Kerala MEDISEP Scheme :- Here today we will discuss about the latest Scheme which is called Kerala MEDISEP Yojana. In this scheme all the Government employee will get Health Insurance. This scheme is only available for the citizens of Kerala, and it will assist almost 30 lakh people, and also making it one of the Finest insurance scheme program in the state. In this article we will discuss about all the important Kerala MEDISEP Scheme details regarding this program, such as, benefits, eligibility, procedure, required documents and so on, read this article till the end.
MEDISEP Kerala Health Insurance Scheme 2023
The Chief Minister of Kerala has announced the scheme which is called MEDISIP, and it’s full form is Medical Insurance for State Employees and Pensioners and is implemented by the Department of Finance, Government of Kerala. So, here we will tell you some key points of the scheme:
- In this scheme, 1920 Diseases will be covered
- At least 24 hours of hospitalization is needed to get this scheme for eligible people.
- MEDICSEP Scheme is a state scheme only for the citizens of Kerala and only for government employees and retired pensioners can get this opportunity.
- During its three-year lifespan, this program will assist 30 million people in the state.
- This scheme covers Rs 3 Lakh annually.
- The concerned authorities make a list of hospitals registered under the scheme.
- Total 15 days of coverage with financial aid before and after hospitalization.
- For registration and all details, visit www.medisep.kerala.gov.in.
- Last date to apply for MEDISEP is 31st, December, 2022.
Overview Of Kerala MEDISEP Scheme 2023
| 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 |
Objective Of Kerala MEDISEP Scheme
The main objective of this scheme is to provide all the pensioners and Government employees a Medical Insurance in order to help them. This scheme will benefit them and those,who are already protected by the existing Kerala Government Servants Medical Attendant Rules [1960]
Benefits of the MEDISEP Scheme
- Here is the list of benefits which is provided by MEDISEP:
- Under the BBP, general surgery therapy packages, the category of “general surgery” has the greatest number of treatment options (197). The segment of cardiology has 168 packages. Surgical oncology contains 156 packages, orthopedics has 144, and dental surgery has 147. Plastic surgery has 111.
- In this basic package (BBP) This three year program will benefit 30 million people. It will give 300,000 rupees per year.
- The total number of 1920 treatments and surgical procedures are covered in the MEDISEP scheme.
- Although the BBP package will consist of 1823 procedures.
- The program pays for hospital-related costs such as lodging, meals, prescription drug costs, doctor and staff fees, and medical expenses.
- A separate package for transplant and catastrophic procedures is included in MEDISEP.
Other Benefits Of The Scheme
- This scheme will provide so many facilities such as cashless facility, which means the insurance provider will pay the Hospital fee, where the treatment were performed.
- In the event of an accident or any other kind of unexpected medical emergency so, that is also included in the approved list of treatments and procedures, however, coverage will be provided even if it is carried out in a facility that is not on the panel.
- This MEDISEP scheme will cover all the financial expenses for the list given for the period of 15 days before and after hospitalization.
- In this scheme, if the mother of a newborn child is insured under the MEDISEP scheme, then those newborn who are affected by any structural or functional disabilities are covered under this program till the scheme period is over.
- The basic plan of the scheme will cover “unspecified procedures” for up to Rs 1.5 lakh.
BBF Plan
- The basic benefit package consists of 1823 procedures.
- The basic benefit package that would be included in the system would include catastrophic secondary and tertiary benefits. care treatments, emergency and trauma care operations, as well as routine care treatments also.
- In addition to that, the proposal provides extra coverage for certain treatments for catastrophic diseases, such as organ transplant surgery. Additionally, it will provide coverage for any pre-existing conditions that the recipients may have. Outpatient treatment, on the other hand, will be excluded from coverage under the MEDISEP plan.
BBP’s Confirmed Amount
- First and foremost, BBP provides beneficiaries with annual coverage of Rs. 3 lakhs. Additionally, another mechanism, MEDICSEP, allows for an increase in coverage of Rs. 6 lakh, which is explained below in the next paragraph.
- The floater system will thus be carried over to the next year if it is not used in the beneficiary’s current year, adding up to a total of 4.5 lakh for the beneficiary in that year. Thus, in three years, if it is not used, it will pile up, and in the last few years, it will be up to 6 lakh rupees
- Basically, BBP has two components. One is fixed, which contains 1.5 lakh, and the other is movable, which is called a floater system. It also contains 1.5 lakh.
- So, the BBP contains a total of three benefits only, which are the room charge, implant cost, and treatment cost.
- Nppa will decide how much the implants will cost
- The room costs are also covered up in the basic benefit package and are fixed rates, such as the general rooms cost up to Rs. 1000 semi private rooms cost up to Rs. 1500. Any fee which is above these rates will not be covered by the insurance.
- Then there is the procedure cost, which includes the cost of the key procedures and drugs as well as the cost of the medical advice and treatment before being admitted to the hospital, the cost of the physician’s services, nursing expenses, post-discharge prescriptions, and after hospitalization reviews.
Costly Procedure Under the BBP
- Expensive surgery covered by the BBP is aortic stenting, which covers up to 5.78 lack and if they exceed the rest, the patient has to pay himself.
- Intracranial balloon angioplasty with stenting, a popular operation, has a ceiling of Rs 2.03 lakh.
- This scheme covers most of its packages or procedures for the cardio segment and the most expensive treatments are also for cardiosurgery, such as from 1 lakh to 2 lakh rupees.
Catastrophic Package Costing
- The maxx amount that might be charged, for instance, for liver transplants is Rs. 18 lakh. The price of a kidney transplant in India is 3lakh. The cost of a heart-lung transplant is 20 lakh. The price of a cochlear implant is 6.39 lakh Indian rupees. The total cost of hip replacement is four hundred thousand rupees. In addition to this, the cost of implanting an auditory brainstem is 18.24 lakh.
