Junior police officers risk being locked out of key health services, including advanced lab services and X-rays, after the new insurance plan cut hospital reimbursements by up to 56.7 percent.
The National Police Service (NPS) and the Kenya Prisons Service contracted a consortium led by CIC General Limited Insurance to offer Sh8.67 billion in comprehensive medical coverage after the contract with the National Health Insurance Fund (NHIF) ended.
Under the new terms, hospitals will now refund between Sh650 and Sh1,300 per visit, down from the fixed Sh1,500 reimbursed per beneficiary per visit under the previous NHIF cover.
The consortium has appointed Medical Administrators Kenya Limited (MAKL) to oversee the administration of the medical scheme for officers in job groups A to L, while those in job groups M to T will be under Minet Kenya Insurance Brokers.
Rural private hospital operators have warned that the new terms of service introduced by MAKL for contracted providers would drastically reduce benefits for lower-cadre police officers.
“To implement your instructions, we will begin to cut our coats to suit our cloth’. Benefits will be reduced,” said Rural Private Hospitals Association of Kenya (Rupha) chairman Brian Lishenga in a letter to MAKL.
The scheme administrator has introduced a clause demanding that the signed-up facilities offer services as stated in the contract with MAKL.
“As you are aware, under existing MAKL contracts our members are contracted variously per visit from Sh650 to Sh1,300,” said Dr Lishenga.
The reduced benefits apply to a host of mission hospitals and RUPHA members that comprise over 360 facilities, which majorly cater to the low-cadre police and prison officers.
The lowest paid police officer —constable or fresh graduate — takes home a monthly salary of Sh32,800 while the highest cadre being that of the Inspector General of police earns Sh854,241 a month.
The job group immediately above that of a constable is of a cadet who earns Sh38,000, followed by a corporal earning Sh42,660 and a sergeant whose take home is Sh45,540 a month.
Insiders say chances are that the junior police and prison officers will only receive basic care, meaning they will be prescribed generic drugs and services, which excludes advanced lab and X-ray services.
The NHIF lost its bid to renew the contract for the NPS/KPS tender to the CIC-led consortium after it offered a figure of Sh9.3 billion.
Over the past eight years, the NHIF had covered the officers and had provided standard terms that did not segregate the police into two groups as is the case with the current scheme administrator.
The NHIF contract expired in September 2022 but was extended for another three months to December 31 2022.
It provided coverage for up to five children or legally adopted children aged zero to 21, with children from 22 to 25 years covered fully dependent on the principal member and enrolled in full-time post-secondary education.
The CIC-led consortium includes Old Mutual General Insurance Kenya Limited and Britam General Insurance Company (K) Limited and will cater to the medical needs of police and prison officers for the next three years.
The consortium has contracted the healthcare facilities for one year, which lapses on December 31, 2023, and will use smart cards as the mode of identification for the beneficiaries.
In the appointment letter to healthcare facilities catering for upper cadre officers, Minet has stated it will provide full administration of the medical scheme and consequently manage all service provider contracts and engagements.
“The credit period for settlement of your bills shall be 30 days from the date of receipt of fully documented claims,” said Minet in the letter stipulating the scope of cover.
The police have been at the centre of public mistrust majorly due to the perception that they take bribes instead of ensuring there is law and order.
This has been linked to their poor pay.
During his vetting in November, Inspector-General nominee Japhet Koome has pledged to stop the rampant taking of bribes by police officers saying the time has come to stamp out the vice.
“This is a matter that has been in the public domain for long. We are at a point where we must stamp authority and eliminate corruption,” he told a joint committee of the National Assembly and the Senate.
