In Kerala, state employees and retirees have access to a health insurance scheme known as MEDISEP. The Kerala MEDISEP Scheme 2024 offers health insurance to retired individuals and those employed by the government. This curriculum started to cover both ailments and their treatments around 1920. The medical system of medicine depends on the card. Previously, the Kerala government has advised to develop a health insurance policy for employees and pensioners by the 10th Pay Revision Commission. Based on it, the Finance Minister declared the programme in the 2017–2018 budget speech, though he did not refer to it by its official name, insurance programme. By July 2022, beneficiaries of this programme will need to present this card when making a treatment request at one of the hospitals with which it has partnered.
About Kerala MEDISEP Scheme
For the benefit of both active and retired government employees, the Central and State Governments frequently introduce numerous services and amenities. The Medical Insurance for State Employees and Pensioners (MEDISEP) Scheme is its full name. the Medisep ID Card programme for retired and current state employees. Under this project, state personnel and retired employees will obtain health cards, which function as a kind of health insurance coverage. Employees who qualify for Medcard Kerala can receive cashless medical services by presenting their health cards to the hospital administration.
The chief minister of Kerala state introduced the Kerala MEDISEP Scheme on July 1st, 2022, even though it alludes to in the announcement of the 2017 and 2018 budgets. A total of 30 million residents of the state will benefit from this programme over its three-year run. This programme covers Rs 3 Lakh each year.
Also Check: Medisep ID Card
Key Highlights of Kerala MEDISEP Scheme
Launched By | Government of Kerala |
Name of Scheme | Kerala MEDISEP Scheme |
Objective | To provide state employees and retirees with access to cashless medical facilities |
Benefits | Insurance Facility for Health |
Application Mode | Online |
Beneficiaries | Government Pensioners and State Workers |
Official Website | https://medisep.kerala.gov.in/ |
The objective of Kerala MEDISEP Scheme
The Kerala MEDISEP, a form of medical insurance, was introduced by Chief Minister Pinarayi Vijayan. This plan’s main objective is to provide health insurance to all state employees and retired public sector workers. As part of the state government’s effort, the beneficiary hands in a health card, which serves as their health identity card.
Benefits of the Kerala MEDISEP Scheme
- The following benefits are provided to qualified residents of Kerala under the Medisep scheme:
- 30 million people will gain access to this three-year initiative through the basic package (BBP). Every year, it will provide 300,000 rupees.
- The MEDISEP programme covers a total of 1920 medical treatments and surgical procedures. even if there will be 1823 processes in the BBP bundle.
- The category of “general surgery” under the BBP, general surgery therapy packages, contains the most treatment possibilities (197). There are 168 packages in the cardiology category. Orthopedics has 144 packages, dental surgery has 147, and surgical oncology has 156. 111 describe plastic surgery.
- The programme covers expenses associated with hospitals, including lodging, meals, prescription medicine charges, staff and doctor fees, and medical costs.
- MEDISEP has a distinct bundle for catastrophic and transplant surgeries.
Other Benefits of the MEDISEP Program
The MEDISEP scheme offers a cashless option for the operations indicated. When a hospital is referred to as a “cashless facility,” it means that the insurance company will pay the hospital directly for the services provided by the list. However, coverage will be offered even if it is performed in a facility that is not on the panel in the event of an accident or any other kind of unanticipated medical emergency that is covered by the approved list of treatments and procedures.
The plan will pay for the above expenses for the 15 days before to and following hospitalization. If the mother of a newborn kid is covered by the MEDISEP programme, then any infants with structural or functional disabilities are covered under this programme until the program’s allotted time has passed. The base plan of the programme will pay up to Rs 1.5 lakh for “unspecified operations.”
Features of Kerala MEDISEP Scheme
- MEDICSEP Health Insurance Scheme is a state programme that is only available to state employees and retired pensioners in the State of Kerala.
- A total of 30 million residents of the state will benefit from this programme over its three-year run.
- This programme covers Rs 3 Lakh each year.
- 1920 diseases that are covered by this programme.
- To be eligible for this programme, a patient must have spent at least 24 hours in the hospital.
- The relevant authorities compile a list of hospitals that have signed up for the programme.
- Total financial assistance coverage before and after hospitalization is 15 days.
- To register and for further information, go to www.medisep.kerala.gov.in.
- The MEDISEP application deadline is December 31, 2022.
New Hospitals Added to the List Under the MEDISEP Program
The MEDISEP Insurance health policy, which is part of the Kerala Program, recently added more facilities to its list of hospitals. There are 31 new hospitals in all. The entire list will be made public by the Kerala Department of Finance and Oriental Insurance. 31 private hospitals have already been incorporated into the programme since 246 hospitals started on July 1. Trivandrum and Thiruvananthapuram-based Kishealth has partnered with the insurance. Transplant operations will initially be performed by MEDISEP and KIMSHEALTH. If hospitals on the list don’t follow the MEDISEP plan, the government will stop supporting them, making it impossible for them to operate effectively.
Progress Since the launch of the MEDISEP Scheme
Each facility’s treatments and fees are listed on the online portal along with other pertinent information. 23,207 individuals have used the state insurance programme as of this time. They were able to secure insurance for 66 crores. For 21,380 claims, private hospitals received compensation totaling Rs 59 crore. Three crore rupees were to the public hospitals (1,684 claims). 3.53 crore has been allocated for the organ transplant surgeries of 143 individuals.
