Thiruvananthapuram: As the government-run Medisep scheme, which ensures medical treatment for government employees and pensioners, prepares to enter its next phase, a surge in grievances has emerged. To address these complaints, the government is set to implement a special grievance redressal mechanism under the upcoming Medisep phase.

Currently, those with complaints are required to approach Medisep directly. In addition, the government is considering the formation of an official committee led by the Finance Secretary to review appeals more effectively. Efforts are also underway to include provisions in the new contract to ensure hospitals provide timely and adequate benefits to patients seeking treatment.

Patients suffering from cancer have particularly raised concerns about cuts in their benefits. While initial payments for medicines and treatments were provided, one patient complained that, in later stages, benefits were restricted to injections and tests alone. Despite submitting appeals, the grievances were dismissed. In another case, a patient hospitalised for several days was denied benefits, with Mediclaim responding that a medical board had assessed the treatment as unnecessary.

Critics allege that, as the second phase of the Medisep contract has yet to come into effect, benefits are being continually denied to reduce the financial burden on insurance company.

Disappointment among pensioners

Pensioners who approached the government with requests for the second phase of Medisep have expressed disappointment. They sought the option to choose from Medisep, inclusion of Ayurvedic treatments, coverage of super-specialities, and the incorporation of all departments of empanelled hospitals into a cashless scheme during discussions with the Finance Secretary.

They also requested that any premium increase be clearly identified as the government's share. However, the talks were described as disappointing by M.P. Velayudhan, President of the Kerala State Service Pensioners Association.