• KES 3.5 billion in medical claims processed since the new scheme began
• 249,000 teachers and dependents treated across the country
• 2,823 hospitals used under the new public health coverage system

Kenya’s teachers’ health insurance scheme has processed KES 3.5 billion ($27.08 million) in medical claims, according to figures released on March 6, 2026 by the Ministry of Health Kenya. The government said the scheme has already supported treatment for about 249,000 teachers and their dependents across the country through a network of 2,823 healthcare facilities.

According to government figures, claims have been concentrated in major urban and medical referral centers. Nairobi County recorded KES 527.7 million in claims, while Uasin Gishu County registered KES 463.2 million, reflecting the presence of large hospitals serving patients from surrounding regions.

The teachers’ health insurance scheme is administered by the Social Health Authority (SHA) in partnership with the Teachers Service Commission (TSC) under the Public Officers Medical Scheme Fund (POMSF). It replaced a private insurance arrangement previously managed by Minet Kenya after the contract expired in November 2025.

It kicked off in December 2025 when teachers were officially transitioned to the state-managed scheme as part of Kenya’s broader reforms aimed at consolidating public health coverage. The new program provides teachers access to treatment through a network of accredited facilities including public, private and faith-based hospitals. This expanded provider network, officials say, allows beneficiaries to obtain care in multiple parts of the country while also increasing participation by healthcare providers in the scheme.

Teachers’ unions have raised concerns about the performance of the new system and warned that unresolved issues could trigger industrial action. Government officials, however, say the scheme is operational and functioning as intended.

According to the Ministry of Health, the transition to the state-managed model removes profit-driven intermediaries and strengthens oversight of public healthcare financing. It is also part of the country’s wider health financing reforms aimed at expanding coverage and integrating public officers into national healthcare funding mechanisms. With billions of shillings already processed in claims and hundreds of thousands of beneficiaries treated, officials say the teachers’ scheme is an early indicator of how the country’s evolving public health insurance system could operate.

By Cynthia Ebot Takang