The medical scheme covers life, funeral as well as both inpatient and outpatient charges. Photo/FILE
By JOHN NGIRACHU jngirachu@ke.nationmedia.com
Posted Thursday, January 5 2012 at 22:30
Posted Thursday, January 5 2012 at 22:30
Some 220,000 civil servants are to benefit from a new insurance scheme that covers life, funeral expenses and hospital charges.
The details of the scheme, to be administered by the National Hospital Insurance Fund, were released on Thursday.
The insurance covers treatment in public, mission and selected private hospitals, Public Service minister Dalmas Otieno said during its launch in Nairobi.
The scheme covers government employees, their spouses and three children under the age of 18, with a provision for the children to enjoy the scheme if they are in college up to the age of 25.
The scheme includes members of the disciplined forces, but excludes teachers who are working on their own package with NHIF.
It also provides for a graduated life insurance, where the families of the deceased employees will receive a lumpsum if they die, and a provision to cater for the burial expenses.
For instance, the family of a civil servant between Job Groups A and G — messengers, cleaners and clerks — will receive Sh200,000 in case of death and Sh40,000 in burial expenses.
Those between Job Groups R and T — permanent secretaries, directors and their deputies — will have Sh500,000 handed over to the families and burial expenses to the tune of Sh100,000.
All civil servants under the scheme will be required to go for an annual medical checkup, the intention being to detect illnesses early and start treatment to avoid the attendant expenses.
Those in Job Groups A to M will only seek treatment at prescribed hospitals, but they will also be allowed to go there as many times as necessary.
Those in subsequent groups would have limits starting at Sh80,000 but they can seek treatment at any of the private hospitals accredited by the NHIF.
Ensure it works
The Union of Kenya Civil Servants is in agreement with the insurance scheme, which took effect on January 1, with chairman Tom Odege saying it is now up to the NHIF to ensure it works effectively.
Mr Odege asked the NHIF to come up with a proper method to ensure feedback from the civil servants to guide the improvement of the scheme.
“Civil servants are dying of treatable conditions,” said Mr Odege.
For the first time, NHIF will foot bills for both in-patent and out-patient treatment.
Mr Otieno said the government had asked private insurers to tender for the most comprehensive insurance scheme for civil servants to date, but they had demanded too many limitations and offered too little.
“I tried the private sector and their conditions were too many and I therefore told them, as a professional colleague, ‘I will not give it to you because you’re not giving me what the people deserve,’” said Mr Otieno.
He said the private insurers could also not meet all the conditions the government had put in place due to “the size and geographical spread of the clientele.”
Teachers and employees of parastatals, the judiciary, parliament and universities are not covered by the new scheme.
The more than 240,000 teachers have been, through their unions, negotiating for a different scheme likely to be agreed on by the end of the month.
Under their scheme, the teachers would forfeit half their medical allowances, which the NHIF would add to their mandatory Sh320 monthly contributions.
They initially rejected the scheme on the basis that it was more expensive yet not as helpful as the system where the NHIF paid for inpatient treatment only
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