He said that the scheme has been implemented after several rounds of discussions with all the employee organizations and has got wide acceptance.
He said that the scheme has been implemented after several rounds of discussions with all the employee organizations and has got wide acceptance.
Medicep is a unique and comprehensive social insurance plan Like no other and who is going to be a model for the rest of the country. However, there was an organized effort by some hospitals and lobbies to thwart the scheme, Finance Minister KN Balagopal said in the Assembly on Wednesday.
“There are initial troubles that need to be addressed and efforts are on to enlist more hospitals so that the plan becomes more meaningful. Some hospitals were deliberately staying away from the plan and if this attitude continues, they will have to be named and exposed,” he said.
He was responding to a calling attention motion by Ramesh Chennithala on Medicep, a health insurance scheme for government employees and pensioners. Mr Chennithala claimed that the medical reimbursement scheme which was earlier in force without any cost cap had been “upset” by the government. Implementation of Medicep And that the government had brought the scheme without doing any homework.
Mr. Balagopal in his reply said that even after the implementation of Medicep, medical reimbursement for outpatient procedures, interest free medical advance and medical advance to pensioners were retained.
He said that a government employee above 50 years of age would have to pay an annual premium of at least ₹ 25,000 to join any health insurance scheme. There was no insurance plan that offered such comprehensive coverage, including government guarantees and covering all pre-existing diseases, for an annual premium of just ₹6,000. Around 35 lakh persons including pensioners were getting benefited from this scheme.
The government has also created a corpus fund of Rs 35 crore, from which the cost of treatment of 12 critical diseases and organ transplant will be met.
Shri Balagopal said that the scheme has been implemented after several rounds of discussions with all the employee organizations and the scheme has got wide acceptance. The plan involved 1,920 procedures. So far only 396 hospitals including 143 government hospitals have been empaneled. However, emergency medical care can also be sought from hospitals that are not listed under Medicep. Three tier grievance redressal mechanism has also been set up
He added that any employee who has tried to claim medical reimbursement would be well aware of the cumbersome procedures and red tape involved in obtaining reimbursement. In contrast, Medicep is a cashless insurance plan, which is completely digitally managed. Within the first few weeks, Medisep . 902 claims worth ₹1.89 crore were settled under
He sought the cooperation of the opposition and all stakeholders to improve the scheme. There is a need for social pressure to connect more hospitals to the scheme. The government has already started several meetings to empanel more hospitals, Mr. Balagopal said.