*AON Minet Switches To Biometric Verification, Lists New Service Providers per county for the year 2022. Check out the new additions*

Date:

Share post:

The teachers medical insurance provider has issued new terms for its teachers and dependants seeking medical services in various facilities begining 1st February 2022.

Join Us On Telegram
ADVERTISEMENT
CONTINUE READING BELOW

 

Join Us On Telegram
ADVERTISEMENT
CONTINUE READING BELOW

Among the new rules, AON Minet, which covers more than 300,000 teachers on Teachers Service Commission (TSC) payroll, will no longer use code verification in all facilities it listed.

 

ADVERTISEMENT
CONTINUE READING BELOW

In the new changes Minet will use biometric verification for teachers and their dependants in its medical service providers to curb unethical practices.

 

Join Us On Telegram
ADVERTISEMENT
CONTINUE READING BELOW

Minet also says referrals will be through TSC offices, Bliss hospitals or referral and teaching hospitals if one needs a specialized check up.

 

ADVERTISEMENT
CONTINUE READING BELOW

Yesterday the insurance sent short messaging services to teachers informing them of the changes it plans to roll out.

“Dear Mwalimu, expect changes to the panel of service providers from 1st Feb 2022. Dial *202*06# or visit the link https://bit.ly/TMServiceProviders to view the updated list for year 2022,” reads SMS sent to teachers.

ADVERTISEMENT
CONTINUE READING BELOW

 

The medical cover cost TSC Sh9 billion in 2019, Sh12 billion in 2020 and Sh14 billion last year.

ADVERTISEMENT
CONTINUE READING BELOW

 

Two months ago AON Minet blacklisted at least 20 hospitals for engaging in unethical practices, exposing dubious ways the health facilities use to defraud the multibillion-shilling teachers’ medical scheme.

 

Teachers and their dependents also came into sharp focus as it was revealed that they collude with hospitals to fleece the TSC of the insurance cover.

 

The vices ranged from making fake claims, overcharging members, listing fake ailments to impersonation.

 

A brief by Minet Kenya, the firm contracted by TSC to manage the scheme, listed at least 10 ways that teachers, their dependents and hospitals use to fleece the scheme.

 

They include impersonation, billing for services not rendered, billing for conditions not covered under the scheme, double billing of medical expenses and falsification of the length of stay of patients in hospitals.

 

Incorrect reporting of diagnosis or procedures, false and unnecessary prescription of drugs, abnormal utilisation of services, bribery and unethical inducement are also ways used to cheat.

In addition to these, Minet Kenya Chief Executive Sammy Muthui said many facilities have been blacklisted and others presently put under investigations for abusing the seven-day rule.

 

Under this rule, Muthui said if a patient is treated for a condition and within seven days returns to the hospital to be cared for over the same ailment, they should not be charged.

 

“The member should never be asked to pay out of pocket. But we have had cases where this rule has been breached and patients asked to pay money or turned away. This is fraud and we take it seriously,” he said.

 

Below are the new service providers listed by AON Minet Kenya

OUTPATIENT BENEFIT

 

This is treatment that does not require admission or daycare surgery in a hospital. The outpatient cover caters for all routine outpatient services which include but are not limited to:

 

• Routine outpatient consultations.

 

• Prescribed Diagnostic Laboratory and Radiology services (X- ray, ultra sound, MRI and CT Scans).

 

• Prescribed physiotherapy.

 

• Prescribed drugs and dressing.

 

• Referral Outpatient to specialists.

 

• HIV/AIDS related conditions and prescribed ARV’s to the full cover limit per family per annum.

 

• Routine Immunizations: KEPI Vaccinations, Baby Friendly Vaccines.

 

• Newly diagnosed chronic conditions.

 

• Pre-existing chronic conditions (including cancer).

 

• Pap smear for ladies and PSA for men- (for principal members only).

 

• Medical Emergency Road ambulance evacuation services.

 

• Rehabilitation services as per limits.

 

• Preventive care: free Medical camps, Mobile Clinics for events, counselling on lifestyle and wellness.

