Site icon Teachers Arena

TSC circular: Medical cover for teachers and their dependants under POMSF

Teachers Arena

TEACHERS SERVICE COMMISSION

Ref.NO: TSC/ADM/192A/VOL.X/73                                       
Date:25th November 2025

TSC CIRCULAR NO: 29/2025

TO: ALL TSC TEACHERS

MEDICAL HEALTHCARE COVER FOR TEACHERS AND THEIR DEPENDANTS UNDER PUBLIC OFFICERS MEDICAL SCHEME FUND (POMSF)

As an initiative toward the implementation of the National Policy on Universal Health Care for the citizens, the Teachers Service Commission has contracted the Social Health Authority through the Public Officers Medical Scheme Fund (POMSF) to offer a medical cover for all teachers in their employment, together with their dependants with effect from 1st December 2025.

i. MEMBERSHIP ELIGIBILITY

The eligibility Criteria shall be as follows:

2. FEE FOR SERVICE

Provision of services shall be based on “fee for service” subfect to an Individual’s limit as set out in the benefits structure below:-

3. SCHEME BENEFITS STRUCTURE

The Scheme benefits are graduated according to grading as outlined below: –

4. SCOPE OF COVER

The Medical cover shall include Inpatient, Outpatient, Dental, Optical, Maternity, funeral (including mortuary fees, hearse, coffin, wreath, and transport for immediate family of maximum 10 people), air and road evacuation allocation, (including fix wing and helicopter) international travel and referral allocations.

 a) Inpatient Benefits

This is treatment, which will require admission in and stay in a hospital or day care surgery/procedure. The benefits (paid net of SHIF rebates) under this cover include but are not limited to: –

b) Outpatient Benefits

This is treatment that does not require admission or stay in a hospital or day care. The outpatient benefits include but not limited to: –

c) Maternity Benefits

Benefits under this cover include but not limited to; •

NB. The maternity benefit is available to Princtpal members and/or their Spouse only.

d)  Dental Benefits

Benefits under this cover include but not limited to; –

e) Optical

Benefits under this cover include but not limited to;

f) Medical Emergency Road and Air Evacuation

This benefit allows for emergency transportation and transfer of sick or injured members or dependents from a place of incident or facility with inadequate care to the appropriate facility using road ambulance, fix-wing and helicopter services within East Africa (Kenya, Uganda, Rwanda and Tanzania). Air evacuation will be limited to two (2) per family per annum within the policy period.

g) International Travel and Referral Allocations

This Will be paid out where authorization has been granted for the member to travel to another country for specialized treatment which is either not available locally or is reasonably cheaper and better quality than is locally, air ticket for patient and aide and their accommodation.

A medical referral report shall be required to facilitate overseas treatment.

h) Chronic, Critical and Terminal Disease Management

These include:

5. SCHEME EXCLUSIONS

The Scheme will have the following exclusions: –

6. LAST EXPENSE

The Last Expense (Funeral) cover provides a fixed amount and payable only in the event of death of the Principal member to defray funeral expenses.

7. SERVICE PROVIDERS

The full list of accredited medical service providers for both direct access and referral medical care facilities is available at the SHA website https://sha.go.ke

Teachers and their dependents are required to access medical care services only from the approved panel of service providers except for emergency cases.

8. FRAUD AND MALPRACTICES

Teachers are strongly advised to desist from engaging in fraudulent activities, which may lead to disciplinary action.

9. REGISTRATION PLATFORMS PROCESSES

Teachers can register their dependents through the following platforms:

a) Web Self-registration

On your web browser, open the SHA website- https://sha.go.ke/ click on register and start the registration process.

b) USSD Self-registration

Dial *147# on your mobile device then proceed to accept the SHA tems and conditions.

c) Assisted Enrolment

It is assisted registration done in our SHA branches, Huduma Centres and TSC County and Subcounty offices

The purpose of this Circular therefore, is to bring to your attention the provisions of the Teachers Medical cover details under Public Officers Medical Scheme Fund (POMSF).

E. J. MITEI (MS)
A.g. COMMISSION SECRETARY/CEO

Exit mobile version