MEDISEP govt insurance scheme to continue in present form till new deal
At present, Oriental Insurance is the service provider and the annual premium for a beneficiary is Rs 5,664 including 18% GST. The government makes advance payment of the premium amount to the insurance company in four installments a year. This amount will be recovered from the salary or pension of beneficiaries in 12 installments. The agreement with the insurance company is from July 2022 to June 30, 2025.
It is learnt that the expert committee has recommended to hike the monthly premium amount from Rs 500 to Rs 750 and to enhance the coverage to Rs 5 lakh. Another recommendation is to collect premiums from only one person in a family having more than one government employee.
Employees should be given the option to stay away from the scheme. The package should be revised to attract more private hospitals, especially speciality hospitals, to join the scheme, it said. At present, the scheme is mandatory for employees and pensioners. The government has directed Additional Chief Secretary (Finance) K R Jyothilal to take further steps on the report. The health secretary will also be asked to submit recommendations.
New scheme to offer better packages, says minister Finance Minister K N Balagopal said the MEDISEP's second edition will be more attractive. 'We want more hospitals, especially major private institutions, to join the scheme. The treatment packages will be revised for this,' he told TNIE.
On whether the premium would see an increase, he said: 'The present rates were fixed some three years ago. A decision on increasing the premium would be taken after consultations with stakeholders.' The minister said the insurance provider for the next edition will be selected through a fair and transparent bidding process.
At a glance
Claims approved (From Jan 1, 2025 to June 6)
Total claims: 10.18 lakh
Amount: Rs 1,863.22 crore
Private hospitals
Claims: 9.43 lakh
Amount: Rs 1,745.36 crore
Government hospitals
Claims: 74,000
Amount: Rs 117.86 crore
Total beneficiaries covered
Employees and pensioners: 11.44 lakh
Dependents: 19.49 lakh
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