THIRUVANANTHAPURAM: The medical insurance scheme for government employees and pensioners, titled Medical Insurance Scheme for State Employees and Pensioners (MEDISEP), will come into effect on June 1. Government employees, including the staff of the High Court, part-time contingent staff, teaching and non-teaching staff in the aided sector, part-time teachers, employees of LSGs, universities and pensioners in all these categories are beneficiaries of the scheme. Eligible dependents will also get the insurance cover. The tenure of the current scheme is three years. The insurance coverage is in three categories:
Basic cover: A basic insurance cover of Rs 2 lakh will be available for all families. Additional cover: A family will get an additional cover of a maximum of Rs 6 lakh for serious ailments including organ transplantation. This will be in addition to the basic cover of Rs 2 lakh.
Extra cover: If the Rs 6 lakh is insufficient for the treatment of serious ailments, a maximum of Rs 3 lakh will also be provided to a family. For this, a corpus of Rs 25 lakh will be formed by the insurance company. MEDISEP was a 2017-18 budget announcement. Afterwards, EoI was invited from companies approved by the IRDA. Later, e-tender was floated and Reliance General Insurance which quoted the lowest annual premium of Rs 2992.48 was selected.
Insurance premium will be collected in instalments of Rs 250 from the government employees. In case of pensioners, the current Rs 300 medical allowance will be deducted and paid as premium. The government will give the insurance premium to the company in three instalments. The medical reimbursement scheme for outpatient treatment will continue as in the past.
The MEDISEP scheme envisages the cashless treatment facility. There shall be no age limit for the beneficiaries or dependants except for child dependents. There will be an online dispute resolution and grievance redressal system. For details contact the toll-free number: 1800 425 1857.
This scheme will also cover newly recruited employees and their families, part-time contingent employees, part-time teachers, teaching, non-teaching staff of aided schools/ colleges and their family, pensioners, and their spouses and family pensioners.
Who all are included
Govt employees, including the staff of the High Court, part-time contingent staff, teaching and non-teaching staff, employees of LSGs, universities and pensioners in all these categories are beneficiaries of the scheme.