Extension of medical facilities of PMJAY to GDS

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Sub- Extension of facilities of Pradhan Mantri – Jan Arogya Yojana (PM-JAY) to Gramin Dak Sevaks (GDS) and Preparation of database of GDS for the purpose of the said scheme-regarding
No. 17-31/2016-GDS-ESIC    Dated 16.02.2024
Issuing Authority  Director GDS, GDS Section, Department of Posts, Governnment of India

 

Directorat has issued a letter to all circles regarding the proposal of extension of medical facilities of PMJAY to GDS of this Department.

Importants Points :

In this context, the Department of Posts is exploring the feasibility of extending the facilities of PM-JAY to GDSs in consultation with National Health Authority (NHA), Ministry of Health. The proposal is under active consideration in the Department. The proposed features of the scheme are as under, The scheme is a family floater scheme with a sum assured of Rs 5 Lakh per family enrolled

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Extension of medical facilities of PMJAY to GDS
Extension of medical facilities of PMJAY to GDS

 

  1. The scheme is a family floater scheme with a sum assured of Rs 5 Lakh per family enrolled.
  2. The scheme facilitates cashless healthcare services to its beneficiary in any of the public sector hospitals and private network hospital.
  3. The Scheme is expected to be on contributory basis and is proposed to be mandatory for all the GDSs. The contribution within Rs 250 to 300/- per month to be drawn from TRCA of the GDS.
  4. To operationalize the scheme, the DOP proposes to remit to the NHA, one month’s contribution per GDS subscriber, as advance of estimated expenditure at the beginning of the scheme. The enrolled GDS and his/her dependent family members would be able to utilize the services under the scheme only after one month from deduction of the first contribution.
  5. The NHA is responsible for providing IT support and handling other operational aspects of scheme implementation. In terms of claim processing, the NHA will provide support up to the level of Claim Processing Doctors.
  6. As regards, three non PMJAY States/UT, viz, Delhi, Odisha and West Bengal. The subscribers of these states/UT are proposed to be covered under the Central Govt. hospitals (including CGHS empaneled hospitals) for treatment
  7. The formulation of policies and guidelines specific to Gramin Dak Sevaks will be exclusively decided by the DOP. The DOP reserves the right to revise any policy regarding cashless treatment for beneficiaries.
  • The NHA will be able to provide access to hospitals empaneled under the Central Government Health Scheme (CGHS) and Pradhan Mantri Jan Arogya Yojana (PMJAY).

3             It Is requested to give your comments and suggestions on the above proposal before the same is finalized. It Is also requested to prepare a database of all the GDSs and their Family members [as mentioned in Rule 3 (h) of the GDS (Conduct & Engagement) Rules, 20201 in excel format as per Annexure-A attached herewith by29.02.2024. The data field discription is attached herewith for reference as Annexure-B. The salient features of Existing PMJAY Scheme of Govt. are at Annexure-C

 

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