Controversial Medisep sees 25000 registrations in Kerala

Thiruvananthapuram: Amid the ongoing calls for boycotting the newly launched Medisep health scheme in Kerala, the number of beneficiaries of the scheme have crossed 25,000 within two months of its implementation on July 1, 2022.

TNIE adds that around 24,439 beneficiaries availed the benefits of the scheme until August 25, 2022 and the total cost of the claims is worth around Rs 73 crore. Most of the patients who availed the scheme were treated for dialysis, cataract surgery and treatment for respiratory diseases. Around seven percent of the total beneficiaries opted Government hospitals for their treatment..

Meanwhile, the total number of hospitals who have agreed to be part of this scheme has increased to 277. However, around 50 hospitals among them are offering selective coverage and only some specific departments of those hospitals are covered under the Medisep scheme. In case of government hospitals, around 150 such hospitals are already a part of the scheme.

Medisep Scheme was implemented from July 1, 2022 and it aims to cover around 1,920 medical procedures. PTI had earlier reported that Government employees and their dependents in Kerala would be able to avail the benefit of this scheme. Besides government employees, pensioners/ family pensioners and their eligible family members, employees and pensioners of state-run universities and the directly recruited personal staff of the Chief Minister, Leader of Opposition, Chief Whip, Speaker, Deputy Speaker and so on can also benefit from the Medical Insurance Scheme for State Employees and Pensioners (MEDISEP) scheme.

Issuing order in this regard, the Pinarayi Vijayan government had fixed the annual premium of the employees and the pensioners as Rs 4,800 plus 18 per cent GST for the policy period of 2022-24. The order had also mentioned that the monthly premium would be deducted as Rs 500.

It was being expected that the scheme would benefit more than five lakh government employees and almost the same number of pensioners and their dependents in the state.

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Medisep policy covers an individual for three years on a floater basis since every year the beneficiary can claim Rs 1.5 lakh fixed coverage and Rs 1.5 lakh floater. The benefit of such an arrangement is the fact that the unused floater benefit gets carried over to the next year. Therefore, a person who did not avail the floater gets the benefit of Rs 4.5 lakh for the next year.

Besides, there is a corpus fund worth Rs 35 crore for the beneficiaries with catastrophic illnesses and the insurance company uses the money from this fund to assist such people.

Debate concerning Medisep:

Ever since the State Government implemented the Medisep health scheme, there has been controversies regarding this. Several empanelled hospitals in the State were not complying with the Medisep agreement with the Government and in this regard, earlier, the State had decided to take stringent action.

In an earlier media report, The Hindu had mentioned that calling these problems an organized attempt to scuttle the scheme, Minister Balagopal recently told the Assembly, "There are teething troubles that need to be settled and efforts are on to empanel more hospitals so that the scheme is more meaningful. Some hospitals were deliberately staying away from the scheme and if this attitude continued, they would have to be named and exposed."

Such a response was given by the Minister while responding to motion by Ramesh Chennithala on Medisep. Mr. Chennithala alleged that Medisep has "upset" the existing medical reimbursement scheme that did not have any cost limit. He also claimed that the State had introduced Medisep without the required homework.

However, replying to this, Mr. Balagopal had informed that the existing Medical Reimbursement scheme for outpatient procedures, interest-free medical advance and the medical advance for the pensioners had been retained even after Medisep came into existence.

More than 25,000 Beneficiaries within two months:

As per the latest media report by The New Indian Express, despite all these controversies, a total number of 24,439 beneficiaries have availed the scheme until August 25, 2022. Among them, more than 200 people availed the special fund dedicated for catastrophic procedures. Besides, 172 cases of knee joint replacements, 15 hip replacements, eight liver transplants, five kidney transplants and three cases of Cardiac Resynchronisation Therapy (CRT) are also included in the list of beneficiaries.

In respect to the most number of beneficiaries, NS Memorial Institute of Medical Sciences, Kollam comes first as a total number of 890 people who were treated in the hospital, availed the Medisep scheme.

Apart from this, 784 people availed treatment at Amala Institute of Medical Sciences, Thrissur, 330 people at the Regional Cancer Centre and 249 patients were treated at Government Medical College, Kottayam.

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