- So, the package will also add coverage for any relevant medical or surgical repercussions, and participating hospitals have been directed not to charge the recipient for the extra expenditures that may be incurred as a result of these consequences.
- A reserve fund with a minimum value of Rs 35 crore has been established by the insurance industry specifically for the treatment of severe diseases.
- The total price of the catastrophic package takes into account: surgery charges, implant prices, lodging charges, and investigation fees.
- There will be a single fee for each individual package.
Contributions To The Plans
- All the beneficiariesare required to make a contribution of Rs. 500 each month from their salaries of government employees and the gross entitlement of pensioners, which is Rs. 6000 annually.
- A policy valued at 4,800 rupees (including GST) will be given to the beneficiaries on an annual basis by the additional government.
- If the insurance company discovers that the Rs 35 crore that it has put aside for catastrophic sickness is inadequate, it will manage the extra money that it has received from the policyholder in order to cover the shortfall.
Who will be Benefited
- This plan will also assist directly recruited staff pensioners and family pensioners.
- Additional family members, children, and spouses of the teaching and non teaching personnel of aided schools and colleges will also be on the list of beneficiaries, plus It’s mandatory for all of the above categories that are defined to participate in the scheme.
- If both parents are on the beneficiary list of the scheme, then their children will also be included on the beneficiary list.
- Among the pensioners, the teaching and the nonteaching staff of the aided schools and colleges and universities that are all retired and have received grants from the State Government and LSGls are considered beneficiaries of this scheme.
- In terms of the MEDISEP Scheme, those who will benefit include all of the state government workers who are currently employed and who are working according to the act of 1960, as well as all of the retired people who are receiving pensions.
- The employees of the universities that have received the grant in aid from the state government and local selfgovernment institutions are on the list of beneficiaries.
- Staff members of the High Court of Kerala are also included.
- And also in service employees which belong to the teaching and non teaching sector of aided schools and colleges.
Who will not be Benefited
In Kerala, there isa list of categories who will not get any benefit form this scheme. Employees and pensioners of independent organizations, cooperative institutions, and boards, such as the Kerala State Electricity Board (KSEB), the Kerala State Road Transport Corporation (KSRTC), and the Kerala Water Authority (KWA), would not be eligible. Employees and retirees of the State Information Commission and the Human Rights Commission were not allowed to participate in the insurance scheme either.
What if employee decide not to participate in this Scheme
If a employee is getting all the benefits of the scheme but still do not want to continue, then they can ignore the remaining benefits if no claims were made while in office. But if claims were made by the office in this scheme, then they will have to pay the premium monthly contribution according to the package beneficiary opted for.
What Happen if an employee suspended
If he/she is recently on suspension, the premium for the time period will be get away from their monthly allowance.
Eligibility Criteria
If you want to be one of the beneficiaries MEDICEP scheme, then you have to follow the important point must be noted down:
- Beneficiaries must be admitted to the hospital for a full day or for a full 24 hours.
Required Documents
- The hospital must accept the beneficiaries for a whole day or a complete 24 hours.
- The documents which is needed for the scheme are first,
- The identity card of the person
- Aadhar card
- Mobile number
- Email ID
Registration Procedure of MEDISEP Scheme
- First visit the official website of the MEDICEP scheme .
- Proceed from here by, register option on the webpage.
- There will be a transition to a new page.
- Fill the application form with relevant information.
- Please submit any pertinent papers that need to be uploaded.
- Make sure that the information is correct, and then choose the submit option.
- You will have an easier time signing up for the program if you do it this way.
Login Process
- Visit the online website, medisep.kerala.gov.in.
- On the homepage of MEDISEP there is a login option, move the cursor towards it and select the department to which you belong.
- After choosing the department, enter your name and password.
- You have to type them in and click on the “login” button.
- Hence your log in procedure is completed.
Steps to Download the MEDCard
- First visit the MEDISEP Scheme’s online abode by clicking here.
- The homepage will open for you automatically.
- Proceed from here by selecting the Download Medcard option on the webpage.
- The screen will then display a fresh login page in its entirety.
- Enter the login details like beneficiary type and MEDICSEP ID, and Employee ID/PEN/PPONo
- Now click on sign in option.
- Then, the MEDCARD will be displayed.
- Click on download option to get it downloaded to your device.
To Know your Status
- First visit the MEDISEP Scheme’s online abode by clicking here.
- The homepage will open for you automatically.
- Proceed from here by selecting the “Status“ option on the webpage.
- The screen will then display a fresh page in its entirety.
- Select the category and enter Emp ID/PEN/PPONO, Date Of Birth.
- Now click on search option.
- The status will be displayed.
- Click on the print option to get it downloaded.
View Hospital List
- Visit the MEDISEP Scheme’s official website by clicking here.
- The homepage will open automatically.
- Proceed by selecting the “Hospital” option on the webpage.
- The screen will then display a new page in its entirety.
- Select the state and district.
- Now click on the search option.
- The district-wise list of hospitals will be displayed on the screen.
View Nodal Officers
- Visit the MEDISEP Scheme’s official website by clicking here.
- The homepage will open automatically.
- Proceed from here by selecting the “Nodal Officers” option on the webpage.
- The screen will then display a fresh page in its entirety.
- The page will have details of department-wise nodal officers.
- Click on the download now option to get any department’s Nodal Officer list downloaded to your device.
Grievance System
- First visit the MEDISEP’s official website.
- The homepage will open automatically.
- Proceed from here by selecting the “Grievance” option on the webpage.
- Click Grievance Filing and Login/Submit.
- A login form appears.
- Enter the medisep id.
- Click Sign In.
- You may complain here now.