Kerala MEDISEP Scheme 2024 – The Kerala government has launched Kerala MEDISEP which comes under the health insurance scheme. The scheme was launched for employees and pensioners working in government sectors. Kerala MEDISEP is a health insurance scheme for government employees and pensioners. Previously, the 10th Pay Revision Commission had proposed setting up a health insurance program for workers and pensioners in Kerala. This is a government scheme available only to residents of Kerala and will help around 30 lakh people there, making it one of the best insurance programs the state has ever seen. This article will provide all the information related to the Kerala MEDISEP Scheme.
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kerala medisep scheme portal
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Kerala MEDISEP 2.0 Scheme
The full form of MEDISEP is Medical Insurance for State Employees and Pensioners. This scheme has been launched by the Ministry of Finance, Government of Kerala. The Minister of Finance had previously alluded to this plan during the 2017-18 budget. However, the Kerala Chief Minister officially launched the scheme on July 1, 2022. Beneficiaries can contribute Rs 500 every month from their salaries and this contribution will be directly transferred to the implementation of the scheme for the people of Kerala. The government has allocated a lot of hospitals to develop this scheme and all people will be able to apply for the scheme starting today.
Highlights of medisep.kerala.gov.in Scheme 2024
Name of the Scheme | Kerala MEDISEP Scheme |
Full Form | Medical Insurance For State Employees and Pensioners |
Launched By | Chief Minister of Kerala |
MEDISEP Portal Maintained and Developed By | IT-Software Division, Finance Department |
Beneficiaries | Pensioners and Employees |
Objective | Enabling state employees and Pensioners to access cashless medical facilities |
Application Mode | Online |
Toll-free Number | 1800-425-857 |
HelpLine (Oriental Insurance) | 1800-425-0237 |
Official Website | medisep.kerala.gov.in |
MEDISEP Kerala Health Insurance Scheme
Here is a list of some of the key points of the medisep.kerala.gov.in scheme:
- MEDISEP is a state scheme that will operate within the state only, government employees and pensioners are eligible for the scheme.
- The program aims to help about 30 million beneficiaries from the country within three years.
- The scheme aims to cover around Rs 3 lakh annually. Under the MEDISEP scheme, a total of 1,920 schemes will be covered.
- For applicants to be eligible for the scheme and receive benefits, they must be hospitalized for a minimum of 24 hours.
- The concerned authority has provided a list of hospitals registered within the system.
- Readers will get detailed information regarding the scheme through the Kerala MEDISEP portal. Officials will provide coverage as well as financial assistance for 15 days before and after hospitalization.
Find a list of MEDISEP hospitals
Medical insurance for state employees and pensioners (MEDISEP) has been set up to provide cashless treatments to all people and treatments up to Rs 20 lakh will be covered by implementing the MEDISEP hospital list. Beneficiaries can contribute Rs 500 every month from their salaries and this contribution will be directly transferred to the implementation of the scheme for the people of Kerala. The government has allocated a lot of hospitals to develop this scheme and all people will be able to apply for the scheme starting today. The deadline to apply for the scheme is December 31, 2022. The program began on July 1, 2022 for all employers.
List of the Medisep Scheme
- Eligibility of Beneficiaries
- Enrolment of Beneficiary
- Family Enrolment
- Addition and Deletion of Family Members
Benefits of the Kerala MEDISEP Scheme
Benefits of the സംസ്ഥാന ജീവനക്കാർക്കും പെൻഷൻകാർക്കും മെഡിക്കൽ ഇൻഷുറൻസ്
- All employees working in the State Government including the High Court of Kerala and their families who are covered under the existing Kerala Government Servants Medical Attendant Rules [KGSMA Rules, 1960], part-time employees, part-time teachers, teaching, and non-employees.
- The teaching staff of sponsored schools and colleges and their families, pensioners, their spouses, and family pensioners on a compulsory basis, and all All India Service employees working under the Government of Kerala on an optional basis.
- In addition to the above categories, employees and pensioners of universities receiving grants from the State Government and local self-government institutions, personal employees directly appointed by the Chief Minister, Ministers, Leader of the Opposition and the Chief Whip, the Speaker and Deputy Speaker of the House of Representatives, Chairmen of Finance Committees and personal employees are also considered to be pensioners/family pensioners.
- Under the Medisep scheme, the following benefits are given to eligible persons in Kerala.
- Under the Basic Package (BBP), this three-year program will benefit 30 million people. It will give 300,000 rupees annually.
- A total of 1,920 surgical treatments and procedures are covered in the MEDISEP scheme. Although the BBP package will consist of 1,823 actions.
Eligibility of beneficiaries
- All employees working in the state government including teaching and non-teaching staff in schools and colleges supported by the transfer of prescribed fees.
- In addition to the above categories, employees of universities receiving grants from the state government, local self-government institutions, personal employees directly appointed by the Prime Minister, Ministers, Leader of the Opposition, Chief Whip, Speaker of Parliament, Deputy Speaker, and Chairpersons of Finance Committees are also beneficiaries of this scheme.
