State Employee Health Insurance Scheme becomes a boon

  • | Saturday | 31st May, 2025

State Employee Health Insurance Scheme is proving to be a boon for government employees. More than 500 beneficiaries have been treated under this scheme in a short period of about 2 months. One beneficiary has been given cashless treatment of more than Rs 24 lakhs and one has been given cashless treatment of about Rs 14 lakhs. Apart from hospitals located in the state, they are also being treated in hospitals located outside the state. Apart from listed hospitals, treatment is also being done in hospitals as per CGHS provisions. When the State Employee Health Insurance Scheme was started on March 1, no one had even imagined that this scheme would become so popular. So far, more than one lakh 83 thousand employees, officers and pensioners of the state government and 4 lakh 65 thousand of their dependents have been included under this scheme. Apart from this, about 15 thousand advocates practicing in the High Court of Jharkhand state have also been included under this scheme. The participation of employees, officers or other beneficiaries under the scheme is increasing day by day. The insurance company has listed 192 hospitals in the state and 673 hospitals outside the state for proper treatment of employees. Hospitals in 169 cities of the country have been covered under the scheme. There is a plan to cover big hospitals of all the main cities of the country. The number of listed hospitals is continuously increasing. All the major hospitals of the state like Orchid, Pulse, Sanford, Paras, Raj, Health Point are listed under this. Along with this, cashless treatment facility is also available in big hospitals like Max, Yatharth Group, Apollo and BM Birla. According to the information received from the department, till now about 600 employees have availed the benefit of treatment in cashless and reimbursement mode (CGHS rate) under this scheme. There is a provision to pay the CGHS rate fixed by the Government of India for treatment from hospitals other than the listed hospitals. It is worth noting here that under this scheme, the cashless package rate is more than the CGHS rate. All the necessary expenses like room rent, medical procedure, nursing expenses etc. have been provided in the treatment package. Under the scheme, insurance coverage of Rs 5 lakh is done in the initial stage and Rs 10 lakh in case of serious illness. If required, all the amount above Rs 10 lakh is given from the corpus fund. Further action is being taken to provide air ambulance facility under this. The biggest feature of the scheme is that the benefits of the scheme start being available from the first day itself, that is, there is no waiting period in it. Also, insurance coverage is given even in case of any pre-existing disease, whereas in other schemes, checkup is done first and a high premium amount has to be paid. There is also no age limit in this. Maternity benefits for women also start from the first day. The department is also developing a mobile app. Through this app, beneficiaries will be able to get all the related information, such as the amount available in the wallet, treatment details, hospitals and the treatment facilities available there. 25 lakh rupees paid to one employee and about 14 lakh rupees to another A state employee met with an accident on the road. Currently, he is undergoing treatment in a very big multi-specialty hospital in Ranchi. Under this scheme, 24 lakh 91 thousand rupees have been paid to the concerned hospital for his treatment. Also, 12 lakh rupees will be given soon. In this way, an amount of about 14 lakh rupees has been made available in hospitals outside the state and within the state for the treatment of another state employee who is suffering from kidney disease.

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