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Bank News Medical Reimbursement scheme for Bank Ocers/Employees under

10th BPS

Medical Reimbursement

scheme for Bank

O†cers/Employees under

10th BPS

The new medical reimbursement scheme scheme covers all the

existing employees/ocers in the bank service and same would also be

continued beyond their retirement/superannuation/ resignation etc.,

subject to payment of stipulated premium by them. New recruits will

be covered from their date of joining to the bank. The scheme also

includes the bene†t of cashless treatment facility in hospitals covered

by the scheme. The ocers / employees need not be required to share

the cost of such bene†ts under the new scheme.

The new Scheme would also cover the ocers/employees retiring from

the banks after the scheme is introduced as well the existing retired

ocers/employees of the Banks and dependent spouse subject to

payment of stipulated premium by them. The quantum of coverage forex-ocers is Rs. 4 lakh and ex-award sta is Rs.3 lakh. The quantum of

contribution towards premium payable by the retired/designed sta

will be decided by the individual banks. Till the new scheme is made

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eective and gets implemented, the existing provisions as per Bipartite

Settlement dated 27.4.2010 will continue to operate.

Salient features of the Scheme

1. The Scheme covers Employee + Spouse + Dependents +

any two of the dependent Parents /Parents-in-law.

2. Hospitalization / domiciliary hospitalization and

domiciliary treatment expenses will be reimbursed.

3. No age limit for dependent children (including step

children and legally adopted children.

4. A child/parents/parents in law would be considered

dependent if monthly income does not exceed Rs.10,000

/- per month.

5. Widowed Daughter and divorced / separated daughters,

sisters including unmarried / divorced / abandoned or

separated from husband/widowed sisters.(viii)

Physically/mentally challenged Brother / Sister with 40%

or more disability shall also be covered as Dependent.

6. Reimbursement shall cover Room and Boarding expenses

as provided by the Hospital/Nursing Home not exceeding

Rs. 5000 per day or the actual amount whichever is less.

7. Reimbursement shall cover Intensive Care Unit (ICU)

expenses not exceeding Rs. 7500 /- per day or actual

amount whichever is less.

8. Reimbursement shall cover Surgeon, team of surgeons,

Assistant surgeon, Anaesthetist, Medical Practitioner,

Consultants, Specialists fee, nursing charges, Service

Charges, Administration Charges, Nebulization Charges,

RMO charges, Anaesthetic, Blood, Oxygen,Operation

Theatre Charges, surgical appliances, OT consumables

,Medicines & Drugs, Dialysis, Chemotherapy,

Radiotherapy, Cost of arti†cial Limbs, cost of prostheticdevices implanted during surgical

9. procedure like pacemaker, de†brillator, ventilator,

orthopaedic implants, Cochlear Implant, any other

implant, Intra-Occular Lenses, infra cardiac valve

replacements, vascular stents, any other valve

replacement, laboratory/ diagnostic tests, X-ray CT Scan,

MRI, any other scan, scopies and such similar expenses

that are medically necessary or incurred during

hospitalization as per the advice of the attending doctor.

10. Hospitalization expenses (excluding cost of organ)

incurred on donor in respect of organ transplant to

ocers/ employee/dependent would also be covered for


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reimbursement. Pre- and Post- Hospitalization expenses

payable in respect of each hospitalization shall be the

actual expenses incurred subject to 30 days prior to

hospitalization and 90 days after discharge.

11. Alternative systems of treatments other than treatment

under Allopathy or modern medicine shall include

Ayurveda, Unani, Siddha, Homeopathy and Naturopathyfor Hospitalization and Domiciliary treatment.

12. Day care Treatments shall be covered under the scheme.

13. Domiciliary Hospitalization shall be covered under this

scheme and would mean medical treatment for an

illness/disease/injury which in the normal course would

require care

14. and treatment at a hospital but is actually taken while

con†ned at home under any of the following

circumstances :

(i) The condition of the patient is such that he/she is not in

a condition to be removed to a hospital or (ii) the patient

takes treatment at home on account of non-availability of

room in a hospital. (iii) Treatment taken for speci†ed

diseases which may or may not require. (iv) Domiciliary

Hospitalization / Domiciliary Treatment : Medical

expenses incurred in case of the following diseases which

need Domiciliary Hospitalization /domiciliary treatment as

may be certi†ed by the recognized hospital authorities

and bank’s ’medical ocer shall be deemed as

hospitalization expenses and reimbursed to the extent of

100%.

Mr. Surendra Naik is a retired Chief Manager from Indian

Overseas Bank and Founder, Chief Editor of

www.bankingschool.co.in. He worked at IOB for three and

half decades and specialized in Credit Appraisal & Forex.

RBI reduces Key Policy rates by…

SURENDRA NAIK

http://www.bankingschool.co.in/mailto:[email protected]://www.bankingschool.co.in/author/surendra-naik/http://www.bankingschool.co.in/bank-news/2182/https://twitter.com/sharehttp://www.bankingschool.co.in/author/surendra-naik/


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RBI releases Strate ic Debt Res…

narendra singh rana

September 14, 2015 at 10:11 pm

I m retd employee and willing to contribute under the scheme.

I tried to contact some friends/ branches but they have denied

for any such scheme in force. May I request to let us know the

progress on the subject. Forms in other banks are being †lled

now-a-days, some source informed.

Surendra Naik - Post author

September 15, 2015 at 11:14 am

Sir, IBA has signed new hospitalization scheme for all

bank's existing and all retirees sta. Some banks like

BOB have sent the option letter to each and every

retiree sta at home address. However, retirees of many

banks are still waiting for their bank's

circular/communication.You may therefore, contact

retirees' association of your bank or the association/

union where you were a member during your service

period, to collect the information. If nobody is available

to you, contact your head oce (PAD/retirees cell).

Regards- Surendra Naik

narendra singh rana

September 19, 2015 at 11:27 am

Thanks Sir for ur information. I will proceed

further in the matter.

r v mangrulkar

October 15, 2015 at 6:03 pm

sir,

many thanks for information.

please let me know implementation date of this scheme?

what will be premium employee will have to bear for this

scheme?

Surendra Naik - Post author

October 16, 2015 at 4:48 pm

(5) COMMENTS

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Type and Press Enter

The terms of reference to the scheme has been

elaborately dealt with in the BPS which is applicable to

all the banks. More so a master policy is issued in the

name of IBA covering all the members. Hence, the only

variable component could be funding pattern of the

premium. Some of the banks have already issued

circulars regarding premium payable by the retirees and

some banks are on the process of issuing circular.

please keep in touch with your bank for the eective

date of the scheme. I understand that the scheme is

eective from 1st November 2015.

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Medical Reimbursement Scheme for Bank Officers_Employees Under 10th BPS _ Banking School