Kerela Medisep Scheme: Medical Insurance Scheme for State Employees and Pensioners (abbreviated MEDISEP) is an insurance scheme launched by the Government of Kerala to provide comprehensive health insurance coverage to all employees and pensioners of the State Government. The scheme envisages a cashless treatment facility for the beneficiaries through an insurance company and a network of empaneled hospitals. The basic benefits package which includes medical, surgical, and daycare procedures will be covered up to an amount of Rs. two lakhs per annum.
In Hindi: राज्य कर्मचारियों और पेंशनभोगियों के लिए चिकित्सा बीमा योजना (संक्षिप्त MEDISEP) केरल सरकार द्वारा राज्य सरकार के सभी कर्मचारियों और पेंशनभोगियों को व्यापक स्वास्थ्य बीमा कवरेज प्रदान करने के लिए शुरू की गई एक बीमा योजना है। इस योजना में एक बीमा कंपनी और सूचीबद्ध अस्पतालों के एक नेटवर्क के माध्यम से लाभार्थियों को कैशलेस उपचार सुविधा की परिकल्पना की गई है। दो लाख प्रति वर्ष।
Contents
Kerala MEDISEP Scheme 2023 Overview
| Name of the scheme | MEDISEP Scheme Kerala |
| Launched by | Chief Minister Pinarayi Vijayan said |
| Year | 2023 |
| State | Kerala |
| Beneficiaries | Pensioners and employees |
| Official Website | medisep.kerala.gov.in |
MEDISEP Scheme 2023: Health Insurance Scheme of Kerala
The full form of the MEDISEP scheme is Medical Insurance for State Employees and Pensioners and it is implemented by the Finance Department of the Government of Kerala. Although the scheme was indicated in the announcement of the budget of 2017 and 2018, the Chief Minister of the state of Kerala launched this insurance scheme on July 1, 2022. The key points of this plan are as follows:
- MEDICSEP health insurance scheme is a state scheme only for the state of Kerala and only for government employees and retired pensioners.
- During its three-year lifetime, the program will assist 30 million people in the state.
- This scheme covers Rs 3 lakh annually.
- 1920 diseases covered under this scheme.
- At least 24 hours of hospitalization is required for eligible people to avail of this scheme.
- The concerned authorities make a list of hospitals registered under the scheme.
- A total of 15 days of coverage with financial assistance before and after hospitalization.
- For registration and all details visit www.medisep.kerala.gov.in.
Medisep scheme: New hospitals added to the list
Recently, the Kerala program namely MEDISEP Insurance Health Scheme added more hospitals to its list of hospitals. And there are a total of 31 new hospitals. Also, Kerala Finance and Oriental Insurance Department will publish the complete list. As of 1st July, 246 hospitals joined the scheme and 31 private hospitals have already been included. KimHealth, Trivandrum, and Thiruvananthapuram have joined KimHealth, Insurance. KIMSHEALTH will initially do transplant surgery with MEDISEP. For the empaneled hospitals to function properly, the government will withdraw funding if they do not comply with the MEDISEP plan.
मेडिसेप योजना: नए अस्पतालों को सूची में जोड़ा गया
हाल ही में, केरल कार्यक्रम अर्थात् मेडिसेप बीमा स्वास्थ्य योजना ने अस्पतालों की अपनी सूची में और अधिक अस्पतालों को जोड़ा है। और कुल 31 नए अस्पताल हैं। साथ ही, केरल वित्त और ओरिएंटल बीमा विभाग पूरी सूची प्रकाशित करेगा। 1 जुलाई तक, 246 अस्पताल इस योजना में शामिल हो चुके हैं और 31 निजी अस्पताल पहले ही शामिल किए जा चुके हैं। KimHealth, त्रिवेंद्रम और तिरुवनंतपुरम KimHealth, Insurance में शामिल हो गए हैं। किमहेल्थ शुरुआत में मेडिसेप के साथ ट्रांसप्लांट सर्जरी करेगा। पैनलबद्ध अस्पतालों के ठीक से काम करने के लिए, यदि वे MEDISEP योजना का अनुपालन नहीं करते हैं, तो सरकार धन वापस ले लेगी।
Progress since the launching of the Medisep Scheme
On the website portal, details about the treatment and charges for each facility are shown along with other related details. So far, 23,207 people have availed of the State Insurance facility. He got Rs 66 crore in insurance. Compensation of Rs 59 crore was paid to private hospitals for 21,380 claims. Government hospitals received Rs 3 crore (1,684 claims). An amount of Rs 3.53 crore has been given to 143 patients for organ transplant surgeries.