Support for the Plans
As a result, the beneficiary is expected to contribute Rs. 500 per month from their pay as a government employee and their yearly Rs. 6000 gross pension entitlement.
The supplementary government will annually offer beneficiaries a policy worth 4,800 rupees (GST included). The additional funds it has received from the insure will be used to make up any gap if the insurance company finds that the Rs 35 crore it has set aside for catastrophic illness is insufficient.
MEDISEP Scheme: Who Stands to Gain?
- All state government employees who are currently employed and who are working per the act of 1960, as well as all retired individuals who are receiving pensions, shall benefit, by the MEDISEP Scheme’s conditions.
- Additionally, there are service personnel who work in assisted schools, colleges, and both the teaching and non-teaching sectors.
- On the list of recipients are the staff members of the universities that have received grants in help from the state government and local self-government institutions.
- There are also employees of the Kerala High Court included.
- Beneficiaries of this programme include the retired teaching and nonteaching employees of aided schools, colleges, and universities who have all received funds from the State Government and LSGls.
- Additionally, this strategy will directly aid in attracting family and staff pensioners.
- The teaching and non-teaching staff of assisted schools and colleges, as well as their additional family members, children, and spouses, will also be included on the list of beneficiaries. It is also mandatory for all of the aforementioned defined categories to participate in the programme.
- Their children will also be listed as beneficiaries if both parents are on the scheme’s beneficiary list.
Those who will not benefit from the MEDISEP Scheme
There is still a list of demographic groups in Kerala who are not includes in this programme. The Kerala State Electricity Board (KSEB), the Kerala State Road Transport Corporation (KSRTC), and the Kerala Water Authority (KWA) are examples of autonomous organizations, cooperative institutions, and boards whose employees and retirees are not eligible. The State Information Commission and the Human Rights Commission’s pensioners and employees were not permit to take part in the insurance programme either.
What happens if a worker decides not to take part?
The remaining benefits may be disregare if no claims have filed while the employee has employed and the employee is still receiving the benefits of the scheme. However, if claims was submited by the office under the programmes, then he or she would be responsible for making the monthly premium contribution in accordance with the package the beneficiary selected.
When an Employee Is Suspend, What Happens?
The premium for the term of suspension will deduct from the employee’s monthly salary if they are currently on suspension.
Eligibility Criteria
The following crucial detail must be notice in order to qualify for the MEDICEP programme:
- The hospital must accept the beneficiaries for a whole day or a complete 24 hours.
Documents Required
The crucial paperwork require for the plan is presents initially. The individual’s
- Identification card
- Mobile number
- Aadhar card
- Email address
Also Read: MEDISEP Hospital List
Registration for the Kerala MEDISEP Scheme 2024
- The home page of the MEDICEP plan will be visible after you open the MEDISEP website for it.
- From here, navigate to the webpage’s registration option.
- The page will change to a new one.
- Complete the application form with the necessary details.
- Please turn in any necessary paperwork for uploading.
- Verify that all of the data is accurate before selecting the submit option.
- If you go about it this way, joining up for the programme will be simpler for you.
Login Procedure for MEDISEP Scheme
- You can either get in touch with the administrators or visit the official website directly at medisep.kerala.gov.in to register or log in for the programme.
- The login option is located on the MEDISEP homepage; point your cursor there and choose the department to which you belong.
- You will be taken to another page after selecting the department where you will be prompted for your name and password in order to capture them.
- They must be typed in before clicking the “login” button.
- Your log-in process is finished as a result.
MEDCard Online Download Procedures
- Please go to the official website of the MEDISEP Scheme first.
- The website’s home page will then immediately load on the screen for you.
- The next step is to click the “Download Medcard” link on the website.
- The new login page will then appear in its entirety on the screen.
- Enter your login information, including your employee ID, MEDICSEP ID, and beneficiary type. No
- Now select the sign-in link.
- The MED CARD will then be seen after that.
- To download it to your device, select the download option.
Know Your Status with the MEDISEP Scheme
- Please go to the official website of the MEDISEP Scheme first.
- The website’s home page will then immediately load on the screen for you.
- The next step is to click the “Status” link on the webpage.
- The new page will then be shown in its entirety on the screen.
- Enter the Emp ID/PEN/PPONO, Date Of Birth, after choosing the category.
- Click the search option now.
- The current status will be shown.
- To download it, select the print option from the menu.
View the Medisep Hospital Directory
- Please go to the official website of the MEDISEP Scheme first.
- The website’s home page will then immediately load on the screen for you.
- Choose “Hospital” from the drop-down menu on the webpage to continue.
- The complete new page will then be seen on the screen.
- Choose the district and the state.
- Click the search option now.
- On the screen will be a list of hospitals organized by district.
MEDISEP Complaints Procedure
- Go to the official Website of MEDISEP first.
- The website’s home page will then immediately load on the screen for you.
- From here, select the “Grievance” link on the website to continue.
- Click File Grievance, then Login/Submit.
- A login form is displayed.
- Type in the medisep ID.
- Press Sign In.
- You may now voice your complaint here.
Contact Details
- Toll Free Number: 1800 – 425 – 1857
- Time: (10.15 AM to 5.15 PM)