 

• Prescribed preventive and curative drugs/care (Including pressure stockings and clinical corset belt).

 

MATERNITY BENEFIT

 

The benefits under this cover include but are not limited to:

 

• Routine antenatal check-up.

 

• Delivery/ Doctors Fees.

 

• Postnatal care up to six (6) weeks post-delivery.

 

• Routine Immunisations (KEPI) and Baby Friendly Vaccines.

 

• 1st emergency caesarean section, subsequent elective CS and normal delivery.

 

• Pre-maturity/Pre-term upto 37 weeks.

 

• Congenital conditions.

 

NB: The maternity benefit is available to principal members and/or their spouse only.

DENTAL BENEFIT

 

The benefits under this cover include but are not limited to:

 

• Dental Consultation and Anaesthetist’s fees.

 

• Dental X-rays and Root canal treatment.

 

• Tooth Extraction.

 

• Deformation surgery.

 

• Scaling necessitated by a prevailing medical condition and prescribed by a dentist.

 

• Dentures necessitated by an accident/ injury.

 

OPTICAL BENEFIT

 

This benefit caters for expenses related to eye treatment which includes but not limited to:

 

• Cost of frames – members who have obtained frames will not be entitled to a replacement within one year.

 

• Cost of lenses – Not entitled to a replacement within one year unless necessitated by a medical condition or change in prescription by an ophthalmologist.

 

• Prescription for ophthalmic treatment and eye lenses.

 

• Ophthalmic ultrasound if prescribed by the Ophthalmologist.

GROUP LIFE BENEFIT

 

This benefit is payable to the next of kin upon the demise of a principal member. To access the group life benefit, the following information should be availed to Minet at the earliest possible convenience:

 

• The death certificate- original or a certified copy.

 

• The burial permit- original or a certified copy.

 

• Surrender of ID form (original or a certified copy) / ID copy of the deceased.

 

• A copy of the Next of Kin’s ID.

 

• A copy of the ATM card or bank statement of the claimant (Next of Kin) indicating the account number, the account name, the bank and the branch where the account was opened.

 

NB: *Payment will be made to a valid account number held in a registered commercial bank.

 

LAST EXPENSE BENEFIT

 

This benefit is payable to the next of kin upon the demise of a principal member mainly to cater for funeral expenses. It is payable within 48 hours subject to confirmation of the Next of Kin and upon provision of the following documents:

 

• The full name of the deceased.

 

• The TSC Number.

 

• The Burial Permit indicating date of death.

 

• The next of kin details (Name, Relationship to Deceased, Phone Number).

 

• A copy of the ATM card or bank statement (of Next of Kin) indicating the account number, the account name, the bank and the branch where the account was opened.

 

Chief’s letter in case the deceased had not declared their next of kin.

 

NB: * Submission of Group Life and Last Expense Claims must be done within 12 months after which it will not be payable.

 

Psychiatric and Counselling Services

 

Provision of Psycho-social support programs for employees for conditions such as chemical dependency, stress, post-traumatic counselling, relationship difficulties, anxiety and depression, parenting, legal or financial distress etc. services will include but not limited to:

 

• Psychiatric and tele-counselling through the Minet toll free line 0800720029 available 24 hours a day, 7 days a week.

 

• Onsite counselling services in some special instances.

 

• Referrals to face to face counselling by a specialist in some special instances.

SCHEME EXCLUSIONS

 

Expenses for the following will not be covered under the scheme:

 

• Massages (except where certified as medically necessary).

 

• Cosmetic treatment unless relating to an accident.

 

• Treatment other than that done by a registered medical practitioner.

 

• Injuries as a result of active participation in war, invasion, riots or terrorism.

 

• Nutritional supplements unless prescribed by a doctor as part of the treatment of a deficiency.

 

• Maternity cover for dependent children.

 

• Medical expenses following attempted suicide.

 

• Self-prescribed drugs.

 

• Infertility investigations and family planning procedures and expenses.

