• Students are identified through unique codes.
• Schools are unable to partner with health service providers to set up clinics in their compounds.
Some 800,000 secondary school students are missing out on the medical insurance cover provided by the government.
It began in April last year. However, principals have raised the alarm, saying the number has yet to be registered on the National Education Management Information System (Nemis), meaning the students are not getting treatment in case they need it. Nemis identifies each student using their unique codes.
The Sh4 billion cover under the National Hospital Insurance Fund relies on the unique code provided to learners for medical services.
Kenya Secondary Schools Heads Association chairman Indimuli Kahi on Sunday said Nemis registration is rocked by hiccups. Also, those not registered cannot get capitation funds. Medical service providers who have been contracted by NHIF to provide health services to students cannot identify them as beneficiaries, Indimuli said.
“Not all students are captured by Nemis and this has become very stressful, as it is only through the scheme that a student will get a premium of Sh1,350 for health insurance,” he said.
Indimuli said some health service providers have lost confidence in the insurance scheme because they cannot be reimbursed after offering service. He said many schools countrywide have been unable to partner with health service providers to set up clinics in their compounds to ease access.
“We really wish that every school had a clinic facility covered under the NHIF scheme to avoid wastage of time and safety of our students, but due to the challenges, very few of our schools have managed to establish such, despite the Ministry of Education directing every school to have its own facility,” Indimuli said.
How it works
Under the plan, the government deducts Sh1,350 from a learner’s capitation to cater for the premiums. The NHIF guidelines on the cover provide allow students to walk into registered hospitals for medical care and use the cover even during holidays.
Outpatient, inpatient, optical, dental, emergency road and air rescue services, as well as group personal accident cover are on offer.
Indimuli said the cover has been slow in facilitating special cases such as dental and eye surgeries.
“The policy by the Ministry of Education is that NHIF should cover all ailments, including surgery,” he said.
Cosmetic or beauty surgery, laser eye surgery, frames and lenses and massage are, however, not included. Dependants of the students are not covered. For instance, maternity costs for female students who fall pregnant are not covered.
Upon completing Form 4, students are deleted from the cover, while newly admitted Form 1 students are enrolled. Parents of students who die in accidents or of illnesses while in school receive Sh600,000 for compensation and funerals.
The first tranche of Sh100,000 is paid within the first two days of a student’s death for funeral plans, and the remaining Sh500,000 is cleared within five days.
(Edited by F'Orieny)