Mwalimu Express Desk for the AON Minet TSC Cover Holders

As an accredited medical service provider for the AON Minet TSC cover, Limuru Cottage Hospital has what we call the Mwalimu Express Desk. This is a fast-track service for all our teachers on the AON Minet TSC cover. As a teacher, you only need to show your AON Minet card to get immediate care at our hospital.

The AON Minet TSC cover is an initiative towards the implementation of the National Policy on Universal Health Care for Workers under the Teachers Service Commission (TSC).

TSC has contracted Minet Kenya Insurance Brokers Limited to offer medical cover for all teachers in their employment, together with their dependents, effective December 1, 2022.

Read on to learn about this cover that benefits all TSC employees who get medical care at Limuru Cottage Hospital.

AON Minet TSC Cover Membership Eligibility

The following persons are eligible for the cover, as well as the eligibility criteria in place:

• All teachers in active service, aged 18 years up to 65 years

• One (1) legal spouse of the teacher

• Four (4) dependent children (biological or legally adopted) are eligible for cover from birth until the age of eighteen (18) years or until the age of twenty-five (25) years if they reside within their parents’ home and are enrolled in a recognized post-secondary school learning institution.

• No maximum age limit shall apply to child dependents with proven disability

• The maximum family size is six (6), comprising the principal member plus five (5) dependents.

AON Minet TSC Co-Pay Details

There shall be a co-payment of Kenyan shillings one hundred (Kshs. 100) per outpatient visit per individual for dental, optical, and specialized doctor consultation services. The co-pay shall not be charged for repeat visits within 14 days from the date of the previous visit or when picking medication for chronic conditions that do not require consultation with the doctor after 90 days from the last visit.

AON Minet TSC Scope of Cover

The medical scheme covers inpatient, outpatient, dental, optical, and maternity care.

AON Minet TSC Inpatient Benefits

This is a treatment that will require admission and a stay in a hospital, or one that will entail a daycare surgical procedure. The benefits (paid net of NHIF rebates) under this cover include, but are not limited to:

• Doctor’s (Physician, Surgeon and Anesthetist)

• ICU/HDU/Critical care and theatre Charges

• Drugs and medicines, dressings and internal surgical appliances

• Pathology/Laboratory

• X-ray, Ultrasound, ECG, computerized tomography, and MRI Scans

• Radiotherapy and Chemotherapy

• In-Patient Physiotherapy, Hydrotherapy

• Occupational therapy

• Hospital accommodation for accompanying parent and /or guardian for hospitalized children below seven (7) years

• Medical education and wellness program for members with pre-existing and chronic conditions

• Medical Emergency Road evacuation services leading to admission

• Congenital defects or genetic disorders

• Post-hospitalization benefit of up to two (2) weeks for other sicknesses and six (6) weeks for accident cases after discharge

• Daycare Surgery for minor surgical treatment that may not require admission

• In-vitro Fertilization (IVF)

• Renal dialysis

• Cancer Treatment and related procedures

AON Minet TSC Outpatient Benefits

This treatment does not require admission or a stay in a hospital or daycare. The outpatient benefits include, but are not limited to:

• Routine outpatient

• Prescribed diagnostic laboratory and radiology services (X-ray, ultrasound, MRI, and CT scans).

• Prescribed physiotherapy

• Prescribed drugs and

• Referral of outpatients to specialists

• HIV/AIDS-related conditions and prescribed ARVs to the full cover limit per family per annum.

• 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

• Rehabilitation service as per limits

• Preventive care: to include free Medical camps, Mobile Clinics for events, and counselling on lifestyle and wellness

• Prescribed preventive and curative drugs and care (Including pressure stockings and clinical corset belts)

AON Minet TSC Maternity Benefits

Benefits under this cover include, but are not limited to:

• Delivery/Doctor’s Fees

• Routine Antenatal check-up

• Postnatal care

• Routine Immunizations (KEPI) and Baby-Friendly Vaccines

• 1st emergency caesarean section, subsequent elective CS and normal delivery

• Pre-maturity/Pre-term

• Congenital conditions

• Private room, if available, for all expectant principal members and their NB. The maternity benefit is available to principal members and their spouses only.

AON Minet TSC Dental Benefits

Benefits under this cover include, but are not limited to:

• Dental Consultation and Anesthetist’s fees

• Dental X-rays and Root canal

• Tooth Extraction

• Scaling necessitated by a prevailing medical condition and prescribed by a dentist

• Dentures necessitated by an accident or injury

• Deformation surgery

AON Minet TSC Optical Benefits

Benefits under this cover include, but are not limited to:

• Cost of lenses and frames: Members who have purchased frames will not be eligible for a replacement within a year unless a medical condition requires it and an ophthalmologist has prescribed it.

• Prescription for ophthalmic treatment and eye lenses

• Ophthalmic ultrasound, if prescribed by the Ophthalmologist

AON Minet TSC Cover for chronic, critical and terminal disease management

• Cancer, kidney failure, hypertension, arthritis, diabetes, HIV/AIDS, liver diseases, etc.

• COVID-19 and all outbreaks of pandemics

• Drugs and substance abuse, including alcoholism and associated rehabilitation

• Work-related trauma

• Domestic violence (including Gender-based violence), trauma

• Depression

• Continuous medical education

• Social counselling

• Mental health and wellness

• AON Minet TSC scheme exclusions

• Active participation in war, invasion, riots or terrorism

• Cosmetic treatment, unless related to an accident

• Massage (except where certified as medically necessary)

• Nutritional supplements, unless prescribed by a doctor as part of the treatment of a deficiency

• Maternity cover for dependent children

• Self-prescribed drugs

• Treatment other than by a registered medical practitioner

• Outpatient, dental and optical co-pay of fifty shillings on each visit

• Reimbursement of costs incurred outside the appointed panel of providers unless for emergency cases, accident cases and on pre-authorization

• Private vaccines and travel vaccines

• Alcohol-related rehabilitation

• Maternity for child dependents

• Cost of lenses and frames not prescribed by an Ophthalmologist

• Replacement of spectacle frames within the same year of

• Photochromatic and/or antiglare lenses, unless prescribed by a doctor

• Cosmetic dental care: cosmetic crowns, Caps, Bridges, Orthodontics and dentures; self-prescribed teeth cleaning and whitening, unless necessitated by accidental injury

• Infertility investigation and family planning procedure expenses

• Replacement or repair of old dentures bridges and plates unless damage to dentures, bridges and plates becomes necessary as a result of an accident

• Treatment otherwise covered by NHIF

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