AON Minet is a medical scheme that covers a total of 340,000 teachers on Teachers Service Commission.
Teachers pay for the cover monthly using their medical allowance. However recently teachers complained and wanted TSC to show the amount they pay for the cover.
The teachers wanted TSC to show the deductions and the medical allowance they earn on their payslips.
AON Minet pays for inpatient, outpatient, maternity, dental and optical among other services for teachers and their dependants.
However there are a number of conditions which AON Minet will never pay for teachers and their dependants.
Kindly note that if you are a teacher and want to register yourself or dependant for ON Minet cover you can dial *865# from your Safaricom or Airtel mobile phone number .
Members of the Teachers’ Medical Scheme can also access any of the service providers countrywide via USSD code *340#.
Kindly note Expenses for the following will not be covered under the AON Minet medical 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.
AON MINET BENEFIT STRUCTURE FOR TEACHERS
Below are benefits teachers get from the AON Minet cover.
|Job Group||Outpatient||Inpatient||Dental||Optical||Maternity||Group life||Last Expense||International Referral||International Travel|
This is treatment which requires admission in a hospital or day care surgery/procedure. The benefits (paid net of NHIF rebates) under this cover include but are not limited to:
• Bed entitlement.
• Doctor’s Fees (Physician, Surgeon & Anesthetist fee).
• ICU/HDU/Critical care and theatre Charges.
• Drugs/Medicines, dressings and internal surgical appliance.
• X-ray, ultrasound, ECG, Computerized Tomography Scans (CT Scans) and MRI Scans.
• Radiotherapy and Chemotherapy.
• In-Patient Physiotherapy & Hydrotherapy.
• Occupational therapy.
• Hospital accommodation for accompanying parent and /or guardian for hospitalised children below seven (7) years.
• Medical Emergency Road evacuation services leading to admission.
• Congenital defects/genetic disorders.
• Post- Hospitalisation benefit of up to two (2) weeks for other sicknesses and six (6) weeks for accident cases after discharge.
• Day care Surgery for minor surgical treatment that may not require admission.
• In-vitro Fertilisation (IVF).
• Renal dialysis.
• Cancer Treatment and related procedures and tests.
• Medical education.
• Chronic Disease Management.
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).
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.
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.
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.