There is good news for pensioners and employees in Madhya Pradesh. Following the steps of Rajasthan
and Haryana, the state government is set to launch a cashless health insurance scheme for over 1 million officers, employees, and pensioners.
The scheme is expected to be officially announced in the upcoming state budget.
It will be a contributory and cashless scheme, providing coverage of up to ₹35 lakh for the treatment of serious illnesses.
The scheme will include employees, their spouses, and dependent children. Every beneficiary will receive a digital card with their photograph. Pensioners and their spouses will also be covered.
The blueprint for the scheme has been prepared by the Public Health and Medical Education Department, with inputs from employee organizations.
After approval from the Finance Department, it will be presented to the state Cabinet.
How the Scheme Will Operate
The scheme will be managed by the State Health Agency, which will include experts from legal, insurance, and health sectors. A technical team will handle claims processing, health packages, and hospital affiliations.
Additionally, a special task force will be formed to review the scheme periodically and make key policy decisions.
Eligibility and Registration
Who can benefit:
Employees, their spouses, parents, two dependent children, and adopted children
Pensioners and their spouses
Registration process:
Eligible beneficiaries will be registered through MPSIDC and provided a unique digital ID card. The head of each office will approve dependent details and carry out annual verification.
Pensioners will be registered using their pensioner code. The card will also show the pensioner’s pay band and department details.
Coverage for Medicines and Equipment
Insured employees will receive ₹20,000 per year for outpatient treatment, medicines, and medical equipment. Costs of equipment and implants will be covered according to CGHS package rates.
Emergency and Non-Affiliated Hospital Treatment
In emergencies, treatment can be provided at non-affiliated hospitals, with costs reimbursed under the scheme.
The plan will cover:
All Ayushman Yojana affiliated hospitals in Madhya Pradesh
Hospitals affiliated with the Government of India health scheme
High-quality hospitals identified outside the state
Through this initiative, Madhya Pradesh employees and pensioners will have access to affordable, convenient, and completely cashless health services.
