Introduction  : Medical Reimbursement For State Government Employees

In This Article We would cover all the relevant details of Medical Reimbursement For State Government Employees. The State provides various facilities to its citizens. Government Servants are crucial human resources of the government, whose assistance is instrumental in implementing various welfare schemes. Therefore, the well-being of government servants is of utmost importance. This is why the state government offers various facilities to its government servants either for free or at a reduced cost.

To Fulfill This Purpose, the Uttar Pradesh Government formulated the Uttar Pradesh Government Servants Medical Reimbursement Rules, 1946, which have been periodically revised through various government orders.

Notification Number 2275/5-6-11-1082/87, dated September 20, 2011, issued by the Health Department, Uttar Pradesh Government, hereby promulgates the Uttar Pradesh Government Servants (Medical Reimbursement) Rules, 2011, incorporating all existing regulations on this subject.

Key Highlights : Medical Reimbursement For State Government Employees

1. Government servants can get their own or their family members’ treatment done in government or non-government hospitals.
2. The reimbursement of medical expenses is to be obtained by the government servant from their department.
3. To avail medical reimbursement, government servants are required to fulfill certain formalities.
4. Within 30 days of commencing treatment, the government servant must inform their office or Within 90 days of completing treatment, it is mandatory to submit a complete medical claim.
5. Medical bills vouchers, doctor’s prescriptions, and related documents must be verified by the relevant doctor or hospital and submitted to the office on a specified form.
6. It is the responsibility of the department or office to have the technical examination of submitted medical bills, vouchers, etc., conducted by the Chief Medical Superintendent.
7. After the technical examination by the Chief Medical Superintendent, the approved amount is transferred to the government servant’s bank account.
8. In this way, the reimbursement of medical expenses is made available to the Government Servant.

Eligibility: Medical Reimbursement For State Government Employees

To receive reimbursement for medical expenses incurred by government employees themselves or their family members, the following eligibility criteria must be met:

Eligible Family Members for Medical Reimbursement:

1. Spouse of the government employee, regardless of their status.
2. Parents.(Father and Mother)
3. Children, Unmarried/Divorced Daughters, Adult Sons till Age 25

Note: The above family members should be wholly dependent on the government employee and must reside with them.

Definition of Dependent: Medical Reimbursement For State Government Employees

To be eligible for medical reimbursement for family members, they must be wholly dependent on the government employee, and their monthly income should not exceed INR 3,500.

1. Sons until they are employed, reach the age of 25, or get married, whichever comes first.
2. Daughters until they are employed or get married.
3. Permanently incapacitated sons, for their lifetime.
4. Adult brothers.
5. Widowed dependent sisters, divorced daughters.

Details of Forms Required for Medical Claim Submission:

1. Annexure A – This form is filled when treatment is done without admission in Hospital                     (Non Admit Case)
2. Annexure B – This form is filled when treatment is done with admission. (Admit Case)
3. Enclosure of Medical claim-related bills, vouchers, receipts, doctor’s prescriptions, etc.
4. Mandatory Certificate: Signed by the treating doctor.
5. Annexure G: This form is submitted to the government employee’s department/office.

Medical Advance Facility: Medical Reimbursement For State Government Employees

Sometimes, Government Employees faces situations where they do not have the financial means to cover the expenses of a serious illness. In such circumstances, the Uttar Pradesh Government Servants (Medical Reimbursement) Rules provide government employees with the option of a medical advance facility.

Under this facility, government employees can prepare a statement of the total expenses incurred for their treatment at their hospital, get it certified by the Chief Medical Superintendent, and submit it to their department for medical advance. The department disburses the amount approved for medical advance to the government employee before the completion of the treatment.

Once the treatment is completed, all bills, vouchers, and related documents must be submitted to the department for reconciliation with the approved medical advance amount. This means that the government employee is required to submit all bills and documents related to the treatment up to the amount approved as a medical advance. After a technical examination, the reconciliation of the medical advance is completed.

It’s important to note that no interest or additional charges are levied on government employees for the medical advance.

UP State Cashless Health Card : Know Full Details

About Pandit Deendayal State Employee Cashless Medical Scheme.

 

The Uttar Pradesh Government, through a government order issued on January 7, 2022, has provided cashless medical facilities to government employees of the state, retired government employees, and their dependent family members. This facility will be available in all registered private hospitals and government medical facilities under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

In private registered hospitals, each beneficiary family can avail cashless medical treatment up to a limit of five lacs (5Lac) rupees annually. On the other hand, government medical institutions/hospitals will provide cashless medical treatment without any financial limit.

To avail the benefits of this scheme, it is mandatory for every eligible beneficiary to possess a State Health Card, which will ensure the identification of the beneficiary for cashless medical treatment in registered healthcare facilities.

Features of Cashless Health Card For Uttar Pradesh Government Employee

1. This program offers free medical treatment to people who work for the government of Uttar Pradesh, as well as retired government employees and their families.
2. You can get free medical treatment at certain private and government hospitals that are part of the Ayushman program.
3. Each family covered by this program can receive free medical treatment up to Rs. 5 lakh per year at private hospitals approved by Ayushman Bharat.
4. There is no financial limit for free medical treatment at government medical colleges, institutions, and other government hospitals in Uttar Pradesh for families in the program.
5. Any government employee in Uttar Pradesh, retired government employees, and their families can use this program to get free medical treatment.
6. People in this program will receive a State Health Card.

Click to Find The District Wise Hospital List Where You Can Avail Cashless Treatment

Conclusion: Medical Reimbursement For State Government Employees

The provision of medical reimbursement by the state government is a boon for any government employee. It is one of the reasons why young individuals aspire to secure government jobs. Medical expenses incurred by government employees are eventually reimbursed, enabling them to seek treatment from their preferred hospitals and doctors.

Alongside the medical reimbursement system, the Uttar Pradesh state government has also introduced a cashless treatment scheme for its employees, known as the Pandit Deendayal State Employee Cashless Medical Scheme.

 

FAQ (Frequently Asked Questions)

 Can I Get Full Medical Claim Amount which i have spent?

Yes, If Chief Medical Officer Approved the Amount after technical examination of your submitted medical Claim

From Where I Get the Medical Annexure for submitting medical claim?

You can get all related medical annexure from your office, the person who is dealing medical reimbursement work, can provide you the same.

In Cashless Treatment Can i get full claim?

No, Depends on your post or designation in your office, you will be eligible for limited amount for cashless claim.

Is State Cashless Treatment Facility covers all illness?

Yes, it covers almost all illness, but you should verifying from hospital first, because some hospitals are not entitled for the same.

Is is mandatory to have Aadhar card for applying cashless card?

Yes, It is mandatory and you should have the same mobile number which is linked to your Aadhar.

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