Goa Mediclaim Scheme, State Govt. Schemes

An unique scheme of "Mediclaim" has been introduced in Goa since 1989. Under this scheme, financial assistance to the maximum extent of Rs. 1.50 lakhs per illness is provided for availing super specialties which are not available under the State Government hospitals, for residents of Goa, whose annual house hold income is less than Rs. 1,50,000/- per annum. However, in the case of medical treatment such as kidney transplantation/ open heart surgery, cancer and neuro surgery, the aforesaid limit will be to the maximum extent of Rs. 3,00,000/- (rupees three lakhs) with medicines for post operative care.
Kind of treatment covered are (i) Neurological Disorders ; (ii) Cardio-Thoracic Surgery ; (iii) Kidney transplantation ; (iv) Plastic Surery; (v) Radiotherapy ; (vi) total Replacement of Joints ; (vii) Any other major diseases/illness. In order to avail this facility one has to apply to the Director of Health Services in the prescribed form C & D along with (i) Medical Certificate in form -A from the Medical Superintendent, Goa Medical College stating that the patient is referred to some other recognized Hospital since the facilities are not available at Goa Medical College and (ii) Income certificate in Form-B from the concerned Mamlatdar. Medical Certificate shall be issued by the Medical Superintendent of Goa Medical College (GMC) on the recommendation of the Unit Head of various Department of GMC or Sr. Consultant of Hospitals attached to this DHS after ascertaining that the particular case cannot be treated at Government Hospital in the State of Goa including GMC. Based on this certificate, Director of Health Services shall issue letter for Mediclaim.
Incase any patient has gone to recognised institute outside Goa for treatment which is not available in Government Hospitals in Goa, without Mediclaim Certificate he shall apply directly to the Director of Health Services along with the relevant papers.
The patients can avail the super specialties under this scheme in any of the following recognized hospitals in Goa State or outside Goa State.
I. In the State of Goa
1. Salgaonker Research Centre, Vasco and
2. Chodankar Nursing Home, Porvorim
3. Maharaj Goa M.R.I Scan Centre, Bambolim
4. Manipal Goa Cancer Hospital, Dona Paula, Panaji Goa.
II. Outside the Goa State:
5. K.L.E.S. Hospital, Belgaum.
6. Kasturbha Hospital, Manipal
7. Wockhardt Hospital, Bangalore
8. Jaslok Hospital, Mumbai
9. Tata Memorial Hospital, Mumbai
10. Wanless Hospital, Miraj
11. Swasthiy Prathistan Fracture & Orthopaedic Hospital, Miraj
12. R. G. Stone Clinic, Mumbai
13. Ruby Hall Clinic of Great Medical Foundation, Pune.
14. Madras Medical Mission, Chennai
15. K.E.M. Hospital, Mumbai .
16. Nanavati Hospital, Mumbai
17. Bombay Hospital and Medical Research Centre, Mumbai
18. P.D. Hinduja Hospital, Mumbai.
19. Wadia Hospital, Mumbai
20. J.J.Hospital, Mumbai
21. Sion Hospital, Mumbai
Government of Goa has tie-ups with the hospitals listed at sr. nos. (1) to (13) above, so that patients need not pay the hospital authority and the hospital authorities will directly submit the bills to the Directorate of Health Services for settlement to the tune of Rs. 1,50,000 or actual whichever is lower. Incase the patients opt to go to the hospital listed at Sr. No. (14) to (21), they have to pay first to the hospital authorities and then submit the bills which are countersigned by the hospital authorities to the Director of Health Services for reimbursement. However such patients before proceeding for treatment should invariably obtain the letter of authority in Form-E from the Director of Health Services.

For Application Forms