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AON Comprehensive Medical Cover for Teachers Employed by TSC, AON rates for various job groups under TSC

AON Kenya is an insurance company which has partnered with TSC to provide medical cover for teachers. The medical scheme and rates for various job groups are as follows.

Benefits Table

Job GroupInpatientComprehensive OutpatientOpticalDentalMaternityGroup Life CoverLast Expense
J 500,000Unlimited10,00010,00075,000300,000100,000
K 600,000Unlimited15,00015,00075,000400,000100,000

Inpatient care including:

The In Patient benefits under this cover include but not limited to:-

Hospital Accomodation Charges

  1. Bed entitlment – standard ward bed net of NHIF rebate per day for Jub Group G-N
  2. Bed entitlement – standard private bed net of NHIF per day for Job Group P-R
  • Doctor’s (Physician, Surgeon & Anesthetist) Fee
  • ICU/HDU and Theatre Charges
  • Drugs/Medicines, dressings and Internal Surgical appliance
  • Pathology, X-ray, Ultrasound, ECG and Computerized Tomography, MRI Scans
  • Radiotherapy and Chemotherapy
  • In-Patient Physiotherapy, Hydrotherapy, Chemotherapy and Radiotherapy
  • In-Patient Prescribed drugs/medicines and dressings
  • Emergency Road and Air Evacuation within East Africa leading to admission
  • Day care Surgery for minor surgical treatment that may not require admission
  • Hospital accomodation for accompanying parent or guardian for hospitalized children below seven (7) years
  • Post-Hospitalization benefit
  • Congenital defects/genetic disorders
  • Pre-existing and chronic conditions (including cancer)
  • Rehabilitation services and limits covered
  • In-Patient Optical and Dental surgeries

Emergency Rescue / Evacuation, including Treatment Abroad

Scheme members will be covered for the following Road and Air ambulance and evacuation services:

  • Emergency Air Ambulance Evacuation Services within East Africa
  • Emergency Road Ambulance Evacuation Services within East Africa
  • Overseas Evacuation / Treatment abroad (e.g. India, South Africa, Europe) where treatment is not available locally and within policy limits

Comprehensive Outpatient Benefits

Aon TSC Outpatient Medical Cover allows for benefit portability countrywide and within East Africa. Members will be allowed to access any service provider of their choice countrywide and within East Africa within the panel of providers.

The outpatient cover will cater for all routine outpatient services which include but not limited to:

  • Routine outpatient consultations
  • Diagnostic Laboratory and Radiology services including – X-Ray, Ultrasound, MRI, and CT Scans
  • Prescribed physiotherapy
  • Prescribed drugs and dressing
  • Prescribed routine laboratory tests
  • HIV/AIDS related conditions and prescribed ARV’s to the full cover limit per family per annum
  • Routine Immunizations
  • KEPI Vaccinations
  • Pap smear for ladies and PSA for men (for principal members only)
  • Routine Antenatal Check-ups
  • Post-natal care up to six (6) weeks
  • Newly diagnosed chronic conditions
  • Pre-existing and chrnoic conditions (including Cancer)
  • Ambulance Services

Chronic Diseases covered; including but not limited to

Cancers, Hypertension, Ashma, Diabetes, Peptic Ulcer Diseases, Arthritis, Cardiac failure, Epilepsy, Chronic renal disease, Schizophrenia, Bronchiectasis, Chronic obstructive pulmonary disorder, Thyroid disease, Systemic lupus erythematous and Hyperlipidemia.

Maternity Benefits

Maternity Cover benefits include but not limited to:

  • Routine Antenatal check-up
  • Delivery Fees
  • Postnatal care up to six weeks
  • Routine Immunizations
  • (KEPI) and Baby Friendly Vaccines
  • Emergency caesarean section
  • Congenital conditions
  • Pre-maturity expenses
  • Prescribed drugs and dressing

Note: Maternity benefit is available to Principal member or their spouse only

Dental Benefits

  • Basic benefits under this cover include but not limited to:
  • Dental Consultation and Anaesthetist’s fees
  • Root canal treatment
  • Tooth Extractions
  • Scaling necessitated by a prevailing medical dental including root canal, tooth extractions, accidents damage to teech but excluding cosmetic dentist

Optical Benefits

This benefit caters for expenses related to eye treatment. This includes but not limited to the cost of:

  • Lenses
  • Spectacle frames

Psychiatric and Counselling Services

Provision of Psycho-Social Support Programs for employees for conditions such as chemical dependency, stress, post-traumatic counselling, relationsip diffulties, anxiety and depression, parenting, legal or financial distress, etc. Services will include but not limited to:

  • Psychosocial tele-counselling services through the Aon Tele-Counselling Centre
  • On site counselling services in some special instances
  • Referrals for face to face counselling by specialist

The Aon Wellness / Wellbeing Programme Benefits

The benefits under this programme will include:

  • Health Education programmes
  • Preventive Care programmes
  • Chronic Disease Management programmes
  • HIV/AIDS workplace programmes
  • Lifestyle improvement programmes

Group Life Cover benefits

A benefit limit graduated per Job Groups will be paid as outlined in the table of benefits above to teachers’ beneficiaries / dependants in case of a teacher’s unfortunate demise while in service. This benefit is only applicable to the principal member (teacher) not dependants.

Last expense (Funeral) Cover Benefits

The Last Expense (Funeral) benefit will also be paid out across all Job Groups as per the table of benefits above to teachers’ beneficiaries / dependants to cater for funeral expenses in case of a teacher’s unfortunate demise. This benefit is only applicable to the principal member (teacher) not dependants.

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