What You Need to Know
The Kenya National Union of Teachers (KNUT) has reached an agreement with the government to enhance medical services for teachers, ensuring zero out-of-pocket payments. This deal aims to resolve previous operational challenges and improve access to healthcare under the Public Officers Medical Scheme Fund (POMSF), benefiting thousands of educators across the country.
Africa-Press – Kenya. Teachers are set to access improved medical services without out-of-pocket payments after the government and the Kenya National Union of Teachers (KNUT) signed a deal to resolve operational challenges that had plagued the transition to the new health scheme.
The agreement, reached in a consultative meeting bringing together the Ministry of Health, the Social Health Authority (SHA) and KNUT, outlines a raft of measures aimed at restoring seamless service delivery under the Public Officers Medical Scheme Fund (POMSF).
It comes just days after a similar breakthrough between the government and the Kenya Union of Post-Primary Education Teachers (KUPPET), signalling a coordinated push to stabilise the teachers’ medical cover following weeks of complaints over access constraints and costs.
At the centre of the KNUT deal is the immediate enforcement of a zero co-payment policy, effectively shielding teachers from any additional charges when seeking care at accredited facilities.
SHA also committed to withdraw the controversial tariff locking system, which had restricted service access and contributed to confusion across health facilities.
The agency said tariff controls will only be reintroduced after comprehensive negotiations with providers and validation at county-level forums involving union representatives.
“All health facilities offering POMSF services are strictly prohibited from charging any teacher any out-of-pocket fees or co-payment,” the parties said in the joint communiqué, underscoring the binding nature of existing contracts between providers and SHA.
The agreement further resolves key benefit administration bottlenecks that had triggered concern among teachers.
A streamlined process has been put in place for the Sh300,000 last expense benefit, with 160 claims already processed and payments to next of kin set to begin on Wednesday, April 29, 2026.
An ex-gratia framework has also been institutionalised to support teachers facing catastrophic medical expenses beyond standard cover limits.
Under the arrangement, requests will be channelled through the Teachers Service Commission (TSC) for vetting and financing, before SHA executes approved payments.
In a significant expansion of benefits, the scheme now includes structured access to overseas treatment, with SHA confirming it has contracted hospitals in India, Turkey and Saudi Arabia to handle specialised cases.
The parties said the first beneficiary of the overseas treatment was scheduled to depart the country on Tuesday night for treatment abroad.
The cover also guarantees access to in vitro fertilisation (IVF) services at designated facilities, including Nairobi West Hospital and Fertility Point, broadening reproductive health support for teachers.
To address systemic pricing disputes, SHA has set a four-week timeline to conclude nationwide tariff negotiations targeting more than 3,500 Level 3 to Level 6 private and faith-based health facilities.
Once the process is complete, the authority will roll out continuous contracting of vetted facilities under a strict “walk-in, walk-out” model, allowing teachers to access services without upfront payments.
The deal also outlines a structured dispute resolution mechanism, including a joint National Executive Council meeting between KNUT, SHA and TSC scheduled for May 6–7, alongside the reactivation of county-level structures to handle grievances locally.
SHA said it will regularly publish and update the list of contracted facilities to enhance transparency, while enforcing cost containment measures such as claims audits and quarterly reviews to safeguard the sustainability of the fund.
The latest agreement mirrors key gains secured in last week’s KUPPET deal, including the removal of co-payments, expansion of specialised treatment, and enhanced benefit packages, reinforcing a unified framework for teachers under the restructured medical scheme.
With both major teachers’ unions now on board, the government is betting on the reforms to restore confidence in the scheme and end disruptions that had threatened access to healthcare for thousands of educators.
“Following the conclusion of the 4-week negotiation period, the SHA leadership will hold meetings with the leadership of KNUT while the Cabinet Secretary for Health will personally hold monthly meetings with private, faith-based healthcare providers to resolve any lingering issues surrounding claims, payments, and system efficiency,” the teams said in the joint communique.
The Kenya National Union of Teachers (KNUT) has been advocating for improved medical cover for educators for years, facing numerous challenges in accessing healthcare services. The recent agreement with the government marks a significant step towards addressing these issues, particularly after teachers expressed dissatisfaction with previous arrangements that involved out-of-pocket payments and limited access to necessary medical services. This deal follows a similar agreement with the Kenya Union of Post-Primary Education Teachers (KUPPET), highlighting a broader effort to stabilize teachers’ medical coverage in Kenya.
