Major hospitals missing from govt health insurance scheme list
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Major hospitals missing from govt health insurance scheme list

By Indian Express calender  28-Jul-2019

Major hospitals missing from govt health insurance scheme list

The absence of reputed institutions in the list of empanelled hospitals for the Medisep insurance scheme has irked government employees and pensioners alike. The UDF-affiliated Kerala NGO Association has even warned of an intense agitation if the government proceeds with the new scheme in the current format.      
While the new scheme is to be implemented from August 1, the government’s efforts to empanel more hospitals for the scheme have not met with success. Major hospitals are staying away from the scheme citing the low rates for procedures and the bad experience with the erstwhile RSBY (Rashtriya Swasthya Bima Yojana) scheme which had the same insurance provider.

Some of the major hospitals missing from the list are VPS Lakeshore, Amrita Institute and the Lisie Hospital in Ernakulam, KIMS, Ananthapuri and Cosmopolitan in Thiruvananthapuram and Baby Memorial, Aster-MIMS and Meitra in Kozhikode.
While the existing reimbursement system does not have a maximum cap, the new scheme offers `2 lakh per annum as the basic benefit package. Additional coverage of Rs 6 lakh would be provided for catastrophic illness. In addition, the insurer will also provide corpus fund of Rs 25 crore from which Rs 3 lakh would be provided for a family (only once in three years) in case of a severe illness.
Employees associations fear the scheme would run into trouble considering the experience of the erstwhile RSBY scheme for which Reliance General Insurance was the insurance provider. 

When compared to the reimbursement system, the new scheme does not cover out-patient treatment and employees are required to pay a premium. Though the insurance cover is for the employee and his family members, all government employees in one family are required to pay separate premium amounts. 

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