Dear Shri Prakash Toke ji, [Chief Editor]
As per your advice,. I have gone through the summary of Group Medical Scheme for in service and Retd employees, issued by Central Office Mumbai
and have touched some important points for the benefit of all concerned.
The financial limit of amount for dependents is revised to Rs 10530 from Rs. 9810.
Dependent parents/in laws of retired persons
are also covered.
Spouse, Dependent children till their marriage of retired employees are also covered.
Spouse and Dependent children of deceased employee [in service/retired] are also covered.
Imp. Some TPAs in some zones are also changed.
1.Northern Zone: Now Good Health TPA instead of MD India
shall look after the cash less medical and other reimbursement of the bills.
Toll free No, for LIC is 1800 103 9533
2. East Central Zone:
Now wef 1.4.20 Vipul Med.Corp. TPA will look after the cashless and other reimbursement of the bills in place of Raksha TPA
The toll free No.for
Vipul Med Corp. is
18001087477
In other zones, the TPAs will remain same
Room rent:
The formula is the same but some stations especially
JAIPUR has been re categarised to A class City from B class
Category earlier revising maximum limit of Rs.7500. In cases where the total SA is 40 or 50 lakhs the limit is further enhanced to Rs 10 000 /- per day.
A great relief to Jaipur people whose constant demand for increase in room rent being Capital city where the room rent is very high is now acceded to.
The rate is 1.5% for all cities but ceiling is Rs.4000 for Class C and 6000(previously 5000) for class B and 7500 for class A city and 10000 for SA of 40 or 50 lakhs.
U may peruse the list of stations given in the summary.
NO CEILING FOR ICCU.
PRE AND POST EXPENSES:
For pre 30 days/post 60 days hospitalisation expenses of reimbursement are sam cue. V8 in However in case of renal failure and or organ transplantation and/or
Cancer related ailment
Treatment, the conditions of 30/60 days are waived.
Payable:
Only Registration/Admn.charges GST/surcharges, are payable. Service charges if charged in hospital bill shall be payable within room rent eligibility.
TPA : TPA will not be changed on transfer to another Zone or residence is shifted to another place,.
Expenses relating to diagnostic test without hospitalisation
MRI Charges 20-21
8000 Each insured
CT scan. 6000
Sonography. 2000
Excluding maternity
Biopsy. 4000
Tread Mill. 2000
Echo. 2000
Gastroscopy 5000
Colonoscopy. 7000
EEG. 1000
EMG. 2000
Holter Monitor. 5000
PAP Smear. 750
PSA(Prostate. 750
Specific Antigen)
Mamography. 5000
PET Scan. 20000
Other conditions remaining the same.
Full detail will be available in MOU when signed.
CP Chugh
Orgn.Secretary
RIEA
Jaipur.
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