The Kerala health department has unveiled its largest-ever health insurance scheme, Medical Insurance Scheme for State Employees and Pensioners (MEDISEP), which will go into effect on July 1, providing significant relief to government employees and their dependents. The beneficiary will be entitled to Rs.3 lakh per year under the scheme.

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MEDISEP will cover nearly 1,920 medical procedures, with a monthly premium of Rs 500 deducted beginning with employees' June salaries and pensioners' July payments. Over 200 private and government hospitals with taluk hospital status or higher would be included in the hospital network.

"The scheme is set to be a relief for those medical practitioners in the government sector who have been struggling due to the financial crisis caused by the Covid pandemic, and answer to the government officials' long-pending demand for a pension scheme," said Sharath Kumar, a junior surgeon at an Alappuzha primary health centre.

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MEDISEP will cover all pre-existing diseases and provide a cashless facility for the listed procedures. The coverage, however, is limited to the state's empanelled public and private hospitals.

However, coverage will be provided even if done in non-empanelled hospitals for accidents or other medical emergencies included in the approved list of treatment and procedures. The beneficiary's treatment costs will be reimbursed based on the scheme's approved rates or package.

An insured mother's newborn, including twins, is covered from day one until the current policy plan expires.

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The Basic Benefit Package (BBP) has three components: procedure cost, implant cost (if any), and room charges.

Even though Rs 6,000 will be deducted from the beneficiaries, the government will only pay Rs 4,800 (Plus GST) per beneficiary to Oriental Insurance Company Limited, which awarded the tender to implement the MEDISEP.

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