 registered teachers and their respective dependants who can access any hospital on the list of service, revealed the commission.
“Based on the feedback at consultative forums on the administration of the scheme and monthly meetings, 32 more medical service providers ranging from private facilities, faith-based institutions, and county referral hospitals were added to the list of medical providers,” Dr. Macharia said.
Dr. Nancy Macharia also said that TSC has ensured the National Hospital Fund (NHIF) has credited hospitals. She also dispelled the claim that some of the hospitals lack qualified personnel saying that it was “completely untrue”.
“Specific details are required in order to deal with such a sensitive issue,” she said.
The Kenya National Union of Teachers (KNUT) and the Kenya Union of Post-Primary Education Teachers (KUPPET) had implored the government to increase funds and help in improving the medical scheme.
KUPPET Secretary General Akelo Misori urged teachers not to shy away from informing the Commission in case they faced problems while using the medical scheme.
“It is important to know the hospitals that lack facilities and qualified workers. This will help in raising the matter with the service providers,” said Mr. Misori.
KNUT Secretary – General Wilson Sossion said that teachers contribute to NHIF in addition to AON Minet.
“To be fair to the service providers, we request to be given specifics that our representatives can follow up and provide feedback,” he said.
Mr. Sossion said that there could be some hospitals offering poor services to sabotage the scheme.
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