Punjab Government Employees health insurance scheme
Punjab government employees pensioner cashless health insurance scheme 2016 for newly state Recruited Retired retiring PGEPHIS Punjab cashless health insurance scheme smart card yojana latest news medical treatment rules
Punjab government employees scheme and pensioner health insurance scheme is for those sarkari naukari people who are All personnel of the Punjab Government cashless health insurance scheme including All India Service officers Newly selected bharti, who are Retired in previous year 2015 and today Retiring 2016 they are eligible under the existing Punjab Medical insurance scheme for state government employees or Attendant Rules [CS(MA) Rules, 1940] shall be offered Health Insurance Scheme policy on compulsory or on optional basis
Punjab health insurance card will be provided to those online registration form who fill Punjab govt health insurance scheme they are advice to submit their Enrollment Form within the duration of Enrollment Period. The enrollment of new employees, who join after the last date of after the date of expiry due date of Enrollment Period, shall continue throughout the policy plan period. Cashless health insurance for Punjab government employees including all IAS & IPS officers serving in the State- serving and retired will be covered under the existing Punjab Medical Attendant Rules PGEPHIS would be available on voluntary/ optional basis
Punjab health insurance scheme PGEPHIS online application form will cover the indoor/ daycare entitlements as specified under the State Services. Maternity and Newborn Benefits means treatment taken in Empanelled Hospital/Nursing Home arising from childbirth including Normal Delivery/Caesarean. Chandigarh cashless health insurance Scheme shall cover a family and dependents current policy irrespective
Income Age Limit for dependency of Punjab family medical insurance members shall be as defined under existing Punjab Medical Attendance. New Employees Cashless Health Insurance Scheme As regards the new incumbents the coverage in the insurance scheme is compulsory. The data of such employees/ pensioners will be collected from the various departments by the Insurance Company.
Base Sum Insured: The Scheme shall provide coverage for meeting all expenses relating to hospitalization of beneficiary members up to Rs. 3, 00,000/- per family per year. In an event the Buffer Sum Insured of Rs 25 crores gets completely exhausted, the cashless reimbursement more than Rs 3.00 lacs will not be available to any employee/ pensioner and the over and above expenses shall be met by the State Government as per the extent of the medical reimbursement policy and procedures.
Payment of Premium:
In case of serving employees/pensioners and mentioned as a opted category,
The premium of the main member as well as dependent
a) The enrolment period shall start with immediate effect from the date of Notification of the Scheme and will be completed by 31-12-2015, except for I) "New employees", who shall be eligible to get covered under PGEPHIS after, The date expiry of the enrollment period, i.e. their date of joining into the Service
Deletion from Family is allowed in following contingencies:
a) Death of covered beneficiary,
b) Divorce of the spouse,
c) Member becoming ineligible (on condition of dependency)
Photo ID Cards along with the Guide Book shall be handed over by the Insurance Company SBI insurance company, oriental insurance LIC Star health insurance to the DDOs for onward delivery to the employee/ pensioner
Network Hospitals for all types of treatment: Govt private hospitals in Punjab, Chandigarh &Panchkula
Punjab Cashless Health Insurance Scheme date: The insurance policy coverage/ Policy Plan Period shall commence from 1st January 2016 and will expire on midnight 12.00 am of 31-12-2016.
CASHLESS ACCESS SERVICE: The TPA/ Insurer has to ensure that all PGEPHIS members are provided with adequate facilities so that they do not have to pay any deposits at the commencement of the treatment or at the end of treatment to the extent of the Services as covered under the Scheme. The service provided by the Insurer along with the responsibilities of the Insurer as detailed in this clause is collectively referred to as the “Cashless Access Service.”