Medisep scheme upgraded: Up to ₹20 lakh for major surgeries

Thiruvananthapuram: The Kerala government has revised specific rules of Medisep, the health insurance scheme for its employees and pensioners. Beneficiaries will now receive up to ₹18 lakh for a liver transplant.

Similarly, ₹17 lakh has been allotted for bone marrow or stem cell transplant surgery. The coverage for various surgeries is as follows: cochlear implant - ₹6.5 lakh, kidney transplant - ₹3 lakh, heart transplant - ₹15 lakh, and heart-lung transplant - ₹20 lakh.

The cabinet has also decided to extend the Medisep scheme, which had lapsed. Previously, the scheme offered coverage of ₹3 lakh for a three-year term. Going forward, the term will be two years, with coverage of up to ₹5 lakh. Additional amounts will be sanctioned for critical illnesses.

It has been proposed that the insurance company awarded the contract should allocate ₹40 crore for the scheme. Although the premium has been fixed at ₹750, it may be revised after discussions with the insurer. All employees and pensioners will be required to pay the premium.

Both government and private hospitals will be empanelled under the scheme. In cases where beneficiaries are unable to seek treatment at empanelled hospitals due to emergencies, they will be reimbursed for their hospital expenses under Medisep.

Emergency treatment at non-empanelled hospitals will be allowed for conditions such as drowning, heart attack, stroke, falls from heights, snake bite, electrocution, sunstroke, burns, poisoning, and animal attacks.