THIRUVANANTHAPURAM: Even as hospital majors continue their ‘boycott’ of Medisep, about 25,000 people have benefited from it during the first two months. The cashless health insurance scheme for government employees and pensioners, Medisep, was launched on July 1.
Until August 25, a total of 24,439 beneficiaries availed of the scheme for claims worth Rs 73 crore. Seven per cent of them were treated in government hospitals. The number of private hospitals partnering with the scheme rose to 277 although about 50 of them are giving selective coverage. The latter are hospitals where only selected departments come under the scheme. Nearly 150 government hospitals are part of the scheme.
Most of the patients were for dialysis, cataract surgery and treatment for respiratory diseases. The top two hospitals in terms of beneficiaries were NS Memorial Institute of Medical Sciences, Kollam (890), and Amala Institute of Medical Sciences, Thrissur, 784. In the government sector Regional Cancer Centre and Government Medical College, Kottayam, were the top performers- 330 and 249 patients respectively.
Over 200 people availed of the special fund for catastrophic procedures. They included 172 cases of knee joint replacements, 15 hip replacements, eight liver transplants, five kidney transplants and three cases of Cardiac Resynchronisation Therapy (CRT). Nearly Rs 4 crore was spent from this fund.
The scheme
Medisep covers 1,920 treatments and surgical procedures, including pre-existing diseases. The policy cover is for three years on a floater basis. Each year the beneficiary is entitled to Rs 1.5 lakh fixed coverage and Rs 1.5 lakh floater. Unutilised floater benefit will be carried over to the next year. Thus, a person who has not availed of floater in the first year will have an eligibility for Rs 4.5 lakh next year. In addition to these, beneficiaries with catastrophic illnesses are given assistance from the Rs 35 crore corpus fund maintained by the insurance company.