मेडिसेप योजना के शुभारंभ के बाद से प्रगति
वेबसाइट पोर्टल पर, प्रत्येक सुविधा के लिए उपचार और शुल्क के बारे में विवरण अन्य संबंधित विवरणों के साथ दिखाया गया है। अब तक 23,207 लोगों ने राज्य बीमा सुविधा का लाभ उठाया है। उन्हें बीमा में 66 करोड़ रुपये मिले। 21,380 दावों के लिए निजी अस्पतालों को 59 करोड़ रुपये का मुआवजा दिया गया। सरकारी अस्पतालों को 3 करोड़ रुपये (1,684 दावे) प्राप्त हुए। अंग प्रत्यारोपण सर्जरी के लिए 143 मरीजों को 3.53 करोड़ रुपये की राशि दी गई है।
Benefits of Medisep Scheme 2023
Under the Medicep scheme, the following benefits are given to eligible individuals in the state of Kerala:
- Three crore people will be benefited from this three-year program under the Basic Package (BBP). This will give Rs 300,000 per year.
- MEDISEP plan covers a total of 1920 treatments and surgical procedures. Although, the BBP package will include 1823 procedures.
- BBP, under the General Surgery Therapy Package, has the largest number (197) of treatment options in the category of “General Surgery”. And there are 168 packages in the Cardiology segment. Also, there are 156 packages in surgical oncology, 144 in orthopedics, and 147 in dental surgery. There are 111 in plastic surgery.
- Then the program pays for hospital-related costs such as housing, food, prescription drug costs, doctor and staff fees, and medical expenses.
- MEDISEP includes a separate package for an implant and non-destructive procedures.
MEDISEP Scheme 2023 Required Documents
The first important document required for the scheme is the identity card of the individual
- Aadhar card
- Mobile number
- Email id
Kerala MEDISEP Scheme 2023 Registration Process
- Open the official website of Medicep Yojana and the home page will be displayed in front of you
- From here proceed by going to the register option on the webpage.
- And there will be a transition to a new page.
- Also, fill out the application form with relevant information.
- Then please submit any relevant documents that need to be uploaded.
- Make sure all the information is correct and then choose the submit option.
- If you do it this way you will find it easier to sign up for the program.
Medicep Scheme Login Process
- To register or sign in for the scheme, you can either contact the officials or directly visit the online website link which is medisep.kerala.gov.in.
- On the homepage of MEDISEP there is a login option, move the cursor over it and select the department you belong to.
- After selecting the department, it will take you to another page where you will be asked to provide your name and password and enter them.
- You have to type them and click on the “Login” button.
- So your log-in process is complete.
Steps to Download Medcard Online: Kerela Medisep Scheme
- To get started, please visit the online residence of the MEDISEP plan.
- And the screen will then automatically load the homepage of the website for you.
- Then proceed from here by selecting the “Download Medcard” option on the webpage.
- The screen will then completely display a new login page.
- Enter login details like beneficiary type and Medicep ID, and Employee ID/PAN/PPO number
- Now click on the Sign-in option.
- After that, the Made Card will be displayed.
- And click on the download option to download it on your device.
Medicep Scheme: Who Will Benefit?
- As per the terms of the MEDISEP scheme, the people who will be benefited will include all the state government employees who are currently employed and who are working as per the Act of 1960, as well as all the retired people who are getting pensions.
- And also in service staff related to teaching and non-teaching sector of aided schools and colleges.
- Employees of universities receiving grants-in-aid from the state government and local self-governing institutions are on the list of beneficiaries.
- Staff members of the High Court of Kerala are also included.
- Among pensioners, teaching and non-teaching staff of aided schools and colleges, and universities who are all retired and have received grants from the state government and the LSG are considered beneficiaries of the scheme.
