MEDISEP Application Form PDF Details
PDF Name
MEDISEP Application Form in Malayalam
No. of Pages05
PDF Size212KB
Language Malayalam
CategoryGovernment
Sourcemedisep.kerala.gov.in

MEDISEP Application Form

The Kerala government is supporting cashless treatment for government employees and retirees, and employees can take advantage of the scheme by filling out the MEDISEP Application Form, which can be found at the bottom of this page. Employees are entitled for medical reimbursement from government and empanelled private institutions for both outpatient and inpatient medical care.

MEDISEP (Medical Insurance Scheme for State Employees and Pensioners) is a scheme that provides comprehensive health insurance coverage of up to Rs 3 lakh per year. In the event of serious illness, a higher amount is permitted. As part of the initiative, hospitals will be able to accept cashless payments. The unclaimed sum from the first year can be carried forward to the next year up to Rs 1.5 lakh. For stays of more than 24 hours in the hospital, insurance coverage will be granted.

MEDISEP Scheme Eligibility Criteria

  • By remitting the specified premium, all serving State Government employees, including teaching and non-teaching personnel of Aided Schools and Colleges, are covered.
  • Part-time contingent employees/pensioners, as well as part-time teachers/pensioners, are required to pay a premium.
  • Dependents, spouses/partners, children under the age of 25, and children of any age with a physical or mental disability are also eligible.
  • Employee’s parents who are financially dependent on him or her

Major treatment expenses – MEDISEP

  • ver transplant: Rs 18 lakh
  • Bone marrow transplant: Rs 9.46 lakh
  • Cochlear implantation: Rs 6.39 lakh
  • Kidney transplant: Rs 3 lakh
  • Knee replacement: Rs 3 lakh
  • Hip replacement: Rs 4 lakh
  • Brain surgery: Rs 18.24 lakh
  • Heart, lungs transplant: Rs 15 lakh

MEDISEP Benefit Package

  • Basic Benefit Package – The Insurer shall pay all expenses (as mentioned in the package costs) spent by the beneficiaries in the course of medical treatment in empanelled hospitals (24-hour admission clause) for the medical, surgical, and day-care procedures listed in Annexure 1
  • Additional Benefit Package: Insurance coverage provided in addition to the baseline coverage listed in Annexure 2 for catastrophic illnesses.
  • Pre-existing disease coverage: All diseases covered by the Scheme will be covered immediately and there will be no waiting time.
  • Pre &Post hospitalization benefit: Benefits up to 15 days prior to hospitalisation and up to 15 days after hospitalisation, which would cover all expenses linked to the treatment of the illness for which hospitalisation was performed. In empanelled hospitals, the beneficiary will be able to use this benefit without having to pay any money.
  • A new-born child or children of an insured woman are covered from the moment they are born until the current policy plan period expires. However, the child or children could be insured as a regular family member next year. The scheme will cover all congenital illnesses in newborn newborns and children.
  • The insurance coverage will begin on the first day of the policy plan period and will last until the policy plan period expires.
  • Based on the pre-authorization process undertaken by the insurance company and authority, ‘Unspecified Procedures’ should be covered within the Basic Benefit package, which will be limited to Rs.1.5 lakhs per annum throughout the three-year block term. According to the regulation provisions released by IRDAI from time to time, new diseases such as COVID-19 will be covered.

Categorized in: