Thiruvananthapuram: The Medical Insurance Scheme for State Employees and Pensioners (MEDISEP) will come into force from August 1. Annual premium is Rs 2,992.48. The Reliance General Insurance company has undertaken the scheme. The finance department has issued the order in this regard.
Insurance coverage is provided in three categories. Under basic cover, each family will get basic insurance cover of Rs 2 lakh for a period of three years. Under extra cover, a maximum amount of Rs 6 lakhs will be given to a family for treatment of life threatening diseases including organ transplantation. This will be given as an extra amount along with the basic cover.
If a family is struggling to find money for medical expenditure, MEDISEP will provide additional assistance. A sum of Rs 3 lakh will be granted under the scheme additionally during the insurance coverage period. The insurance company will reserve Rs 25 crore for this purpose.
The scheme offers cashless treatment for the beneficiaries in government hospitals and private hospitals that enter into a deal with the government. The deserving beneficiaries will be provided ID cards. The finance department will issue a special order for enrolment procedures.
Under MEDISEP, Rs 250 will be deducted from the salary every month. At the same time, the premium amount of pensioners will be deducted from their medical allowance. There is no age limit for the physically or mentally challenged children. The expenses for medicine, treatment, doctor’s fee, room rent and consulting fee will be provided. Existing diseases also will be included in the coverage.
Meanwhile, the medical reimbursement scheme which is in force will continue for treatment through Out Patient department. But the assistance for Out Patient is limited to government hospitals, Sree Chitra, RCC, Malabar and Kochi cancer centres.
In case of specialised treatments, 24 hour In Patient treatment is not required. Accident care can be sought from hospitals which are not part of the scheme. In such cases, the insurance company will provide a special package amount to the hospitals.
Beneficiaries of the scheme
- State government employees including staff in High Court who comes under the ambit of Kerala Govt. Servants Medical Attendance rules
- Part-time contingent employees
- Pensioners and family pensioners
- Teachers, non-teaching staff and part time teachers in Aided schools
- Staff and personal staff in local self-government offices and universities
- Personal staff of chief minister, ministers, opposition leader, chief whip, speaker, deputy speaker and finance committee chairman
- The employee’s spouse who is not included in the scheme, dependant parents and unmarried and unemployed children aged less than 25 years