As the final chapters of the Teachers Service Commission (Amendment) Bill 2024 are written in February 2026, the spotlight has shifted to the most critical welfare issue: healthcare. Following the expiration of the long-standing Minet (AON) contract, the TSC has officially transitioned its entire workforce—over 400,000 teachers and their one million dependents—to the Social Health Authority (SHA).
This move represents a massive pivot from private insurance to a government-managed framework, promising expanded access but facing a staggering Sh10 billion funding gap.
From 800 to 9,000 Hospitals: The “Expanded Access” Promise
The primary motivation for the shift to SHA is the drastic expansion of the service network. Under the previous private scheme, teachers were limited to approximately 800 empanelled facilities, often leading to long travel distances for those in rural areas.
The SHA transition integrates teachers into a network of over 9,000 hospitals, including public, private, and faith-based institutions nationwide. This “universal” access is intended to eliminate the rejection of admission requests that plagued the old system and ensure that a teacher in a remote sub-county can access care as easily as one in Nairobi.
The Sh10 Billion Financial “Black Hole”
Despite the high hopes, the transition has hit a major financial snag. In February 2026, TSC Acting CEO Evaleen Mitei informed the National Assembly’s Education Committee that the commission faces a Sh10 billion deficit. While the government allocated Sh16.5 billion for the cover, the actual actuarial cost required by SHA to provide comprehensive benefits stands at Sh26.5 billion.
Without this additional funding, the TSC warns that the “quality and breadth” of the cover—including specialized treatments like oncology, renal dialysis, and overseas surgeries—could be severely compromised.
A Tailored Package: The Public Officers Medical Scheme Fund (POMSF)
To address union concerns that teachers would be “lumped in” with the general public, the new law utilizes the Public Officers Medical Scheme Fund (POMSF). This creates a ring-fenced, “premium” tier within SHA specifically for teachers. The benefits package includes:
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Comprehensive Family Cover: Principal member, spouse, and up to five children.
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Specialized Care: Coverage for chronic illnesses, organ transplants, and drug rehabilitation.
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Maternity & Dental: Standardized limits including Sh30,000 for C-sections and annual check-ups.
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Overseas Treatment: A cap of Sh1.1 million for overseas surgeries for conditions not manageable locally.
The “Zero Human Interference” Goal
A key reform in the 2024 framework is the full automation of medical claims. The TSC and SHA have launched a digital portal where admissions and discharges are processed automatically, intended to “tame” the corruption and delays associated with manual approvals. However, as of early 2026, “teething problems” remain.
Lawmakers have pressed the TSC to accelerate sensitization, as many teachers remain confused about how to navigate the new system. The Commission has responded by setting up “assisted enrollment” desks at every TSC County and Sub-county office to ensure no teacher is left without a valid digital health card.
Tags
TSC medical cover transition SHA, Social Health Authority teachers Kenya 2026, TSC Sh10 billion budget deficit, Public Officers Medical Scheme Fund (POMSF), Teacher medical benefits 2026, SHA vs Minet for teachers.