- Newly appointed employees who join the service during the policy period of three years have to join the scheme by transferring the premium from the month of joining and can avail of Rs 1 lakh per annum as a basic sum assured.
- Part-time employees/pensioners and part-time teachers/pensioners are subject to the transfer of prescribed premiums. Prospective pensioners/family pensioners and Exgratia pensioners/family pensioners must execute a declaration to deduct the scheduled monthly installment from their monthly pension.
- All serving pensioners including teaching and non-teaching staff in schools and colleges are supported by medical allowance deduction.
- In addition to the above categories, university pensioners receiving grants from the state government, local self-government institutions, and retired personal employees/family pensioners are also considered as beneficiaries of this scheme.
Important Points – MEDICAL INSURANCE FOR STATE EMPLOYEES AND PENSIONERS
- Government means the Government of Kerala.
- A medical insurance policy is a contract between an insurer and the Government in which the insurer agrees to provide specified health insurance coverage to the employees and pensioners at a particular premium.
- A hospital means any institution established for in-patient care and daycare treatment of illness and/or injuries and which has been registered as a hospital with the local authorities under the relevant Act, having the standards and benchmarks for hospitalization that provide a network prescribed by IRDAI.
- Hospitalization means admission in a Hospital for a minimum period of 24 consecutive inpatient care hours except for specified procedures/treatments, where such admission could be for less than 24 consecutive hours.
- Inpatient care means treatment for which the insured person has to stay in a hospital for more than 24 hours for a covered event.
- Insurer means an Insurance Company registered under IRDAI and selected by the Government of Kerala.
- Insured Person means a person who has insurance coverage under the scheme.
- Medical Board means a standing medical board constituted by the Director of Health Services consisting of not less than 3 members.
- Medical Expenses are those expenses that an Insured Person has necessarily incurred for medical treatment on account of illness or Accident on the advice of a Medical Practitioner.
- New Born Benefit means the benefit given to the newborn child/children along with the insured mother.
- Newborn baby means a baby born during the Policy Period.
- AB-PMJAY means Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.
- KASP means the proposed Karunya Arogya Suraksha Padhathi.
- Period of Contract means three years from the date of signing of MoU/Agreement.
- Period of Insurance means three years from the date of signing of the MoU/Agreement between the Government and the Insurer.
- A pre-existing disease is a medical condition/disease that existed before the commencement of the insurance coverage obtained from the health insurance policy.
- Pre-hospitalization Post-hospitalization Medical Expenses mean medical expenses incurred during a pre-defined number of days preceding/succeeding the hospitalization of the Insured Person. 30 days before hospitalization and 60 days after discharge.
- Premium means the payment made on behalf of the insured persons as consideration for the policy. The Premium of the employee shall be deducted from their salary in monthly installments and the premium of the pensioner shall be met from their medical allowance.
- The policy plan period means the three years from the date which the scheme starts.
- Provider Network means hospitals or health care providers enlisted by an insurer, to provide medical services to an insured by cashless facility.
- State Nodal Cell means the implementation and monitoring mechanism for MEDISEP under the Authority.
- Sum Assured means the total benefit coverage provided by the insurer.
- CGHS means Central Government Health Scheme.
- HDU means High Definition Unit.
- ICU means Intensive Care Unit.
Enrolment of the Beneficiary
- Beneficiaries must mandatorily fulfill their registration procedures as prescribed by the government during the registration period.
- These beneficiaries may not be registered after the expiration of the registration period.
- In the case of pensioners, the prescribed registration procedures as prescribed by the Government from time to time must be followed.
- The database of beneficiaries will be maintained by the government nodal cell and will be shared with the selected insurance company to initiate the registration process. Beneficiaries will be registered and ID cards will be issued by the insurance company.
- The expiration date of the policy must be a common expiration date for all beneficiaries.
- The insured will have the option to change the details regarding the dependent beneficiary.
- Every employee/pensioner will be notified regarding registration with Permanent Staff Numbers/Pension Payment Order Number.
- Hospitals/nursing homes/day care clinics and beneficiaries must have access to the designated website to see relevant information.
Addition and Deletion of Famly Members
The Scheme must cover family and dependents as follows.
In the case of an insured employee:
- The employee’s legal spouse (who does not have the eligibility to register in this scheme).
- A minor or adopted child/children who are dependent on the insured, until they get a job, get married, or reach the age of 25, whichever comes first.
- Physically/mentally disabled child/children of the employee without any age restriction (certificate must be issued as specified in the scheme).
- The employee’s dependent parents.
In the case of an insured pensioner:
The spouse (who does not have the eligibility to register in this scheme) and the child/children of the physically/mentally disabled pensioner without any age restrictions. (The certificate must be issued as specified in the scheme).
In the case of an insured family pensioner:
The physically/mentally disabled child/children of the pensioner without any age restrictions. (The certificate must be issued as specified in the scheme).
The MEDISEP scheme – who will not benefit from it?
