Thiruvananthapuram: Kerala’s flagship Medisep health insurance scheme, covering government employees, pensioners, and their families, is poised for significant revisions as the state government prepares for crucial discussions next week. The proposed changes come amid rising healthcare costs and growing dissatisfaction among beneficiaries.
Premium Hike & Expanded Coverage
With medical inflation driving up expenses, the government has confirmed that premiums will increase from the current ₹500 per month. While the exact hike remains undisclosed, sources indicate it could align with revised treatment packages, which include new procedures and updated cost structures.
The scheme, currently administered by Oriental Insurance Company, operates under a three-year contract set to expire on June 30, 2025. Authorities must finalize a new agreement before the deadline, with negotiations expected to address coverage gaps and reimbursement delays—key pain points for policyholders.
Growing Demand for Opt-Out Option
A major flashpoint is the mandatory enrollment policy, which has drawn sharp criticism from employee unions and pensioners. Many argue that the scheme’s poor hospital network, claim delays, and perceived second-tier treatment make it ineffective.
“We are treated like burdened patients in empaneled hospitals,” said a state employee under anonymity. “If we’re paying premiums, we deserve dignified care.” Several service organizations have formally urged the government to introduce an opt-out mechanism, allowing beneficiaries to seek alternative insurance.
Private Insurers Back in the Picture?
In a potential policy reversal, the government is also reconsidering its earlier decision to exclude private insurers from Medisep. Insiders suggest that competition could improve service quality, though critics warn of higher costs.
Scheme’s Massive Reach
With 3.08 million beneficiaries, including dependents, Medisep is one of Kerala’s largest health security nets. Yet, its mixed reputation—praised for affordability but criticized for execution—has fueled the current debate.
What’s Next?
The Health Minister’s office has not yet responded to queries, but stakeholders expect clarity after next week’s meeting. Key questions remain:
- How much will premiums rise?
- Will the opt-out demand be accepted?
- Can private insurers fix the scheme’s flaws?
- Updates will follow as officials weigh these critical decisions.
Related topics:
IRDAI Chairman Proposes Full Foreign Investment in India’s Insurance Sector to Boost Growth
Prudential Partners with Thomson Medical to Enhance Healthcare Access for IP Customers
Mitsui Sumitomo to Invest $4 Billion in W. R. Berkley for 15% Stake
