Hospitals urged to terminate services for teachers amid transition to SHA

Ziporah Boyani, a Grade 4 class teacher at Royal Metropolis Academy in Nyamira, teaches her pupils. [Stanley Ongwae, Standard]

Medical Administrators (K) Limited (MAKL) has directed hospitals to end services for teachers with health insurance coverage for which it serves as an administrator.

In a letter to the health facilities, MAKL warned that it will not settle any claims for services offered after midnight on Sunday, November 30, owing to the lapse of its contract with the Teachers Service Commission.

“This letter serves to formally notify you that the Teachers Service Commission (TSC) Medical Scheme will lapse at midnight on November 30, 2025, in accordance with the terms of our contract with the client,” read part of the letter. 

“In this regard, we kindly request that all members currently admitted under MAKL’s mandate be fully discharged in our system on or before November 30, 2025, at 11:59:59 PM. Please note that any continued admissions, treatments, or healthcare services rendered beyond this date and time will not be considered MAKL's liability, nor shall they be deemed authorised,” it added.

The directive comes after TSC opted to transfer teachers’ medical cover from MINET to SHA after a decade of the former’s service.

The process of onboarding some 400,000 teachers to SHA has been ongoing.

SHA Chief Executive Officer Mercy Mwangangi issued an advisory to the hospital on the new plan, clarifying that SHA will pay for medical bills incurred by teachers from December 1.

Further, she stated that measures were already in place to resolve challenges arising from the transfer of service providers, including failure in the biometric identification of patients.

“For TSC teachers admitted under MAKL before the transition, you must formally discharge them from the MAKL system by 23:59 on November 30, 2025 and then readmit them under the SHA Public Officer Medical Scheme Fund (POMSF) TSC scheme immediately after 00:00 on  December 1, 2025. Accurate documentation with clear timestamps for both discharge and readmission is mandatory to prevent billing disputes,” she said.

The deal unlocks a benefits package for teachers that includes access to inpatient and outpatient services, maternity services, treatment for chronic conditions, and dental and optical services.

Others include road and air evacuation and overseas treatment.