The new Mwalimu Comprehensive Medical Cover officially takes effect today, Monday, December 1, marking a major shift in how more than 400,000 teachers access healthcare services.
The rollout follows a deal between the Social Health Authority (SHA) and the Teachers Service Commission (TSC).
The cover is designed to support teachers and their households with an expanded range of medical services.
Who is covered?
According to SHA, the principal members under the new scheme are registered teachers.
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Their declared spouses are also included, while the cover extends to a maximum of five children from birth to age 21.
Children who continue with full-time studies can remain covered until the age of 25.
Children living with disabilities are equally eligible for the benefits, provided they are registered with the National Council for Persons with Disabilities.
Where to access the cover
Teachers can obtain services from over 8,000 contracted healthcare providers distributed across all 47 counties.
These include government hospitals, faith-based facilities and private institutions, ensuring that teachers can access care regardless of their location.
To access care, members will be required to present their National Identification Cards and authenticate their identity using biometric verification or a One-Time Password (OTP).
How to register and add dependents
For beneficiaries to fully access the Mwalimu Comprehensive Medical Cover, they must be registered with SHA and be fully paid-up contributors to the Social Health Insurance Fund (SHIF).
Teachers wishing to add dependents can do so through multiple channels.
Registration and dependent updates can be completed by dialing *147#, or by visiting the official SHA portals at www.sha.go.ke or www.afyayangu.go.ke.
How to make enquiries
SHA has set up a 24-hour Customer Experience Centre dedicated to supporting teachers throughout the transition.
The centre can be reached through the toll-free hotline 0800 720 601.
Beneficiaries seeking clarification can also send their inquiries via email to [email protected] for assistance on access, registration or benefit-related issues.
Benefits package
Under the Mwalimu Comprehensive Medical Cover, teachers will have access to inpatient and outpatient treatment, maternity care, dental services and optical care.
The package further provides chronic illness management, road and air evacuation, last expense support and overseas treatment options where necessary.
Elsewhere, on Saturday, November 29, Medical Administrators (K) Limited (MAKL), the long-time administrator of the TSC medical scheme, issued fresh instructions to healthcare providers and teachers a day before the scheme came to an end at midnight on Sunday.
In its notice, the company told all contracted health facilities that the TSC Medical Scheme would expire on Sunday at 11:59 p.m., bringing MAKL’s engagement with the commission to a close.
"This letter serves to formally notify you that the Teachers Service Commission (TSC) Medical Scheme will lapse at midnight on 30th November 2025, in accordance with the terms of our contract with the client.
"Consequently, Medical Administrators (K) Limited (MAKL) will cease providing healthcare administrative services under the TSC Scheme effective 1 December 2025," read the notice.
The administrator also instructed hospitals to ensure that all teachers admitted under the programme were discharged from MAKL’s system before the cut-off time.
It warned that any admissions, treatment, or services offered past the deadline would not be recognised under the scheme.
"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 authorized," the notice added.
MAKL also expressed gratitude to facilities for their cooperation throughout the contract period.
"We extend our sincere appreciation for your continued support and invaluable partnership in managing our esteemed members.
"Your professionalism, dedication, and unwavering commitment have played a vital role in safeguarding the health and well-being of our members, and we are truly grateful for your consistent collaboration," the notice further read.
