Today, December 1, 2025, marks the official end of the medical insurance between TSC and Medical Administrators (K) Limited (MAKL) as TSC completes the nationwide transition of all teachers to a new health scheme under the Social Health Authority (SHA).
At midnight on November 30, 2025, MAKL’s agreement to manage teachers’ health benefits expired. Hospitals and clinics contracted under the MAKL scheme have been notified that any admissions or treatment after the deadline will no longer be covered under MAKL. To prevent their claims from being rejected, teachers who are currently admitted under MAKL have been advised to ensure they are discharged from the clinic before their contract expires.
From December 1, 2025, all teachers under TSC will join the SHA-managed medical cover under the Public Officers Medical Scheme Fund (POMSF).
The major teacher unions and TSC approved the switch from the private insurer to the public health insurance program through a negotiated agreement.
The new SHA-based scheme promises a far wider network of hospitals and medical facilities compared to the previous arrangement: teachers will now have access to thousands of accredited institutions nationwide.
Some of The Benefits Under the SHA Scheme
Under the new cover, depending on their job group and SHA entitlement, teachers and their dependents will benefit from a comprehensive benefits package that includes inpatient and outpatient services, maternity, dental, optical, emergency, chronic illness treatment, and even overseas treatment (within limits).
Each job group will have different annual benefits limits. For instance, lower-cadre teachers will have a defined coverage cap for hospital stays and treatments, while higher-cadre teachers will have larger benefit limits that correspond to their roles and responsibilities.
Transition Process
TSC has formally requested MAKL (via its broker) to transfer all medical records, including ongoing treatments, chronic illness cases, maternity, registered dependents, and pending claims, to SHA administrators.
Teachers are being urged to finish any ongoing treatments, settle pending hospital admissions, and lodge their claims promptly before midnight on November 30.
To guarantee that all TSC employees and dependents are enrolled in SHA on time, county and sub-county education offices, along with SHA teams, are holding registration drives and sensitization campaigns.
The move has drawn mixed reactions from the teaching unions: Many teachers and union leaders applaud the change, pointing out that access to care could be significantly improved by the larger hospital network under SHA, particularly in underserved or remote areas. While some teachers remain cautious due to previous complaints about restricted hospital coverage, pre-authorization delays, and significant out-of-pocket expenses associated with delayed hospital bills under MAKL, they are still evaluating the new system.
A few teachers have already filed a lawsuit, claiming that the change was made without sufficient consultation and that it might interfere with ongoing treatments, particularly for patients with chronic illnesses or pregnant women.
In conclusion,
The transition marks a major restructuring in how Kenya’s educators access health care. The shift holds potential benefits, including expanded hospital access, enhanced benefit structures, and formal integration into the national health insurance framework. Success will depend on the smooth execution, timely registration, and effective communication between TSC, SHA, and the teachers themselves.
