- Medisep Medical Insurance Scheme Phase 2 launched with Rs 5 lakh basic coverage for Kerala state govt employees and pensioners.
- Expanded coverage includes over 2,100 treatments, cardiac therapies, knee/hip surgeries, and increased emergency procedures.
- New benefits: room rent reimbursement, pre/post-hospitalisation cover, PSU employees included, and robust grievance redressal system.
Medisep Medical Insurance Scheme phase 2 has been launched for Kerala government employees and pensioners, offering a much better insurance scheme for state govt employees, pensioners with higher coverage and new benefits. This scheme is made to give you more complete financial protection against treatment costs by increasing the base coverage and including more treatment options. If you work for the state government or are a pensioner in Kerala, this updated scheme can help meet your healthcare needs effectively.
Who Can Avail and What’s New in Medisep Phase 2
Phase 2 of the Medisep scheme covers about one million families of Kerala state government employees and pensioners. It now also includes employees and pensioners from public sector undertakings (PSUs), boards, corporations, self-governing institutions, and cooperative sectors not covered under ESI. The major change is the increase in basic insurance coverage from Rs 3 lakh to Rs 5 lakh, giving you better financial security against treatment costs.
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More Treatment Options and Expensive Procedures Included
The scheme now covers over 2,100 treatment procedures in 41 specialty categories. Importantly, two costly cardiac treatments—Cardiac Resynchronisation Therapy (CRT with Defibrillator) and ICD Dual Chamber Implantation—which were not covered before, are now included with coverage up to Rs 6 lakh and Rs 5 lakh respectively. Also, surgeries like knee and hip replacements have been added to the basic package, giving you access to key high-cost treatments.
Financial Benefits and Hospital Stay Coverage
Medisep Phase 2 offers reimbursement for room rent up to Rs 5,000 per day in private hospitals and Rs 2,000 per day in government hospitals, supporting better hospital stays. It also covers pre-hospitalisation expenses for 3 days and post-hospitalisation expenses for 5 days, making your hospital stay more affordable and manageable.
PSU Employees Included and Policy Terms Updated
Beyond state employees, those working or retired from PSUs and related sectors can now use Medisep insurance benefits. The policy term has been shortened from three years to two years, and premium rates along with package costs will be reviewed and adjusted in the scheme’s second year. Only public sector insurance companies that meet specific technical qualifications from Phase 1 can take part in the tender for Phase 2.
Emergency Treatments and Daycare Procedure Benefits
Reimbursement for emergency treatment procedures from non-empanelled hospitals has increased from 3 to 13 procedures, adding 10 more cases beyond heart attack, stroke, and road accidents. Also, daycare procedures like dialysis and chemotherapy now allow a one-time registration on the insurance portal. Combined approvals for surgical and medical packages will also make your treatment process smoother.
Grievance Redressal and Quality Control Steps
To protect your rights, the scheme introduces a strong three-level grievance redressal system at district, state, and appellate levels. Beneficiary Medisep cards will come with QR codes for quick access to your data. The insurance company will follow a Standard Operating Procedure (SOP) for strict action against hospitals breaking contract terms, stopping overbilling and bad practices. This monitoring will be supported by the Clinical Establishment Authority’s services.
| Key Features | Details |
|---|---|
| Basic Insurance Coverage | Raised from Rs 3 lakh to Rs 5 lakh |
| High-Cost Procedures Included | Cardiac Resynchronisation Therapy, ICD Dual Chamber Implantation |
| Room Rent Reimbursement | Up to Rs 5,000/day private hospitals; Rs 2,000/day govt hospitals |
| Pre/Post Hospitalisation Cover | Pre – 3 days; Post – 5 days |
| Emergency Procedures Covered | Increased from 3 to 13 procedures |
| Policy Term | 2 years (shortened from 3 years) |
| Claim Processing (Till July 1, 2025) | Over 10.5 lakh claims worth Rs 1,911 crore |
| Website & Info | https://medisep.kerala.gov.in/ |
This updated Medisep scheme greatly improves the financial protection available to you and your family as a Kerala government employee or pensioner. With more treatment options, higher coverage, and better grievance handling, you can confidently get better healthcare without worrying about your money. Make sure you know the new benefits and keep your Medisep card ready to use these facilities well.