I keep hearing about the MEDISEP scheme in Kerala. Can you give me a simple overview of what this scheme is, who it is for, and what benefits it provides?
MEDISEP, which stands for Medical Insurance Scheme for State Employees and Pensioners, is a mandatory health insurance scheme launched by the Government of Kerala. It is specifically for state government employees and pensioners and provides them with a cashless hospitalization cover of ₹3 lakh per family per year.
Who is Covered Under the MEDISEP Scheme
My friend, who is a government school teacher in Kerala, explained the eligibility to me. He said that he, his wife, and his young son are all automatically covered under this scheme. It is a mandatory program for all serving state government employees, all state government pensioners (including family pensioners), and their eligible dependent family members.
The Financial Benefit: ₹3 Lakh Cashless Cover
I was speaking with my uncle, who is a retired pensioner living in Kerala, about the benefits. He confirmed that the scheme provides his family with a total health cover of ₹3 lakh per year. He explained that this is a ‘family floater’ policy, meaning the ₹3 lakh is a single, shared pool of money that both he and my aunt can use for any covered hospitalization expenses during the year.
Where the MEDISEP Scheme Can Be Used
My teacher friend recently had to use the scheme for a minor surgery. He was able to get completely cashless treatment at a large empanelled private hospital in his city. He also mentioned that one of the best features of the scheme is its portability, which allows beneficiaries to get treatment at certain designated super-specialty hospitals in other states like Tamil Nadu.
How the Scheme is Paid For
My uncle explained that he doesn’t have to worry about missing premium payments. A fixed, nominal amount is automatically deducted from his monthly pension as his contribution towards the scheme. For my teacher friend who is still working, the same premium amount is deducted from his monthly salary. This ensures that the coverage is always active.