The State government has effected a conceptual change in its new health insurance scheme for its employees by including medical treatment of various illnesses and associated diagnostic procedures.
Under the previous scheme, the cost of surgical procedures was covered, but not that of medical treatment or diagnostic procedures.
But, under the new scheme, the coverage will include the cost of medicines, laparoscopic or open surgeries, doctor and attendant fees, room charges, diagnostic charges, dietary charges availed in the approved hospitals, according to a government order issued by the Finance Department on June 29. However, transport charges would be excluded. The coverage would include pre-existing illnesses, which had been included in the list drawn up by the government.
Among those who were covered under the new scheme were employees of government departments, teaching and non-teaching staff of aided educational institutions; Noon Meal Workers and Village Assistants; employees of local bodies, State Public Sector Undertakings, Statutory Boards and State Universities; employees of willing organisations/institutions registered under the Tamil Nadu Registration of Societies Act, 1975, covered under the previous scheme for 2008-2012; employees on deputation to other departments, those recruited through employment exchanges on a regular basis and employees of the Hindu Religious & Charitable Endowments Board. They along with their family members covered under the new scheme could avail themselves of assistance up to the limit of Rs. four lakh in a block of four years, from July 1, 2012 to June 30, 2016, on a cashless model.
The government, after going through the motion of a national competitive bidding, has chosen the United India Insurance Company for implementation of the scheme. The annual premium for the scheme would be Rs. 1,860 per employee, excluding service tax, whereas the premium under the previous scheme was Rs. 495.
Under the new scheme, the amount of medical assistance is Rs. four lakh, whereas it was Rs. two lakh under the earlier scheme.
The premium to be paid by an employee is Rs. 150 per month, while it was Rs. 25 earlier. At the same time, the government’s contribution has gone up from Rs. 200 to Rs. 300. The official attributes the increase to factors such as inflation, provision of higher amount of medical assistance and wider coverage.
For a person who is not in government service, the annual premium would have been at least Rs. 10,000 for a similar health insurance policy.