- The scheme will also assist in the direct recruitment of staff pensioners and family pensioners.
- In addition to the teaching and non-teaching personnel of aided schools and colleges, family members, children, and spouses will also be on the list of beneficiaries, as well as it is mandatory for all the above categories to participate in the scheme.
- If both parents are on the beneficiary list of the scheme, then their children will also be included in the beneficiary list.
मेडिसेप योजना: किसे लाभ होगा?
- MEDISEP योजना की शर्तों के अनुसार, लाभान्वित होने वाले लोगों में वे सभी राज्य सरकार के कर्मचारी शामिल होंगे जो वर्तमान में कार्यरत हैं और जो 1960 के अधिनियम के अनुसार काम कर रहे हैं, साथ ही सभी सेवानिवृत्त लोग जो पेंशन प्राप्त कर रहे हैं।
- और सहायता प्राप्त विद्यालयों और महाविद्यालयों के शिक्षण और गैर-शिक्षण क्षेत्र से संबंधित सेवा कर्मचारियों में भी।
- राज्य सरकार एवं स्थानीय स्वशासी संस्थाओं से अनुदान प्राप्त करने वाले विश्वविद्यालयों के कर्मचारी हितग्राहियों की सूची में हैं।
- केरल के उच्च न्यायालय के कर्मचारी सदस्य भी शामिल हैं।
- पेंशनरों में, सहायता प्राप्त स्कूलों और कॉलेजों के शिक्षण और गैर-शिक्षण कर्मचारी, और विश्वविद्यालय जो सभी सेवानिवृत्त हैं और राज्य सरकार और एलएसजी से अनुदान प्राप्त कर चुके हैं, उन्हें योजना के लाभार्थी माना जाता है।
- यह योजना स्टाफ पेंशनरों और पारिवारिक पेंशनरों की सीधी भर्ती में भी सहायता करेगी।
- सहायता प्राप्त विद्यालयों एवं महाविद्यालयों के शिक्षण एवं गैर शिक्षण कर्मियों के अतिरिक्त परिवार के सदस्य, बच्चे एवं पति/पत्नी भी हितग्राहियों की सूची में होंगे साथ ही उपरोक्त सभी वर्गों का योजना में भाग लेना अनिवार्य है।
- यदि माता-पिता दोनों योजना की लाभार्थी सूची में हैं, तो उनके बच्चों को भी लाभार्थी सूची में शामिल किया जाएगा।
Kerela Medisep Scheme: Who Will Not Benefit?
In the state of Kerala, there is still a list of categories of people who will not be eligible for this scheme. Employees and retirees of independent organizations, cooperative institutions, and boards such as the Kerala State Electricity Board (KSEB), Kerala State Road Transport Corporation (KSRTC), and Kerala Water Authority (KWA) will not be eligible. Employees and retirees of the State Information Commission and Human Rights Commission were also not allowed to participate in the insurance scheme.
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FAQs on Kerela Medisep Scheme
Which is the 5 lakh health insurance scheme by the Government of India?
PM-JAY is the world’s largest health insurance/assurance scheme which is fully funded by the government. It provides a cover of Rs. 5 lacks per family per year for secondary and tertiary care hospitalization in public and private empaneled hospitals in India.
Are There Any Benefits of Health Insurance?
Health insurance policies cover hospitalization, pre- and post-hospitalization expenses, daycare, and home treatment expenses. You can also avail of financial coverage for the cost of diagnostics and tests recommended by the doctors.
What is the benefit of the Kerala government health card?
It provides a cover of Rs. 5 lacks per family per year for secondary and tertiary care hospitalization in public and private empaneled hospitals. KASP – PMJAY provides cashless access to health care services to the beneficiary at the point of service, i.e. in the hospital.
What is the use of a government health card?
A health card is a health insurance identity proof that holds your personal details, policy information, and financial coverage under a health insurance plan. It offers cashless payment options to pay for your medical bills arising out of hospitalization and other treatment charges.
How do I get reimbursed for my health insurance?
Present bills, prescriptions, discharge summaries, and other required documents when you request reimbursement. Download and fill up the reimbursement form available on the insurance website. Submit the form along with the medical records to the insurance company. The check will be given after the claim is approved.
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