Medisep Phase 2 Monthly Premium Raised to ₹750

Quick Summary

• The State has issued a Government Order (GO) approving Phase 2 of the Medical Insurance Scheme for State Employees and Pensioners (Medisep).
• Monthly premium for medisep Phase 2, including taxes, will increase to ₹750, up from ₹500 in Phase 1, subject to finalisation of the bid.
• Medisep covers over 30 lakh individuals, including approximately:

– 5.45 lakh government employees,
– 5.89 lakh pensioners and their dependents.

• Enhanced basic insurance coverage under Medisep Phase 2 is ₹5 lakh with provisions for larger medical procedures and catastrophic illness coverage.
• Policy period: Two years; a 5% increase in premiums and package rates is applicable in the second year.
• Expert committee recommendations include:

– Extending insurance cover to employees/pensioners of public entities without ESI benefits such as autonomous bodies and cooperative sectors.
– Empanelment of national-level institutions like Sree Chitra Tirunal Institute or reimbursement based on revised package rates if empanelment is unfeasible.
– Direct enrolment by respective institutions via payments made to the insurer for eligible beneficiaries under similar terms as Medisep Phase 2.

• Over 2,100 procedures are part of its benefit package covering around 41 specialised treatments,developed based on Health Benefits Package (HBP) formulated by the National Health Authority.

The revamped scheme seeks improved accessibility through advanced health benefits costing models.

Indian Opinion Analysis

Medisep Phase 2 represents an ambitious upgrade aimed at providing robust health insurance coverage to state employees and pensioners while possibly addressing broader underserved segments such as workers in public sector undertakings who lack ESI support. This notable shift reflects an institutional effort toward inclusive social security mechanisms amidst escalating healthcare costs.

The enhancement from ₹3 lakh to ₹5 lakh basic coverage combined with an expanded procedure list indicates a recognition of increasing medical expenses associated with catastrophic illnesses. Though, cost implications-such as a presumable burden via increased premiums-raise questions about affordability for lower-tier beneficiaries among this target demographic.

Empanelment or reimbursements tied to national-level institutions further prioritise access-oriented policies but also demand seamless coordination between insurers and high-expertise hospitals. Overall success hinges on obvious implementation aligning both beneficiary needs and service accountability within available resources.

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