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6.  Medical Facilities and Health Fund

 

6.1   Medical Facilities

According to G.O.1629 Health 22.06.1971, pensioners are eligible for free medical attendance in Government Hospitals for self and the dependent members of the family. Further there was a provision for reimbursement of medical expenses for treatment other than hospitalisation  upto one month pension or Rs.200 per annum which ever is less. The limit was modified as 10 % of annual pension or Rs.200 per annum which ever is less G.O.2430 H.P.F. 14.09.1976. In lieu of such reimbursement, Government have sanctioned monthly medical allowance as follows.

01.09.1986 Rs.15 per month G.O. 861 Fin 11.09.1986

01.04.1994 Rs.30 per month G.O. 314 Fin 08.04.1994

01.12.1995 Rs.50 per month G.O. 130 Fin 20.03.1997

01.1.2006 Rs.100 per month vide G.O.MS.No.235 Fin (Pay Cell) Dept 1.6.2009

This is extended to the family pensioners also.

 

6.2    Identity Card

For purposes of medical attendance in Government Hospitals, an Identity card had to be issued to the pensioners indicating the amount of pension and other details including the names of members of family dependent on him. The card had to be annually renewed. In G.O. 653 HIMHFW 26.04.1991 this system of annual renewal of the card was dispensed with and in G.O.358 H H F W 03.08.1996 the Production of  Pension Payment   Certificate was ordered as unnecessary and Pension Payment Order to be treated as sufficient for purposes of medical attendance in Government Hospitals.

 

6.3  Tamilnadu Government Pensioner’s Health Fund Scheme

Government has constituted a Health Fund to administer a scheme to reimburse the pensioners the cost of special treatment taken in the accredited Private medical institution for specified surgeries and ophthalmic surgeries upto 75% of the actual cost or Rs.1,00,000 which ever is less. Each pensioner had to subscribe at Rs.5 per annum from 01.04.1995, @ Rs.10 per annum from 01.04.1997, at Rs.5 per month from 01.10.1998, and at Rs. 10 per month from 1.10.2001.Rs.50/-P.M from 1.4.2008, Rs.100P.M. from 1.09.2009 Rs.150/- from 01.01.2012. G.O.562 Fin 11.07.1995, 379 Fin 16.07.1997, 587 Fin 09.10.1998, 404 Fin 9.10.2001. Subject to overall limits, a pensioner can avail assistance for any number of specified surgeries or treatment ( G.O.379 Fin 16.07.1997) The subscription is recovered from the pensioner by way of deduction from the monthly pension.

After taking the treatment, the pensioner has to send an application with such evidence as may be necessary or relevant to establish the need for such treatment for which the assistance is sought to the pension disbursing officers such as Sub Treasury Officers / District Treasury Officers / Pension Pay Officers. Such pension disbursing officers shall scrutinise the claims and forward the claims to the Director of pension with a certificate that the subscription was deducted from the pension to the Pensioners Bank account  through ECS by means of funds Transfer by Indian Overseas Bank, Secretariat Branch G.O.No.81, Fin(Pension) Dept, dt 20.03.2014

The pensioner while sending the application for the claim should enclose an advanced stamped receipt. The Director of Pension should forward a copy of sanction order to the Pension Disbursing Officer who in turn shall make entries in both the HALVES of Pension Payment Order. Letter 61267/ 99- 2 Fin 08.09.1999.

 

Treatments for which Assistance is allowed

1. Open heart surgery

2. Renal  transplant  

3. Lithotropsy 

4. Invitero Fertilisation

5. Emergency Life saving operations on the  in Brain and spinal cord

6. Advanced and Specialised operations on  the Brain and, Spinal cord, such as cardiovascular surgery (Amnoryous AVMS), Skull base surgery,  Deep seated Tumours, Synotactic Surgery, Brain Transplantation etc.

