With special focus on pensioners and serving Central government employees, a health insurance scheme is in the offing.
While, the government has proposed to make the scheme voluntary-cum-contributory for serving employees & pensioners, it is proposed to be made compulsory for the new entrants in government service.
The new scheme, according to the health ministry, will cover all the members of family as per the CGHS norms. “The sum insured — `5 lakhs per year on a family floater basis, corporate buffer of `25 crores to take care of cases exceeding `5 lakhs has been proposed.â€
The scheme includes pre and post hospitalisation benefits, domiciliary hospitalisation benefit and maternity benefit up to two living children. “While, the OPD consultations will be free, the new scheme will have cashless treatment facility,†proposes the government.
The government is also set to subsidise significantly the payment of premium. The employees/pensioners will contribute 20 to 30 per cent of the premium. For identification, a smartcard has been proposed. The proposed scheme will be an alternative to the CGHS and it will provide an option to the serving employees and pensioners to choose a scheme as per his/her convenience.
The scheme will also have special focus on the pensioners living in non-CGHS areas who are getting fixed medical allowance at the rate of `300 per month to take care of their medical needs and have been demanding extension of CGHS or CS (MA) Rules to cover their OPD and in-patient medical needs.
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http://www.asianage.com/india/health-insurance-scheme-offing-061
