Medical claims of Govt servants to be reimbursed only beyond SEHAT cover

Excelsior Correspondent
JAMMU, Sept 1: Finance Department has clarified that medical claims of the Government servants and their dependents, who are registered under the Ayushman Bharat (PM-JAY SEHAT) Scheme, shall be considered for reimbursement under Medical Attendance Rules only for the amount beyond the insurance cover being provided under the scheme.
A circular in this regard has been issued by the Finance Department (Code Division) of J&K Government, inviting attention of all the Administrative Department observing that large number of medical reimbursement claims of employees are not being preferred under the insurance scheme being provided by the Government due to various reasons.
“The issue has been examined in the Finance Department and it has been decided that the claims for medical reimbursement of employees and their dependent family members pertaining to the post launch period of SEHAT Scheme shall invariably be preferred under the said scheme,” reads the circular, adding that the expenditure beyond the insurance cover shall continue to be reimbursed by the Government as per the provisions of the J&K Civil Services Rules, 1990.
The circular further clarifies that the medical claims of the Government Servants, where beneficiaries have applied for registration under the scheme but have not been registered, will be considered for reimbursement under Medical Attendance Rules, provided it is established with documentary evidence that the application of the patient for registration under the scheme has been submitted prior to the date of undertaking treatment.
The medical claims of the Government Servants and their dependants, who have not applied for registration under the scheme, shall be considered for reimbursement under Medical Attendance Rules, only for the expenditure incurred beyond the admissible Insurance cover, further reads the circular.