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The Goa Mediclaim Scheme helps Goa residents get financial support for advanced medical treatments not available locally, Read More... covering critical surgeries and therapies. Read less

Details

The Government of Goa, through its Health Services Department, has introduced the Goa Mediclaim Scheme to support its citizens. This initiative aims to make advanced and super-specialty medical care accessible to those who need it, especially when these treatments aren't offered in state-run hospitals.

What Is This Scheme?

The Goa Mediclaim Scheme is designed to provide financial assistance for complex medical procedures and treatments that are beyond the scope of services offered by Goa's government hospitals. It ensures that residents don't have to face a financial burden when seeking life-saving or advanced medical care elsewhere.

Who Can Benefit From This Scheme?

This scheme is for permanent residents of Goa who have lived in the state for at least 15 years. It specifically targets individuals who require specialized medical interventions like dialysis, complex surgeries, cancer treatments, and more, which are not available within Goa's public healthcare facilities.

Why This Scheme Is Important

In today's medical landscape, certain super-specialty treatments can be extremely expensive. This scheme bridges the gap by providing crucial financial support, ensuring that residents can receive timely and appropriate medical care without worrying excessively about the costs. It underscores the government's commitment to the health and well-being of its people.

Objective

The Goa Mediclaim Scheme helps Goa residents get financial support for advanced medical treatments not available locally, covering critical surgeries and therapies.

Benefits

Pension Amount:The scale of benefit under the pension will be notified by the Government of Andhra Pradesh.Mode of Disbursement:The Bill Collector disburses the pension to the eligible individuals in the presence of Ward members and office bearers of DWCUA.Time of Disbursement:The pension is disbursed on the first date of every month.

Sources and references

Guidelines

Eligibility Criteria

You must be a permanent resident of Goa.
You need to have lived in Goa for at least 15 years, be listed in the voters' list, and possess a permanent ration card.
Your annual family income should be less than ₹1,50,000. However, if you are a retired state government employee, your income does not matter for eligibility.
The treatment you require must not be available in any Government Hospital in Goa (including Goa Medical College, Bambolim, and District Hospitals). An exception is made for NICU, Ventilatory Support, and Kidney Dialysis, where you can choose an empanelled hospital even if the facility is available in a government hospital.
You must be suffering from a condition requiring one of the specified super-specialty treatments covered by the scheme.

How To Apply

Obtain the necessary medical certificates and fill out the application form.
Submit the completed application along with all the required documents to the designated authority.
Ensure all information provided is accurate and meets the scheme's requirements.

For detailed application procedures and to download the declaration form, please refer to the official scheme guidelines and the links provided in the documents section.

Documents Required

Medical Certificate from a doctor at Goa Medical College, Bambolim, Hospicio Hospital, Margao, or Asilo Hospital, Mapusa.
Income Certificate (Form ‘B’ from the Mamlatdar) in original OR Certified Copy of Pension Payment Order (PPO) if you are a retired state government employee.
Residence Certificate.
Mediclaim Certificate from the Medical Superintendent, Goa Medical College, Bambolim, along with a photocopy.
Recent Passport Size Photograph of the patient.
Completed Declaration Form. (Available via official link)
Photocopy of the Election Card / Ration Card of the patient. If the patient is a minor, a photocopy of either parent's Election Card is needed.
Deen Dayal Swasthya Seva Yojana (DDSSY) card.
Aadhaar Card.

Official Sources

Goa Mediclaim Scheme Guidelines & Declaration Form

FAQ’s

What is the income limit to apply for the Goa Mediclaim Scheme?

Your annual income should be less than ₹1,50,000. However, retired state government employees are exempt from this income requirement.

Which super-specialty treatments are covered by this scheme?

The scheme covers a range of treatments including dialysis, plastic surgery, ICU care, chemotherapy, radiotherapy for cancer, open heart surgery, kidney transplants, neurosurgery, cochlear implants, and treatments for spastic children, cerebral palsy, and skeletal deformities.

Do I have to go to a specific hospital for treatment?

You should choose from the list of hospitals recognized under the scheme. However, for treatments like NICU, Ventilatory Support, and Kidney Dialysis, you can opt for any empanelled hospital, even if the facility is available in a government hospital.

What is the maximum amount I can get for open heart surgery?

The maximum financial assistance provided for open heart surgery, including procedures like valve replacement, is ₹3,00,000.

Can retired government employees benefit from this scheme?

Yes, absolutely. Retired state government employees are eligible for the Goa Mediclaim Scheme, and there is no income ceiling for them.

What is the financial aid for bone marrow transplants?

The scheme provides financial support up to ₹8,00,000 for bone marrow transplants.

Is cancer treatment covered under this scheme?

Yes, the scheme covers radiotherapy and chemotherapy for cancer treatment with a maximum financial assistance of ₹5,00,000.

What if the treatment cost is less than the ceiling limit?

The financial aid will be the lower of the two: either the permitted ceiling limit for the treatment or the actual expense incurred for the treatment.

What documents are needed to apply for the scheme?

You will need documents such as a medical certificate, income proof (or PPO for retirees), residence proof, a certificate from the Medical Superintendent, a declaration form, patient's ID proofs (election/ration card, Aadhaar), and DDSSY card.

Does the scheme cover cochlear implants?

Yes, cochlear implant surgery is covered under the scheme with a financial limit of ₹1,50,000.

What is the role of the Medical Superintendent in the application process?

The Medical Superintendent of Goa Medical College provides a crucial Mediclaim Certificate, often confirming that the required treatment is not available in state government hospitals.

Are there specific benefits for children with certain conditions?

Yes, treatments for spastic children, cerebral palsy, and skeletal deformities are covered, with a financial limit of ₹1,50,000.