Darkness ahead! Crucial Rs 16,500 vaccination excluded from MEDISEP 2.0

THIRUVANANTHAPURAM: MEDISEP, the health insurance scheme implemented for state government employees and pensioners, will no longer provide benefits for vaccinations to prevent blindness. The vaccination for age-related macular degeneration (AMD), a disease that affects the elderly, was excluded from MEDISEP 2.0, which came into effect on the 1st of this month. AMD, which is common in people over 50 years of age, can cause blindness if the intravitreal vaccine is not administered on time.

In the first phase of MEDISEP, Rs 30 crore was sanctioned in 19,326 claims for this disease. This is one of the ten most expensive treatments in MEDISEP. It is alleged that the insurance company and the government have joined hands in a bid to reduce claims of pensioners.

An intravitreal injection costs Rs 16,500. The number of injections required depends on the patient's condition. In the first phase of MEDISEP, claims were sanctioned for up to six injections in a year. This resulted in a benefit of Rs 99,000.

Causes of the disease

👉 Age

👉 Smoking

👉 High blood pressure

👉 Diabetes

Almost 18.51% of people in Kerala are affected by the disease.

MEDISEP’s decision comes at a time when this treatment is being covered under the pension scheme for central government employees, the CGHS, the ECHS for retired soldiers, the pension scheme for VSSC employees, and the policies of private insurance companies.

Hospitals are ready to accept all the suggestions put forward by the government to ensure transparency in MEDISEP. The decision to deny essential treatment was taken without consultation -Dr. Devin Prabhakar, Ophthalmologist, State President, Qualified Private Medical Practitioners Association (QPMPA).