SHA Comprehensive Cover for Teachers: Full Breakdown by Job Group
If you’re searching “SHA comprehensive cover for teachers,” you’re probably trying to work out one of three things: what it actually pays for, who’s covered besides you, or why a hospital asked you to pay when you thought you were fully covered. This guide answers all three, with the real benefit limits by job group.
Quick clarification before you read on: “SHA comprehensive cover for teachers” is not a separate SHA product on its own — it’s the Mwalimu Comprehensive Medical Cover, a top-up scheme layered on top of your normal SHIF cover, run through the Public Officers Medical Scheme Fund (POMSF). Keep that distinction in mind, since it explains why some of your benefits look different from a non-teacher’s SHA cover.
Every TSC-employed teacher is enrolled in SHIF like any other employed Kenyan, then topped up by POMSF’s Mwalimu Comprehensive Medical Cover once SHIF’s own limits run out. It covers you, one declared spouse, and up to five children, with inpatient, outpatient, maternity, dental, optical, overseas treatment, and last-expense benefits. Exact limits depend on your TSC job group — see the full table below.
- Replaces the previous AON Minet scheme teachers used before
- Covers principal member, one spouse, and up to five children
- Benefit limits are tiered by TSC job group (B5 to D5)
- Facilities are not allowed to charge you out-of-pocket on top of this cover
What Is Mwalimu Comprehensive Medical Cover?
Every teacher employed by TSC is enrolled in the Social Health Insurance Fund (SHIF) the same way any employed Kenyan is. Mwalimu Comprehensive Medical Cover sits on top of that as a POMSF top-up scheme: when your SHIF benefits run out on a particular bill, POMSF steps in to cover the rest, up to the limits set for your job group.
- It replaced the previous scheme teachers held through AON Minet
- It is designed and priced around TSC job groups, not a flat rate for everyone
- The same POMSF structure also now covers National Police Service and Kenya Prisons Service officers and their dependants
Who’s Covered Under Your Teacher’s SHA Cover
Your cover extends to a defined family unit, not just yourself.
- You, as the principal member
- One declared spouse
- Up to five declared children, from birth to age 21, or up to age 25 if they’re in full-time education
- A child living with a disability, if registered with the National Council for Persons with Disabilities (NCPWD), with no upper age limit
- Additional children beyond five can typically be added, usually at an extra premium — confirm the current terms with your SHA/TSC contact before assuming this applies automatically
Benefit Limits by Job Group
Inpatient, outpatient, maternity, and last-expense limits rise with job group. Dental, optical, and overseas treatment limits stay fixed across every job group.
| Job Group | Inpatient | Outpatient | Dental | Optical | Overseas | Maternity | Last Expense |
|---|---|---|---|---|---|---|---|
| D5 | KES 3,000,000 | KES 450,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 300,000 | KES 300,000 |
| D4 | KES 2,800,000 | KES 400,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 250,000 | KES 300,000 |
| D3 | KES 2,500,000 | KES 235,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 250,000 | KES 300,000 |
| D2 | KES 2,200,000 | KES 325,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 200,000 | KES 300,000 |
| D1 | KES 2,000,000 | KES 300,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 200,000 | KES 300,000 |
| C5 | KES 1,800,000 | KES 250,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 120,000 | KES 300,000 |
| C4 | KES 1,500,000 | KES 225,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 120,000 | KES 300,000 |
| C3 | KES 1,300,000 | KES 200,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 120,000 | KES 300,000 |
| C2 | KES 1,000,000 | KES 150,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 120,000 | KES 300,000 |
| C1 | KES 1,000,000 | KES 150,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 120,000 | KES 300,000 |
| B5 | KES 1,000,000 | KES 150,000 | KES 45,000 | KES 60,000 | KES 2,200,000 | KES 120,000 | KES 300,000 |
Not sure which job group you fall under, or want to confirm these figures haven’t changed for your specific case? Message us on WhatsApp and we’ll help you check.
What This Cover Doesn’t Pay For
A few standing exclusions apply across the scheme, regardless of job group.
- Treatment at facilities not contracted under the scheme
- Care received through an unauthorized referral
- Non-conventional or alternative therapies
- Filling a tooth after an extraction — the cover currently pays for the extraction itself, but not the follow-up filling (see the complaints section below)
Not Sure If You’re Correctly Registered?
Message us your job group and we’ll help confirm your spouse and children are properly declared, so your cover actually pays out when you need it.
💬 WhatsApp: 0751 947 700We never ask for your SHA password — you stay logged in and in control throughout.
Facilities offering POMSF services are not allowed to charge teachers any out-of-pocket fees or co-payments on top of this cover. If a hospital asks you to pay, ask them to first confirm your POMSF/SHA status rather than paying immediately — a facility-level billing issue is a far more common cause than an actual gap in your cover. If you do end up paying, keep the receipt, since it may be queryable later.
Common Complaints Teachers Are Raising
A few gaps come up repeatedly among teachers discussing this cover, worth knowing before you assume something is fully settled.
- Dental filling isn’t covered — only the extraction is, which some teachers have flagged as something SHA should expand
- Only one spouse is covered — teachers in polygamous marriages have raised this as a limitation they’d like reviewed
- Facility-level cash demands — some hospitals have asked teachers to pay upfront due to billing configuration issues on the facility’s end, not because the cover itself has lapsed
Teachers’ SHA Cover Questions (FAQ)
What is SHA comprehensive cover for teachers?
It’s the Mwalimu Comprehensive Medical Cover, a top-up scheme for TSC-employed teachers under the Public Officers Medical Scheme Fund (POMSF). It sits on top of your normal SHIF cover and pays out when SHIF’s own limits are exhausted, replacing the previous AON Minet scheme.
Who is covered under a teacher’s SHA comprehensive cover?
The teacher as principal member, one declared spouse, and up to five declared children from birth to age 21 (or 25 if in full-time education). A child registered with the NCPWD as living with a disability is covered with no age limit.
Does SHA comprehensive cover pay differently by job group?
Yes. Inpatient, outpatient, maternity, and last-expense limits are tiered by TSC job group, from B5 up to D5, with higher job groups getting higher limits. Dental, optical, and overseas treatment limits stay the same across all job groups.
Does the teachers’ SHA cover pay for dental fillings?
Currently the cover pays for tooth extraction but not for filling a tooth afterward, which teachers have flagged as a gap they want SHA to address. It’s worth confirming with your facility before treatment.
What if a hospital asks a teacher to pay cash despite having SHA cover?
Facilities offering POMSF services are not permitted to charge teachers out-of-pocket fees or co-payments. If you’re asked to pay, ask the facility to confirm your POMSF/SHA status before paying anything, and keep any receipt if you do pay so it can be queried later.
Does the teachers’ cover include overseas treatment?
Yes, up to a set annual limit, covering the teacher plus one accompanying person’s travel and accommodation, with contracted hospitals in destinations such as India, Turkey, and Saudi Arabia.
Need Help With Your Teacher’s SHA Cover?
Message us on WhatsApp — whether it’s adding your spouse and children, checking your registration, or a billing issue at a hospital — and we’ll guide you through it, usually within 30 minutes.
💬 WhatsApp: 0751 947 700We only ever contact you from 0751 947 700, and we never ask for your password.
Disclaimer: MyCyber is an independent digital assistance service, not affiliated with SHA, TSC, or any government body. Benefit limits shown are drawn from publicly reported figures and may be revised by SHA or TSC at any time. Always verify current details on sha.go.ke, with your TSC/SHA administrator, or by calling 0800 720 601.
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