MRS Rulings for Working and Retired BSNL Employees
10/9/13
BSNL MRS In a Nutshell
All about BSNL Medical Reimbursement Scheme.
· this
scheme came into force from 24 th feb-2003 for the benefit of bsnl working
& retired employees
and their family members.
·
GENERAL GUIDELINES
·
all serving and
retired employees (including vrs) of
bsnl who had opted and retired from
bsnl are eligible.
·
non optee employees are not eligible for the scheme
·
on the death of bsnl
employee who was availing the facilities, the family pensioner shall continue
to avail the same facility.
·
OUT DOOR TREATMENT –
WITH VOUCHER:
·
the employee and his
eligible dependents are entitiled to
the reimbusement of actual expenses for
any branch of health care such as:
· homeopathic,
· ayurvedic,
· naturopathy,
· yogic etc.,
·
in case of chronic
diseases as listed below, this limit of 25 days salary will be waived off in deserving cases.
·
cancer,
·
renel failure,
·
cerebral
·
palsy & spastics,
·
t.b.
·
thalassemia major.
·
the claim form shall
be supported by the copies of prescriptions along with origional vouchers (in
duplicate) towards the expenses incurred.
·
the claim must be
submitted once in a month
·
out door treatment
with out voucher:
·
payment once in three
months for out patient treatment with out vourcher scheme was discontinued
from 1-10-2011
· all employees
are eligible , for with vouchers
scheme only
·
TREATMENT IN
RECOGNISED HOSPITALS:
·
criteria of
dependency shall be as defined under cghs and cs ma rules and as amended from time to time
·
every april or on
crossing the above eligibility, mrs
card to be updated
·
group-d -- general ward
·
group-c -- semi private ward
·
gr-a jag and above
o
private ward with ac
TREATMENT IN NON
RECOGNISED HOSPITAL:
·
in emergency cases, the reimbursement will be
allowed for treatment in non recognised hospitals also with the approval of
cgm.
·
the amount will be restricted to rates applicable as
per cghs rates/ package charges.
·
DETAILED OPERATIVE
INSTRUCTIONS
·
in general, employee
to take indoor treatment at hospitals as applicable for his place of posting
and place of residence of his family.
·
WHO ARE THE
DEPENDENTS?
·
the term family for the purpose of the cs ma
rules-1944 shall mean a govt servant’s
·
wife or husband
·
parents (if getting income / pension
below rs. 3500 p.m.)
·
son below 25 years of
age and unemployed
·
daughter till gets
married
·
the retired employee have the option to choose the
circle / ssa of their choice for availing the facility under bsnl mrs.
·
they should furnish a joint declaration as to who
will prefer the claim of medical expenses in respect of spouse and child.
·
SPECIAL
GUIDELINES FOR BSNL MRS
·
reimbursement of cost of appliances is within the
annual limit of outdoor treatment only.
·
cost of spectacles is not reimbursable
·
costmetic surgery shall not be allowed.
MEDICAL CARD
·
employees who are on
deputation to bsnl at the time of retirement,
and absorbed in bsnl subsequently, are
also eligible.
·
procedure for
reimbursement
·
the medical card of the
pensioner will be revalidated every year in the month of april.
·
out patient claim to
be submitted to zonal ao (p&a)
only.
·
inpatient treatment
bills to be submitted to a.o.
(mrs) at o/o dgm admn
·
the condition of
emergency are,
·
acute coronary
sydnromes (bye pass/ angioplasty)
unstable angina, paroxysmal. ventricular failure,
·
cardiac failure,
accelerated hyper tension, heart block, stoke
·
adam attack
·
acute limb inschemia,
sudden unconsciousness, head injury, respiratory failure , accute paralysis,
acute visual loss
·
road traffic
accidents with injuries including fall
·
acute poisioning
·
acute renel failure
·
acute obstertrical
and gynecologial emergencies.
·
where no cghs rates are prescribed on any indoor
treatment, rates notified by govt.
hospitals or aiims hospital will be taken into account for settlement.
·
treatments taken in ayurvedic, unani & naturopathy shall be considered as outdoor
treatment
·
reimbursement of cost of applainances such as cpap /
bpip machine , only 50% of the cost will be reimbursed. remaining 50% to be paid by the employee in out patient limit only.
·
as per order
dated 2-9-2009, those who are having
mediclaim policies, can prefer his claims from both the sources.
·
reimbursement will be restricted only to the
admissible amount of cghs rates/ packages.
·
cost of stent and angioplasty is reduced by cghs.
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BSNL MRS In a Nutshell