If
you are polygamous then you are not going to reap the maximum benefits of the
TSC cover. If you have more than four children then you will also not reap the
maximum benefits. If you are single with no children then you will
also not
enjoy the maximum benefits.
This
an objective review and analysis of the Kenya teachers medical cover/ scheme. The
polygamous, the bachelors and those with more than 4 children will benefit
partially from the Kenya teachers medical cover/ scheme.
The
Teachers Service Commission released a circular about the new medical scheme
whereby all teachers will not earn their medical allowance. The circular
contains some grammatical errors that makes it look like it was written in
haste.
Eligibility
In
spite of the fact that all teachers will contribute towards the scheme, not all
teachers are eligible to benefit from the cover. Let’s look at the eligibility requirements
in detail.
- One legal spouse: Married teachers
are only allowed to present one wife during the application. This will leave
out teachers who are polygamous.
- Four children only: The scheme covers
only four children. Therefore, teachers with more than four children will not
be able to secure a cover for their other children.
- Bachelors: Teachers who are
not married will contribute the same amount to the scheme just like their
married counterparts. Even if the unmarried teachers would wish to cover some children
then the children must either be biological or legally adopted. Therefore, you
cannot use the scheme to cover children of your relative or friend unless you
have legally adopted them.
Application process
How
one would apply for the teachers medical cover draws some questions. The applications
will open on July 1st 2015. One would expect that the application would
be made through the TSC website. As per the circular, the applications would be
made through an SMS service. The SMS number is yet to be released. The cost of
using the SMS service for application/ registration is yet to be released.
Ambiguous sections
There
are several areas that are not clear in the medical cover. For example, the
medical scheme for a teacher in job group K provides covers as shown below;
- Inpatient:
KShs. 500,000.
- Optical:
KShs. 15,000.
- Dental:
KShs. 15,000.
- Maternity:
KShs. 75,000.
- Life
cover: KShs. 400,000
The
circular is silent on the frequency of payment for the above medical services.
For example, if a teacher sees an optician and exhausts the KShs. 15,000 cover would
the teacher be entitled for another cover the next time he/ she visits the optician?
Terms and
Conditions
Some
crucial terms and conditions of the cover have not been spelt out and yet the
program would come in force in July 2015. One such term is on the timeframe of
the cover. Are the covers renewed annually or monthly?
The
claim application process has not been stated. How will a teacher claim for
payments? For example, for the life cover, how will the next of keen apply for
compensation upon the death of a teacher? How long will it take for the
payments to be made?