Punjab Government Employees Cashless Health Insurance Scheme
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
Enrollment Period:
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.”
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