Both teachers and other civil servants are now covered by the Public Officers Medical Scheme Fund (POMSF), managed by the Social Health Authority (SHA), ushering in a new era of medical coverage for public servants.
However, after the transition from Minet to SHA on December 1, 2025, teachers have emerged with a significantly superior package compared to other civil servants.
The new scheme offers expanded benefits, faster approvals, and a wider hospital network of over 9,000 facilities nationwide, compared to just 816 under Minet, which were also associated with delays and limited hospital access.
A Major Upgrade for Teachers
The most striking difference between the two packages is the financial limits offered by SHA.
Teachers now enjoy inpatient limits ranging from Ksh750,000 to Ksh4,500,000, depending on job group.
In contrast, other civil servants under POMSF receive KSh700,000 to KSh2,500,000.
Outpatient benefits for teachers start at Ksh100,000, rising to Ksh350,000, while civil servants’ outpatient cover ranges from Ksh70,000 to Ksh350,000.
Maternity benefits also favor teachers, with limits of Ksh 100,000 to 300,000, compared to Ksh 100,000 to 200,000 for other public officers.
Optical cover for teachers stands at Ksh60,000, significantly higher than the Ksh40,000 allocated to civil servants.
Dental benefits are slightly lower for teachers at Ksh 45,000, versus Ksh 50,000 for other public servants.
Teachers enjoy a last expense benefit of Ksh 300,000, a critical cushion for families during bereavement, while Civil servants typically receive Ksh 100,000 to Ksh 200,000 under the same provision.
Both packages include group life cover, but teachers’ negotiated terms offer higher payouts and faster processing.
Specialized Care and Technology Integration Under SHA
The teachers’ scheme incorporates telemedicine, automated pre-authorization within five minutes, and enhanced coverage for specialized treatments.
Oncology care is capped at Ksh 400,000, while imaging services, such as MRI, are capped at Ksh 11,000.
Civil servants under POMSF also have access to specialized care, but their access remains limited, and the rollout of telemedicine is less aggressive.
Teachers can enroll one spouse and up to five children, with coverage extending to 21 years—or 25 for those in full-time education.
Persons with disabilities registered with NCPWD are also included.
Civil servants have similar dependent provisions, but teachers’ package offers clearer guidelines and broader inclusivity.
Why the Difference
The difference between the two packages comes from historical negotiations and union influence.
Teachers’ unions pushed for a premium package, citing the sector’s size and unique needs.
With over 400,000 members, TSC leveraged its bargaining power to secure better terms.
Civil servants, though covered under the same SHA framework, received standardized benefits aligned with job group classifications.
The government aims to harmonize benefits across the public service, but differences persist.
Teachers’ superior package sets a benchmark that other public servants may seek to match, potentially triggering future negotiations.
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For now, educators enjoy a health plan comparable to corporate schemes, while civil servants settle for a solid but less generous package.
Impact on Service Delivery
Enhanced health benefits for teachers are expected to improve classroom performance by reducing absenteeism linked to medical challenges.
Access to a wider hospital network and faster approvals means educators can seek timely treatment, minimizing disruptions in learning.
Telemedicine and specialized care further ensure teachers remain healthy and productive, supporting curriculum delivery and exam preparation.
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For civil servants, standardized benefits provide essential coverage but may not fully address sector-specific demands, potentially affecting morale and efficiency.
Some individuals argue that differences in health packages could influence retention and job satisfaction, making comprehensive healthcare a critical factor in sustaining public service performance.
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