Big update for CGHS beneficiaries! The Centre has launched an optional health insurance scheme called ‘Paripoorna Mediclaim Ayush Bima’ for existing beneficiaries of the Central Government Health Scheme (CGHS).
The new bima policy will offer CGHS beneficiaries features like cashless facilities, modern treatments and access to a wide network of hospitals, according to the Department of Financial Services (DFS), under the Ministry of Finance.
These facilities can be availed on a paid basis by subscribing to the Paripoorna Mediclaim Ayush Bima plan, while existing CGHS facilities will continue for beneficiaries.
The Centre’s aims to expand medical coverage for existing eligible government employees and pensioners through this bima plan.
Paripoorna Mediclaim Ayush Bima key features
- It complements existing CGHS facilities
- Beneficiaries can avail modern treatments through a wide network of hospitals across the country
- Cashless facilities available
- The plan will cover a maximum 6 members per policy
- Room rent is capped at 1% and 2% of sum insured per day for normal room and ICU, respectively.
- A pre-hospitalization coverage for 30 days and post-hospitalization coverage for 60 days is available.
What is the maximum sum insured under the plan?
The Ayush Bima provides indemnity-based in-patient hospitalization coverage within India, with sum insured options of Rs 10 lakh or Rs 20 lakh. The product will have co-payment component allowing beneficiaries to choose between 70:30 or 50:50 co-sharing between insurance company and the subscribers.
AYUSH treatments are covered up to 100% of the sum insured for in-patient hospitalization and modern treatment is covered up to 25% of the sum insured, with an optional rider for 100% coverage. Cumulative bonus of 10% for every claim-free year, up to a maximum of 100% of sum insured.
As compared to regular policy, it will be available at a discount of 28% and 42% for 70:30 and 50:50 premium co-sharing, respectively.
How can CGHS beneficiaries buy this policy?
This optional health insurance plan will be available as a retail product for all CGHS beneficiaries, with No GST to ensure maximum affordability.
“Designed to complement existing benefits, this enhanced policy will provide seamless experience, with greater flexibility and expanded access to quality healthcare services across India, thus leading to additional financial security with ease and confidence for all CGHS beneficiaries,” the finance ministry said.
The bima policy will be available for purchase via New India Assurance Company Limited’s offices and online platform, shortly.