The Teachers Service Commission (TSC) announced that more than 400,000 teachers across the country will move to the Social Health Authority (SHA), which has replaced the existing Minet scheme, effective December 1, 2025.
Teachers will be enrolled in the Public Officers Medical Cover, a scheme popular with civil servants.
The decision follows a consultative meeting between TSC, the Kenya National Union of Teachers (KNUT), the Kenya Union of Post-Primary Education Teachers (KUPPET), and SHA officials, where the benefits of the new scheme were discussed.
Under the new program, teachers will have access to outpatient and inpatient services, as well as specialized care such as dental and optical services, annual check-ups, ambulance services for both road and air emergencies, and overseas treatment, among other benefits.
The scheme covers the principal member, their spouse, and up to five children or dependents.
Under the benefits, TSC outlined SHA medical tariffs, specifying the coverage limits for various services.
Full List of Medical Tariffs for TSC Teachers under SHA
Primary Health Care (PHC) and Outpatient Services
Under the PHC package, teachers can access routine outpatient consultations at a cost of Ksh 900 per beneficiary per year. Additionally, children under 18 years are eligible for optical services, with a maximum annual expenditure of Ksh 1,000.
Also Read: SHA Packages Teachers in Every Job Group Will Enjoy After TSC Shift from Minet
Inpatient and Maternity Care
For hospital admissions, the Social Health Insurance Fund (SHIF) will pay Ksh 2,240 to Ksh 4,480 per day, for up to 180 days per household annually.
Maternity services include Ksh 10,000 for normal delivery, Ksh 30,000 for Caesarean Sections (CS), and Ksh 6,000 for Anti-D serum.
Oncology and Renal Care
Under the SHA medical tariffs, oncology treatment is covered up to Ksh 400,000 per member per annum.
For chronic and specialized care, SHA will cover cancer and kidney treatments, including renal dialysis, at a rate of Ksh 10,650 per session.
The authority will cover the cost of peritoneal dialysis at Ksh 85,200 per month, pre-transplant evaluation up to Ksh 150,000 per household, and related surgeries.
Recipient surgery is covered up to Ksh 700,000, while donor nephrectomy procedures are reimbursed at Ksh 168,000.
Under the tariffs, Post-renal replacement therapy is also supported, with a limit of Ksh 200,000 per household.
Medical Imaging
At the same time, teachers will have access to specialized diagnostic services, including SHA Magnetic Resonance Imaging (MRI), for which SHA will cover up to Ksh 11,000 per household annually.
CT scans are covered up to Ksh 6,900, while CT angiograms cost Ksh 8,000 per scan. Mammography is covered at Ksh 3,000, and fluoroscopy at Ksh 4,000.
Heart examinations, such as echocardiograms (ECHO), are reimbursed at Ksh 3,500, and specialized ultrasounds (Dopplers) are reimbursed up to Ksh 5,000.
Electroencephalograms (EEGs) are covered at Ksh 8,000 for children and Ksh 5,000 for adults.
Each household is eligible for up to two imaging sessions per year.
Also Read: Inside New SHA Oncology Package as Govt Moves to Raise Cancer Cover
Under the outpatient package, SHA covers essential diagnostic laboratory tests for chronic conditions once per person per year.
Teachers and their dependents can access testing for diabetes at Ksh 4,300, sickle cell at Ksh 6,800, hypertension at Ksh 2,850, and COPD or asthma at Ksh 700.
Surgery and Emergency Tariffs
In addition, the scheme provides surgical coverage, with minor procedures reimbursed up to Ksh 145,600, major surgeries reimbursed up to Ksh 280,000, and specialized operations reimbursed up to Ksh 1,120,000.
SHA’s package also includes coverage for overseas treatment up to Ksh 500,000, as well as drug and substance abuse rehabilitation up to Ksh 67,200.
Additional benefits under the Emergency and Critical Care Fund (ECCF) package include coverage for Intensive Care Unit (ICU) and High Dependency Unit (HDU), oncology support, and accident and emergency services.
ICU and HDU admissions are reimbursed at Ksh 28,000 per day, for up to 12 days.
Oncology treatment under this package is covered up to Ksh 150,000 per beneficiary, while accident and emergency services are supported up to Ksh 107,633.
For intra-metro travel within a 25 km radius, ambulance services cost Ksh 4,500, with an additional Ksh 75 per km for distances beyond 25 km.
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