Thiruvananthapuram: The health insurance scheme facilitating cashless treatment for Kerala government employees and pensioners will finally become a reality from the New Year. The Cabinet meeting scheduled to take place next week will give its approval for the MEDISEP scheme and it is expected to commence from January 2022.
MEDISEP denotes Medical Insurance for State Employees and Pensioners.
The annual insurance premium of Rs 6,000 will be deducted from the employees salary in monthly instalments of Rs 500 each.
The monthly medical allowance of Rs 500 for pensioners will be diverted to the MEDISEP.
The State government had implemented the scheme once in the past but it failed to take off. Now it is being implemented after calling a new tender which has been won by the Oriental General Insurance Company.
All employees and pensioners should join the insurance scheme. Those who have not enrolled and those who have not included the names of their dependents should make the required changes and additions.
Applications should be submitted to the Chief Data Officer (CDO) before December 15. The pensioners should submit their applications to the Treasury Officer.
Comprehensive health insurance coverage of up to Rs 3 lakh would be provided under the scheme every year. A higher amount is allowed in case of grave ailments. Cashless facility will be available in hospitals as per the scheme.
Up to Rs 1.5 lakh from the unclaimed amount during the first year can be carried forward to the next year. Insurance coverage will be provided for hospitalisation of more than 24 hours.
As many as 1,920 ailments have been included in the approved list. The expenses for 15 days before and after hospitalisation can also be claimed under the scheme.
Who all will be covered?
Besides employees and pensioners, their dependents, spouse/partner, children who have not attained the age of 25 and children of any age who are facing physical or mental disability are eligible.
Don't duplicate dependents
A person cannot be dependent of more than one person. Those who have not given the names of dependents should submit application before December 15 and include their names. There will be no more opportunities for including dependents.
Major treatment expenses
* Liver transplant: Rs 18 lakh
* Bone marrow transplant: Rs 9.46 lakh
* Cochlear implantation: Rs 6.39 lakh
* Kidney transplant: Rs 3 lakh
* Knee replacement: Rs 3 lakh
* Hip replacement: Rs 4 lakh
* Brain surgery: Rs 18.24 lakh
* Heart, lungs transplant: Rs 15 lakh
Where to check and update
One can find out about the inclusion of name(s) in the insurance scheme by logging on to the website www.medisep.kerala.gov.in and may give details in the status option.
Those who need to make any changes should fill the application form attached with No 110/2021/finance order and submit to the DDO/Nodal officer and examine whether the details given have been updated. Pensioners should submit application for making any changes to the Treasury Officer.
Those working in aided institutions without appointment approval would be included in MEDISEP only when they receive such an approval.
For any doubts call toll-free number: 1800-425-1857