State employees will now have health insurance coverage of up to five lakh rupees through New India Insurance or Oriental Insurance. Both these government companies have qualified in the technical bid issued by the Health Department. The financial bid for this is now set to open. The company that offers the lowest premium in the financial bid will be selected for health insurance. The selection of the insurance company will be for a period of three years.
Health Department is finalizing the tender this month to start health insurance for state employees. Before this, the selection of the insurance company will be made and a work order will be issued along with an MOU. Health insurance will be provided to approximately five lakh current and retired employees through the insurance company. Current and retired members of the legislative assembly and educational institutions will also benefit from this.
Insured employees and their dependents will receive cashless treatment at listed hospitals up to five lakh rupees. In case of serious illness, payment of up to ten lakh rupees will be made from the insurance company’s corporate fund. If there is a claim for an amount exceeding this, it will be settled by the society. In an emergency situation, insured employees or their dependents can also be admitted to non-listed hospitals.
In such cases, the insurance company will have to compensate at the CGHS rate. Pre-existing illnesses will also be covered under this insurance. Treatment for insured patients can also be done at listed hospitals in other states.
Within one month of the work order being issued, the insurance company will create health insurance ID cards for all enrolled employees. The portal for payment of claims by hospitals will also be prepared by the insurance company.
Free treatment up to five lakh rupees Under health insurance, free treatment up to five lakh rupees will be available at listed hospitals. If the expenses exceed this amount, it will be reimbursed to state employees. Earlier, this reimbursement was done at AIIMS rates. But now it will be done at the CGHS rate.
If both husband and wife are government employees, only one of them will be insured. The benefit of insurance will be available to the wife, parents, and other dependents. If the son is up to 25 years old or employed (whichever comes first), his treatment will also be covered. Similarly, daughters will also receive free treatment up to 25 years or until marriage
