Thiruvananthapuram: The Department of Finance has decided to continue the Medisep health insurance scheme for government employees and pensioners. However, the second phase of the scheme will be implemented with major changes.
Considering the complaints against Medisep, the department has issued an order appointing an expert committee headed by IAS officer Dr Sriram Venkitaraman to suggest the changes. Members of the committee include technical advisor Dr Arun B Nair; Superintendent of Kottayam Medical College, Dr T K Jayakumar; Prof Biju Soman; Dr A Jayakumar; Dr A V Jayakrishnan; Dr A L Lijeesh and Dr Binoy.
According to the government, the monthly premium should be increased from Rs 500 for the scheme to be effective. Oriental Insurance Company, which has partnered with the government for Medisep, has also demanded this. The government points out that while claims worth Rs 450 crore were anticipated during the first two years of the scheme, the actual claims crossed Rs 600 crore in both years.
The three-year agreement between the government and Oriental Insurance will end on June 30, 2025. The government will invite fresh bids to operate the scheme in the coming years after receiving the report from the expert committee.
The chief complaint against Medisep was that the insurance company did not meet the full treatment expenses of employees and pensioners. Consequently, the beneficiaries were forced to pay the difference in hospital bills out of their pockets. Moreover, several hospitals expressed reluctance to join the scheme as the treatment charges fixed by the insurance company were lower than the actual rates. Finance Department officials said that the solution to both these issues is an increase in the monthly premium collected from employees.
