HEALTH INSURANCE SCHEME FOR
THE CENTRAL GOVERNMENT EMPLOYEES WAITS FOR APPROVAL OF PLANNING COMMISSION
New Delhi, May 18, 2012(PIB): There is a proposal for
introduction of a health insurance scheme for the central government employees
and pensioners on pan-India basis, with special focus on pensioners living in
non-CGHS areas.
The
proposal is to make this scheme voluntary cum contributory for serving
employees & pensioners.
However,
it is proposed to be made compulsory for the new entrants in Government
service.
The
salient features of the proposed Health Insurance Scheme are as under;
Optional for serving Central Government
employees and pensioners including
future pensioners,Compulsory for new recruits,Covers all the members of family
as per CGHS norms,Sum insured – Rs. 5 lakh per year on a family floater basis,Corporate
buffer of Rs 25 Crore to take care of cases exceeding Rs. 5 lakh,All pre
existing diseases covered from the day one,Pre and post hospitalisation
benefits available,
Domiciliary Hospitalisation benefit,Maternity
benefit upto two living children,
OPD not covered however OPD consultations
will be free,Payment of FMA for meeting OPD needs,Cashless treatment facility,Govt.
to subsidise significantly the payment of premium, Employees / pensioners to contribute
20 to 30 percent of the premium,Identification of beneficiaries through a Smart
Card.
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 have special focus on the pensioners living in non-CGHS areas who
are getting Fixed Medical Allowance at the rate of Rs.300/- only 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 Inpatient medical needs which is not
feasible due to resource constraints.
The
Health Insurance Scheme seems to be a viable alternative. It will have
additional implications, due to coverage of pensioners living in non-CGHS areas
and not covered under any Government Scheme.
The
proposal for inclusion of the Health Insurance Scheme for the Central
Government employees and pensioners in the 12th Plan has been moved by the
Ministry for consideration of the Steering Committee on Health in the Planning
Commission.
On
receipt of approval of Planning Commission, the proposal would be placed before
the Expenditure Finance Committee and finally before the Cabinet for approval
of the scheme. No strict time frame can be given in this regard.
This
information was given by the Union Minister for Health & Family Welfare
Shri Ghulam Nabi Azad in reply to a Starred question in Lok Sabha on Friday,
i.e. May 18, 2012.
MACP –SCRUTINY COMMITTEE
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