Teachers Are Warned Against Exploitative Medical Facilities Targeting SHA Outpatient Cover

A warning has been issued to teachers in Bomet County. The caution came from the Kenya Union of Post Primary Education Teachers (KUPPET) Bomet branch. It concerns private medical facilities accused of exploiting Social Health Authority (SHA) outpatient schemes.

The warning was delivered by branch vice chairman Kibet Samoei. He said some health facilities have capped SHA outpatient cover at as little as Sh1,000. Teachers and other public servants are said to be exposed to unfair financial losses as a result.

Samoei described the practice as a coordinated scheme. He said cartels are targeting public servants through it. Patients are asked to pay cash directly for services that should be covered by insurance.

Those same facilities are then said to claim refunds for the services from the national insurer. Samoei called this practice double-dipping. He said the patients pay twice, while the facilities collect payment from both sides.

The unauthorised caps are also said to weaken public health insurance reforms. Those reforms were designed to ease the medical burden on workers and their families. Samoei stressed that the reforms should work as intended.

He urged teachers and public workers across the region to stay alert. They were advised to check every medical charge carefully. Any facility that imposes arbitrary limits on insurance benefits should be reported.

Samoei also called on regulators and law enforcement agencies to act. He asked them to crack down on facilities that exploit public health frameworks for illegal gain. He said the union would work to block any attempt to defraud its members.

The warning arrives at a time when SHA has become central to healthcare access. Many Kenyans depend on the scheme for medical cover. Teachers who notice suspicious charges are encouraged to raise the matter quickly.