 

• Outpatient,dental and optical co-pay of Ksh. 50/= on each visit.

 

• Cosmetic dental care – cosmetic crowns, caps, bridges, orthodontics & dentures, self- prescribed teeth cleaning and whitening, unless necessitated by accidental injury.

 

• Replacement and repair of old dentures, bridges and plates unless damage to dentures, bridges and plates becomes necessary as a result of an accident .

 

• Replacement of spectacle frames within the same year of cover.

 

• Reimbursement of costs incurred outside the appointed panel of providers unless for emergency cases, accident cases and only cases that have been pre-authorised by Minet.

 

• Private vaccines and travel vaccines.

 

• Alcohol related rehabilitation.

 

• Photo chromatic and/or antiglare lenses are excluded unless they form part the prescription lenses.

 

• Treatment otherwise covered by NHIF

PRINCIPAL REGISTRATION

Step 1:

Dial *865# from your Safaricom or Airtel mobile phone number.

 

Step 2:

Key in your TSC and National ID Numbers when prompted. The details will be verified against our database.

 

Step 3:

If successful, you will be prompted to enter your name (surname and other name), role and gender.

 

*Once done, you will receive a message confirming your successful registration onto the scheme and a prompt to register dependants.

 

DEPENDANT REGISTRATION

Step 1:

Dial *865# from your Safaricom or Airtel mobile phone number

 

Step 2:

Select the dependant you wish to register i.e spouse or child

 

Step 3:

Enter Relation, full names, Disability status, Date of birth, ID number if you are over 18 years

After successful registration the member will recieve a link to complete the registration process: https://collaborationkenya.minet.com/TSC

 

If not successful, kindly contact us on our call centre hotline number 1528 for further assistance.

 

Procedure for access to medical cover under the scheme

 

Members of the Teachers’ Medical Scheme can access any of the service providers on our panel countrywide. This list is accessible via USSD code *340# or Minet/TSC Website.

 

Step 1:

Present yourself at the service provider on our active panel.

 

Step 2:

Identify yourself or your dependant with the TSC number

 

Step 3:

The service provider will generate an SMS that contains a One-Time-Pin (OTP), sent to the principal member’s registered mobile number.

 

Step 4:

You will present this OTP to the service provider representative to register the fingerprints.

 

Step 5:

You will be requested to place a finger on the biometric device and the impressions will be saved against your membership record.

On successful registration the member or dependant can access medical services.

 

NB: Children under 5 years of age will be registered under either the parent or an appointed guardian.

 

Medical Facilities

Direct facilities

These are primary care facilities that members can access directly without the need of a referral letter.

 

Referral facilities

These are facilities that offer medical services for cases that require specialized  treatment. A Referral letter from a direct facility is required to access medical services in these facilities.

 

MEMBER EDUCATION

Scheme member education is a continuous process to sensitise members on the operation of the medical scheme.

Join Our Other 1000+ E-Mail Subscribers.Its Free😂😂

* indicates required
Which Topics Are You Interested In?
    Choose A Topic

    LEAVE A REPLY

    Please enter your comment!
    Please enter your name here

    Related articles

    TSC Announces new Recruitment Selection Criteria For Teachers July 2022

    Primary School Teachers’ Selection Criteria Applicants shall be awarded marks as per the recruitment score sheet.   Where applicants tie in...

    Former KNUT secretary Wilson Sossion finally speaks about the firing of TSC deputy Dr. Kennedy Mulunda. Checkout full detailed report below

    Former Kenya National Union of Teachers (KNUT) Secretary General (SG) Wilson Sossion, has condemned the dismissal of Teachers...

    Confirmed! Teachers with CBC upgrading certificate to be given first priority in 2022 July TSC Mass Recruitment Exercise-TSC CEO

    It has come out clearly that teachers with CBC upgrading certificates will have a better chance of being...

    KUCCPS 2022/2023 Access Links to Admission letters for all universities and colleges

    All the 2021 Kenya Certificate of Secondary Exams (KCSE) candidates have been assigned to their Course -choice to...