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
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 |
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:
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।
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।
Under the Medicep scheme, the following benefits are given to eligible individuals in the state of Kerala:
The first important document required for the scheme is the identity card of the individual
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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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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