The New Health Insurance Scheme will provide cashless health insurance coverage to the families of all the employees of Government of Tamil Nadu, State Public Sector Undertakings, Local Bodies in Tamil Nadu, State Government Universities and Statutory Boards under the control of the Government of Tamil Nadu.
MD India Implementing Agency (TPA)
Issue I.D Cards and Guide Book containing all the details of the Scheme, List of Network Hospitals and Contact details of the offices of TPA, to all the Beneficiaries. Issue Authorization Letter (Approval letter) to the Network Hospital for cashless treatment of the beneficiary in the Network Hospital. Establish 24 hrs functioning, dedicated BSNL Toll Free No./Help Line no. Process and settle the claims of Network Hospitals. Process and settle the reimbursement claims of beneficiaries who have taken treatment at the Government Hospitals.
New Health Insurance Scheme Rules, 2016
To extend the scope of assistance for medical treatments available under the existing Scheme. To cover more ailments and more hospitals including payment wards of Government Hospitals. To extend assistance for medical treatments to the employees of State Public Sector Undertakings, Local Bodies in Tamil Nadu, State Government Universities, Statutory Boards under the control of the Government of Tamil Nadu, the Noon Meal Workers, Anganwadi Helpers, Village Assistants, etc., State Government Organisations / Institutions registered under the Tamil Nadu Registration of Societies Act, 1975, Regular Employees of the Tamil Nadu Electricity Regulatory Commission and Tamil Nadu Institute of Labour Studies.
To provide financial assistance upto Rupees Four lakhs per Family of the Employee for a block of four years. To provide the assistance through cashless model.
Enhanced Sum Insured will be applicable for Rs.3.5 Lakhs for the specified Procedures.
MD India Implementing Agency (TPA)
Issue I.D Cards and Guide Book containing all the details of the Scheme, List of Network Hospitals and Contact details of the offices of TPA, to all the Beneficiaries. Issue Authorization Letter (Approval letter) to the Network Hospital for cashless treatment of the beneficiary in the Network Hospital. Establish 24 hrs functioning, dedicated BSNL Toll Free No./Help Line no. Process and settle the claims of Network Hospitals. Process and settle the reimbursement claims of beneficiaries who have taken treatment at the Government Hospitals.
New Health Insurance Scheme Rules, 2016
To extend the scope of assistance for medical treatments available under the existing Scheme. To cover more ailments and more hospitals including payment wards of Government Hospitals. To extend assistance for medical treatments to the employees of State Public Sector Undertakings, Local Bodies in Tamil Nadu, State Government Universities, Statutory Boards under the control of the Government of Tamil Nadu, the Noon Meal Workers, Anganwadi Helpers, Village Assistants, etc., State Government Organisations / Institutions registered under the Tamil Nadu Registration of Societies Act, 1975, Regular Employees of the Tamil Nadu Electricity Regulatory Commission and Tamil Nadu Institute of Labour Studies.
To provide financial assistance upto Rupees Four lakhs per Family of the Employee for a block of four years. To provide the assistance through cashless model.
Enhanced Sum Insured will be applicable for Rs.3.5 Lakhs for the specified Procedures.
- Surgery, Chemotherapy, Radiotherapy and Immunotherapy for all Malignancies including Inpatient procedures for diagnosis.
- Liver, Kidney, Heart, Lungs and Bone Marrow Transplantation.
- Complex Open Heart Surgeries and Implants.
- Accident and Trauma cases involving Multiple Fractures.
- Heart valve replacements, Aneurysms and Angioplasties.
- Management of Burns.
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