In Kerala, there is still a list of categories of people who will not be eligible for this scheme. Employees and pensioners of autonomous organizations, cooperative enterprises, and boards, such as 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 Media Authority and the Human Rights Commission were not allowed to participate in the insurance system either.
Required Documents
The required documents for the plan are submitted at the beginning.
- ID card
- Mobile Phone Number
- Aadhaar card
- E-mail address
Registration for the Kerala MEDISEP Scheme 2024
- Open the official website of MEDICEP Portal – medisep.kerala.gov.in.
- The home page will be displayed in front of you.
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medisep.kerala.gov.in official website
- Proceed from here by going to the registration option on the webpage.
- There will be a transition to a new page.
- Fill out the application form with the relevant information.
- Please provide any relevant documents that need to be uploaded.
- Make sure all information is correct, then choose the submit option.
- It will be easier for you to join the scheme.
MEDISEP Login Process
- To register or log in to the scheme, you can either contact the officials or directly visit the website link, which is medisep.kerala.gov.in.
- On the MEDISEP home page, there is a login option.
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medisep.kerala.gov.in login
- Login
- University
- Treasury
- Municipality
- Panchayat
- Corporation
- Department
- Enter your login details in the fields.
- You must write it and click on the “Log in” button.
- Your login procedures have now been completed.
MEDCard Online Download Procedures
- Please go to the official MEDISEP website.
- The website’s home page will then load on the screen for you instantly.
- The next step is to click on the “Download Medcard” link on the website – https://medisep.kerala.gov.in/CircularView.jsp.
- The new login page will then appear on your screen.
- Enter your login information, including your Employee ID, MEDICSEP ID, and beneficiary type number.
- Now enter the login button.
- The MED CARD will then be seen. To download it to your device, select the download option.
Know Your Status with the MEDISEP Scheme
- Please go to MEDISEP’s official website.
- The website’s home page will then load on the screen for you instantly.
- Continue from here by selecting the “Status” option on the web page.
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- Select Category and enter Emp ID/PEN/PPONO, Date of Birth.
- Now click on the search option.
- The status will be displayed.
- Click on the print option to download it.
View Medisep Hospital List
- To get started, please visit the MEDISEP Scheme website.
- The screen will then load the website’s home page for you automatically.
- Proceed from here by selecting the “Hospital” option on the web page.
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medisep.kerala.gov.in status check online
- Hospitals (Govt & Private Hospitals)
- View
- Packages
- Reimbursement
- The screen will then display a whole new page.
- Select state and district.
- Now click on the search option.
- The list of hospitals by district will be displayed on the screen.
Top Private Hospitals 2024
Hospital Name | No.of Claims | Amount |
---|---|---|
Amala Institute Of Medical Sciences | 16,154 | 40,57,54,850 |
NS Memorial Institute of Medical Sciences | 12,680 | 35,79,64,047 |
AKG Hospital | 12,003 | 22,51,99,068 |
Malabar Institute of Medical Science | 10,722 | 23,45,54,047 |
MVR Cancer Centre and Research Institute | 10,425 | 29,21,57,410 |
Kozhikode Distrcit corporative Hospital | 10,017 | 25,31,73,632 |
APOLLO ADLUX HOSPITAL (A UNIT OF ADLUX MEDICITY AND CONVENTION CENTRE PRIVATE LIMITED) | 9,900 | 16,84,80,779 |
Badagara Sahakarana Asupathri | 7,738 | 8,52,67,700 |
Top Public Hospitals 2024
Hospital Name | No.of Claims | Amount |
---|---|---|
Regional Cancer Centre | 9,519 | 17,90,28,296 |
Govt. Medical College Hospital Kottayam | 5,322 | 12,14,04,101 |
Medical College Thiruvananthapuram | 3,906 | 12,26,10,946 |
Pariyaram Medical College | 3,141 | 6,69,56,767 |
Medical College Kozhikode | 3,055 | 7,36,00,090 |
General Hospital Trivandrum | 1,909 | 3,64,14,865 |
Medical College Vandanam | 1,841 | 3,38,33,511 |
General Hospital Neyyattinkara | 1,376 | 1,12,92,810 |
Sat Hospital | 1,144 | 2,15,62,412 |
Govt.Medical College Hospital | 1,074 | 2,36,70,149 |
Gh Thalassery | 1,011 | 17,00,705 |
MEDISEP Grievance System
- First, visit the official MEDISEP website.
- The screen will then load the website’s home page for you automatically.
[IGNDPS] इंदिरा गांधी राष्ट्रीय विकलांगता पेंशन योजना
kerala medisep scheme grievance system
- Proceed from here by choosing the “Grievance” option on the web page.
- Click File Grievances and Login & Submit.
Contact Us
Location:
Finance (Health Insurance) Department, Govt Secretariat Thiruvananthapuram, Kerala 695001
Email:
info.medisep@kerala.gov.in
Call:
Phone No.: 0471-2517486
Toll-Free Number: 1800-425-1857
HelpLine(Oriental Insurance): 1800-425-0237
Time: (10.15 AM to 5.15 PM)