Civil Servants across the country have gotten reprieve following the extension of the Comprehensive Medical Insurance Scheme for Civil Servants (CMIS).
In a notice dated October 9, the Public Service Ministry indicated that the move is to ensure uninterrupted health services for government employees.
According to the Ministry, the contract for the provision of medical cover, provided by the National Health Insurance Fund (NHIF), began on July 1, 2023, and was due to end on June 30, 2024.
However, to accommodate necessary adjustments, the contract was first extended by three months, running through September 30, 2024.
“The Contract was executed for a period of one (1) year with effect from 1st July 2023 to 30th June 2024 and was extended for three (3) months up to 30th September 2024.”
“The Scheme covers National Government employees in Ministries and State Departments, officers deemed seconded to the County Governments and staff of the National Youth Service (NYS),” a statement from NHIF read in part.
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SHIF on the Civil Servants Comprehensive Cover
On the other hand, to ensure that beneficiaries do not face gaps in their healthcare coverage, the scheme has extended the contract again to November 21, 2024.
“Following the lapse of the extension of the Civil Servants Medical Insurance Scheme on 30th September 2024, the State Department for Public Service in consultation with Social Health Authority (SHA) has agreed to extend the contract up to 21st November 2024.”
“This will enable seamless transition and effective service delivery to the Scheme beneficiaries,” explained the statement.
Consequently, the Social Health Authority (SHA) has informed all the contracted health facilities of the exception, as the rest of Kenyans begin using the newly launched cover.
However, the civil servants will be expected to use SHA after November 21.
“SHA has undertaken to inform all the contracted service providers (health facilities) to ensure that all beneficiaries of the Scheme access the medical cover with immediate effect as required.”
“In addition, the State Department for Public Service has undertaken to ensure seamless transition upon the expiry of this extension,” it was explained further.
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How Much Money is Provided for Medical Services Under the Comprehensive Cover
The medical insurance scheme offers different limits depending on the employee’s job grade and group.
The benefits are categorized into different sections: in-patient, out-patient, dental/maternity, optical, and charges within the in-patient limit.
CSG 17-13 (Job Group A-G, H) receive in-patient coverage of Ksh700,000, out-patient limit of Ksh70,000, up to Ksh50,000 for dental or maternity expenses and Ksh40,000 for optical care. An additional amount of Ksh100,000 is charged within the in-patient limit.
Moreover, CSG 11, 10 (Job Group JG 3, K) receive the same in-patient, out-patient, dental/maternity, and optical benefits as the previous groups. However, the amount charged within the in-patient limit increases to Ksh150,000.
CSG 7 (Job Group P) enjoys in-patient coverage of Ksh1,750,000, with Ksh225,000 for out-patient services, Ksh50,000 for dental/maternity, and Ksh50,000 for optical services. An extra Ksh40,000 is charged within the in-patient limit.
CSG 6-4 (Job Group Q, R, S, T), the Senior civil servants in these grades receive the highest coverage, with in-patient limits of Ksh2,500,000. Out-patient coverage is Ksh350,000, with dental/maternity at Ksh50,000 and optical at Ksh40,000. An additional amount of Ksh200,000 is charged within the in-patient limit.
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