THIRUVANANTHAPURAM: There have been complaints regarding the MEDISEP scheme which was initiated to offer cashless healthcare to government employees. It's alleged that a person seeking treatment worth Rs 5000 was only allowed Rs 5 under the scheme.

A kidney patient who sought treatment at the medical college was surprised by the MEDISEP cashless claim. Gayathri, an employee of the museum department had an unpleasant experience with MEDISEP. Last Friday, she came for treatment at the super specialty nephrology department of the medical college. After regular registration, one should be able to purchase medicines and medical equipment from approved medical stores.

However, only Rs 5 was granted. When she reached out for clarification, she was informed that this allocation was indeed correct. As a result, she had to cover over five thousand rupees for medicine and other necessary expenses, which weren't covered by insurance. Thankfully, the expenses within the hospital ward were covered. Subsequently, the patient is seeking assistance from the CASP scheme for further treatment.

The MEDISEP project which began in 2022, functioned well in its first year. Nevertheless, there have been complaints that the service did not improve in the second year. It is known that this program is being terminated after the government rejected the insurance company's request to increase the premium. The Oriental Insurance Company which operates the scheme has requested a monthly premium increase from Rs 500 to Rs 550 due to the rise in claims through MEDISEP. This would result in an annual premium increase from Rs 6,000 to Rs 6,600.

The insurance company initially estimated that, in the first year, the MEDISEP scheme, which commenced in July 2022, would need to allocate Rs 500 crore to hospitals. However, the final estimate shows that claims had to be paid to the tune of Rs 697 crore. The company is reporting a loss of 217 crores in the first year. Presently, the claim rate is at 136 percent. The 35 crore rupees, intended for the treatment of serious diseases over three years were disbursed within eight months. Allegations suggest that there is a lack of responsiveness in reducing these losses through claims.