The Kenya Union of Post Primary Education Teachers (Kuppet) wants members to choose from several medical insurance providers instead of being locked to one.
Locking the teachers to AON Minet has been wrought with challenges for the last seven years, most of which have not been addressed despite hue and cry from beneficiaries and their family members, said Kuppet assistant national treasurer Ronald Tonui.
"We want the National Hospital Insurance Fund (NHIF), being a government body, to be appointed as an option to AON Minet or any other medical insurer that will be picked in a competitive process,” Mr Tonui said.
“NHIF only needs to enter into a memorandum of understanding with the Teachers Service Commission (TSC) to provide the service to teachers across the country.
“It cannot compete with the other private insurers in a tendering process since, like TSC, it is a government body.”
Speaking during the Kuppet Kericho branch annual general meeting held at Farhills hotel, Mr Tonui said AON Minet services were riddled with challenges, with frequent withdrawal of services by prequalified hospitals, forcing beneficiaries to pay for the services from their own pockets.
This meant teachers depleted their savings, with others forced to sell property, take emergency loans or hold fundraisers to pay for treatment.
While NHIF offers a comprehensive medical insurance package to some civil servants in Kenya, teachers get the services from AON Minet in a contract signed by the TSC.
Minet Kenya, the administrator of the teachers’ medical scheme under the TSC, has for years provided insurance for services at private and faith-based hospitals but recently started offering covers for public facilities, especially those managed by county governments.
“In the 47 counties, teachers have repeatedly raised very serious concerns over the services offered by AON Minet which we want addressed under a new contract, and, most importantly, there should be [several] providers for the teachers to choose from,” said Mr Tonui, a former Bomet Central MP.
“In fact, there should be a public participation process before a contract is signed by TSC on behalf of the teachers as the concerns raised by the users of the service should be captured and addressed beforehand.”
Mr Paul Maingi (Kuppet national organising secretary), Mr Henry Obwocha (secretary for secondary schools), Ms Mary Rotich (Kericho branch executive secretary), her Narok counterpart Charles Ngeno and Mr Paul Kimetto (Bomet) were among those who attended the meeting and pushed for improved medical services for teachers.
“We have had cases where it takes a long time to get pre-authorisation for treatment in hospitals and the insurer should address it as a matter of urgency so as to restore the teachers' confidence,” Ms Rotich said.
She said there was an urgent need for Minet Kenya to ensure that teachers have uninterrupted access to medical services in the pre-qualified hospitals countrywide even as the contractual issues with the TSC are being addressed.
Minet Kenya has incorporated more than 70 public health facilities in counties in an ongoing expansion programme aimed at taking on board all referral and sub-county hospitals to cater for its clients countrywide.
CEO Sammy Muthui recently said in Kericho that the number of public hospitals that provide medical services to teachers had risen to 370.
“Minet Kenya covers 1.2 million members, including 341,000 teachers and their dependents countrywide and we are expecting the numbers to rise in ,” Mr Muthui said.
The government has pledged to hire 116,000 more teachers in two years, with the first lot of 30,000 set to be recruited by the TSC in January next year.
Knut secretary-general Collins Oyuu has said the AON Minet provided a better deal for teachers than that offered by NHIF and should be retained.
“While it is true that AON Minet needs to improve in service delivery as demanded by our members, it is still the best deal for teachers and as a union we will rally behind it,” Mr Oyuu said during the Nyamira branch’s annual general meeting last month.
“The services offered by AON Minet are superior and it should be noted that it includes emergency air evacuation of members to referral hospitals and up to Sh2 million in the cost of treatment for complicated cases abroad,” Mr Oyuu said.
NHIF has had its fair share of challenges in providing medical services to civil servants and members of the public, with the government urging reforms in the insurer.
Some 660 hospitals recently threatened to sever links with NHIF over claims of mismatch in capitation rates and delay in signing contracts.
The Rural Private Hospitals Association and the Kenya Faith Based Health Services Consortium accused NHIF managers of failing to distribute the contracts for 2022-2024 for signing.
Cases of patients and NHIF being billed at the same time for services offered have also arisen in the past, with demands for the insurer to deal with the issue.
CEO Peter Kamunyo was recently engaged in a boardroom battle with the insurer’s chairman, Lewis Nguyai, over the cancellation of services offered by 17 hospitals over alleged fraud in the EduAfya in which the government covers secondary school students.
Dr Kamunyo has also repeatedly fended off claims that NHIF did not cover the costs of treating various ailments for subscribers when it should.