Last Updated on September 1, 2021 at 1:17 pm
Finance Department of Jammu and Kashmir has decided that the medical claims of government employees will be covered under SEHAT scheme.
“Attention of all the Administrative Departments is invited to the Ayushman Bharat PM-JAY-SEHAT Scheme implemented in the Jammu & Kashmir. The Government is providing free health insurance cover to all the citizens of J&K for Rs 5 lakh per family per year on floater basis. The Government employees are also eligible for enrollment under the said insurance scheme” a circular read.
It further read “However, it has been observed that large number of medical reimbursement claims of employees are not being preferred under the insurance scheme being provided by the Government due to various reasons”.
The issue has been examined in the Finance Department and it has been decided that the claims for medical reimbursement of employees and their dependent family members pertaining to the post launch period of SEHAT Scheme shall invariably be preferred under the said scheme. The expenditure beyond the insurance cover shall continue to be reimbursed by the Government as per the provisions of the J&K Civil Services (Medical Attendance-cum-Allowance) Rules, 1990, the circular read.
The medical claims of the Government Servants and their dependents, who are registered under the scheme shall be considered for reimbursement under Medical Attendance Rules, only for the amount beyond the insurance cover being provided under the SEHAT insurance scheme.
The medical claims of the Government Servants, where beneficiaries have applied for registration under the scheme but have not been registered will be considered for reimbursement under Medical Attendance Rules, provided it is established with documentary evidence that the application of the patient for registration under the scheme has been submitted prior to the date of under taking treatment.
The medical claims of the Government Servants and their dependents, who have not applied for registration under the scheme, shall be considered for reimbursement under Medical Attendance Rules, only for the expenditure incurred beyond the admissible Insurance cover.
