Source: Daily Nation
By SAMUEL SIRINGPosted Friday, December 30 2011
New Year came early for a million public servants, the disciplined forces and their families after the government announced a Sh6 billion medical insurance deal.
The cover will be provided by the National Hospital Insurance Fund (NHIF).
Each patient will only be required to fork out Sh100 as co-payment in public hospitals, including Kenyatta and Moi Teaching and Referral Hospital, for a range of medical services.
But those visiting high cost private hospitals will be required to pay Sh200 in the arrangement that will also cover staff from the National Youth Service and Kenya Prisons.
Each of the 220,00-plus staff under the scheme will be allowed to register four dependants — a spouse and three children.The children must be under 18 but those still in full time school or college qualify until they are 25.
In a circular dated December 21, Public Service Permanent Secretary Titus Ndambuki said the NHIF will administer the cover starting on Sunday.
He said the scheme will bring relief to civil servants and members of the disciplined services who have been meeting the high costs of medical bills from their own resources.
The targeted staff will, however, forfeit their medial allowances that have been included in their salaries.
Mr Richard Kerich, the chief executive of NHIF, confirmed on Friday that the institution was ready to serve civil servants.
“We will provide the cover as agreed from January 1 as long as they visit hospitals that are on an agreed list. It is massive but we must deliver on our promises,” he said.
The circular, titled Introduction of a Medical Insurance Cover for Civil Servants and Disciplines Services, said the scheme will be partly funded by pooling the current monthly medical allowances payable to staff and funds allocated for medical ex-gratia and in-patient refunds.
Currently, medical allowances paid to staff add up to about Sh4.3 billion per year.
Additionally, the government allocates about Sh1.6 billion as ex-gratia payments to take care of medical bills for staff that exceed NHIF cover ceilings.Currently, each civil servant pays a standard Sh320 to NHIF for health insurance.
“This is to ensure that the quality of cover for the government employees is comparable to that of other public servants,” Mr Ndambuki said.
He said refunds of inpatient medical bills will be stopped immediately.
“You are required to stop payment of monthly medical allowances to all staff with effect from January 1, 2012. Stop further processing of any medical ex-gratia claims and inpatient refunds which will not have been committed in the vote-book by December 31,” Mr Ndambuki said.
The scheme is similar to one unveiled by the Kenya National Union of Teachers (Knut) early this month, the difference being that teachers staff will only forfeit half their medical allowances.However, NHIF will also allow officers to cover additional members. In that case, they will pay extra premiums directly to the fund.
The scheme will cover both outpatient and inpatient medical services.
“On commencement, offices will be expected to choose their preferred hospitals as per a list to be provided by NHIF,” Mr Ndambuki said.
The facilities listed will be government, mission or private hospitals.
According to the policy, there will be no limits on inpatient treatment in the health facilities for officials and their dependants.
But there will be specified ceilings in high cost private hospitals for officers in specified job groups.
Outpatient costs that will be covered include doctors’ consultation, laboratory tests and X-ray charges.
Others are prescriptions and dressings and pharmacy services.
The cover also makes provision for life insurance for principal members at graduated rates based on their job groups.
The staff will be legible for an annual mandatory general medical check-up.Mr Ndambuki said details on the new scheme will be sent to staff to enable them understand how the new policy works.
Early this month, teachers agreed to pay up to Sh2,000 toward the planned scheme.
Currently, the lowest paid teacher receives a monthly medical allowance of Sh767.
The highest paid teacher, a chief principal, earns Sh4,412 per month.
The changes will increase the total contribution by teachers to NHIF from the current Sh1 billion to Sh3.4 billion.Earlier, Public Service minister Dalmas Otieno had planned that the new scheme for teachers and civil servants be ran by private insurance companies.
Mr Otieno advertised for the tenders to provide the medical cover to public servants, a move that had been opposed by his Medical Services colleague Anyang’ Nyong’o and the teachers.