Teachers to Get Expanded Medical Cover After Government Deal with KNUT

Teachers in Kenya will receive expanded medical cover after the government reached an agreement with the Kenya National Union of Teachers (KNUT), removing out-of-pocket charges and revising benefits under the Public Officers Medical Scheme Fund (POMSF).

The agreement follows weeks of tension over access to healthcare and comes shortly after a similar deal with the Kenya Union of Post-Primary Education Teachers (KUPPET). A central provision is the enforcement of a zero co-payment policy, allowing teachers to access treatment at accredited facilities without additional charges. 

The Social Health Authority (SHA) has also withdrawn the tariff-locking system that had limited access and created uncertainty in hospitals. Any future tariff controls will be introduced only after consultations with providers and union representatives.

The reforms address administrative delays as well. Payments under the Sh300,000 last expense benefit are set to begin on Wednesday, with 160 claims already processed. An ex gratia arrangement has been introduced to support teachers facing high medical costs, with applications reviewed by the Teachers Service Commission and settled by SHA. 

The scheme now includes overseas treatment, with hospitals in India, Turkey and Saudi Arabia contracted for specialised care. The first patient is expected to travel abroad immediately. Reproductive health services have also been expanded to include in vitro fertilisation at designated facilities, including Nairobi West Hospital.

Further measures focus on system improvements. SHA has a four-week deadline to complete tariff negotiations with more than 3,500 private and faith-based facilities nationwide. Once concluded, teachers will be able to access services without making upfront payments under a “walk-in, walk-out” model. 

Dispute resolution mechanisms have been strengthened through scheduled meetings between KNUT, SHA and the Teachers Service Commission, alongside the reactivation of county-level structures to address complaints locally. Transparency will be improved through regular publication of contracted facilities, while claims audits and quarterly reviews will support long-term sustainability.

Health Cabinet Secretary Aden Duale confirmed the changes in a joint statement with SHA Chief Executive Mercy Mwangangi and KNUT Secretary General Collins Oyuu, saying that payments for the last expense benefit will begin immediately and that the first overseas referral is already underway.