7. Surgery of Intractable Epilepsy

8. Total Hip replacement

9. Total knee replacement

10. Surgical Management of Malignancy (Cancer)

11.Treatment of Cancer/Laser Treatment

 

 Ophthalmic Treatment

 1. Any Cataract Surgery with or without I.O.L (Intra-ocular Lens)

2. Surgery for detachment of  Retina

3. Vitrectomy

4. Kevatoplasty (Corneal Grafting)

5. Laser Treatment– Excimer Laser Argon Laser, Photo Coagulation

6. Glucoma Surgery & Laser  Treatment.

7. Linear Accelerator therapy( for Senile Mascular degeneration,  Tumour etc.,) 

 

List of Accredited Institutions for specialised surgeries / treatment

1.   Apollo  Hospital Enterprises, Chennai . 600 006

2.   Vijaya Hospital, Vadapalani, , Institute of  Cardio Vascular Diseases)

3.  Vijaya Hospital, Vadapalani, Chennai (All Institutions)

4.  Vijaya Health Centre, Vadapalani ,Chennai (All Institutions)

5.  Heart Institute Vijaya Health Centre, Vadapanai, Chennai

6.  Madras Medical Mission under Vijaya Hospital, Vadapalani Chennai-26

7. Trinity Acute Care Hospital, Chennai.-4

8.  K.J. Hospital, Poonamallee High Road, Chennai-84.

9.  G.G. Hospital, Chennai-34.

10.  Tamilnadu Hospital, Cheran Nagar, Perambakkam, Chennai

11.  Devaki Hospital, Luz Church Road, Mylapore, Chennai – 4.

12.  Wellington Hospital, Nungambakkam, Chennai – 6.

13.  Railway Hospital, Perambur, Chennai - 11

14.  Bharthiraja Hospital & Research Centre, 11, Madley Road, T.Nagar, Chennai.17

15.  Santhosh Hospital, Pvt. Ltd. 7th Avenue, Besant Nagar Chennai.90

16.  Guest Hospital, Chennai.

17.  Pandalai Cardiac Thoracic Foundation Transplantation Centre,  Chennai.

18.  Voluntary  Health Service, Adyar, Chennai - 20

19. Sri Ramachandra Medical College & Research Institute, Porur, 
       Chennai - 16

20. Kuppuswamy Memorial Hospital, Coimbatore.

21. Kovai Medical Centre & Hospital  Ltd.  Coimbatore.

22. Christian Mission Hospital, Vellore.

23. T.N. Urological Research Centre Pvt. Ltd., Annanagar, Chennai - 
      102.

24. Meenakshi Mission Hospital & Research Centre, Madurai.

 Ophthalmic Treatments (EYE)

1. Wellington Nursing Home, Haddows Road, Nungambakkam, Chennai - 34

2. Malar Hospital, Adyar Chennai - 20

3. Prems Eye Clinic, Bazar Road, Saidapet, Chennai - 15

4.  Kumaran Hospital, Poonamallee High Road, Chennai-10.

5. Apollo Cancer Institute, Anna Salai, Chennai.

6. Sankara  Nethralaya, College Road, Chennai - 6.   

7. Vijaya Hospital, (TERF), Chennai.

8. M.N. Eye Hospital, Tondiarpet, Chennai.

9. Tamilnadu Hospital, Cheran Nagar, Perambakkam, Chennai

10. Arvind Eye Hospitals at Madurai, Tirunelveli, Theni and 
      Coimbatore.

11. Joseph Eye Hospital, Tiruchirapalli.

12. K.G. Hospital, Coimbatore.

13. T.M.S. Eye Hospital, Salem.

14. Dr.Agarwal's Eye Hospital Ltd., Cathedral Road, Chennai 86.  

15. Sri Kanchi Kamakodi Medical Trust, Ponnurangam Road, West R.S.Puram, Coimbatore - 641009

( G.O. 562 Fin 11.07.1995 ; 818 Fin 20.10.1995 ; 207 Fin 22.04.1997 ; 379 Fin 16.07.1997 ; Letter 55343 / 96 –7 Fin 15.11.1996 ; 6289 / 96 – Fin 05.03.1996  Letter 68485/Pension /2000-01-Fin 04.09.2000) .

6.4    In case of pensioners in receipt of two pensions like pension and family pension, only single medical allowance is admissible. Where the family pension is shared by two widows, medical allowance will be divided equally (Letter 15596 / 99 – 1 Fin 22.09.1999)

6.5   If the spouse of pensioner is in Government service both of them may receive medical allowance at their option. But the option of the spouse in service, to get reimbursement facility will make the pensioner ineligible for Medical reimbursement but he will eligible for medical allowance.
( Letter 86226 / 97 – 2 Fin 17.03.1998 ).


 

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