In a significant step to strengthen healthcare security for government employees, the Department of Financial Services (DFS), Ministry of Finance, has launched Paripoorna Mediclaim Ayush Bima for beneficiaries of the Central Government Health Scheme (CGHS). The optional insurance plan is designed to complement existing CGHS facilities by offering wider hospital access, cashless treatment, and coverage for modern and AYUSH-based therapies at affordable premiums.
A Complementary Health Cover for Government Employees
The newly introduced Paripoorna Mediclaim Ayush Bima enhances the healthcare safety net available to CGHS beneficiaries by providing additional financial protection during medical emergencies and planned treatments.
The scheme focuses on:
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Cashless hospitalization
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Coverage for modern medical procedures
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Inclusion of AYUSH treatments
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Access to a large nationwide hospital network
The initiative aims to ensure greater flexibility, choice, and peace of mind for Central Government employees and their families.
Eligibility and Insurance Coverage Details
The policy is exclusively available to CGHS beneficiaries, with the following coverage structure:
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Maximum of 6 members per policy
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Coverage limited to in-patient hospitalization within India
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Two Sum Insured options:
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₹10 lakh
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₹20 lakh
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To maintain affordability, the product offers a co-payment model, allowing beneficiaries to choose:
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70:30 cost sharing (Insurance Company : Subscriber)
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50:50 cost sharing
This flexible structure enables employees to select coverage based on their financial preferences and healthcare needs.
Key Features of Paripoorna Mediclaim Ayush Bima
Hospitalisation Benefits
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Room rent capped at:
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1% of Sum Insured per day (Normal room)
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2% of Sum Insured per day (ICU)
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Pre-hospitalisation expenses covered for 30 days
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Post-hospitalisation expenses covered for 60 days
Treatment Coverage
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AYUSH treatments covered up to 100% of the sum insured for in-patient care
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Modern treatments covered up to 25% of sum insured, with an optional rider for 100% coverage
Additional Benefits
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Cumulative bonus of 10% for every claim-free year (up to 100% of sum insured)
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Premium discounts compared to regular policies:
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28% discount for 70:30 co-pay model
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42% discount for 50:50 co-pay model
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No GST on premium to maximise affordability
Designed for Seamless Access and Financial Security
DFS highlighted that the scheme is structured as a retail product for CGHS beneficiaries, ensuring easy enrollment and flexibility. It is intended to work alongside CGHS facilities by expanding treatment choices, reducing out-of-pocket burden, and improving access to quality healthcare services across India.
The plan provides:
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Additional financial security
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Wider hospital network access
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Support for both traditional and modern treatment systems
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Hassle-free cashless settlement process
Availability and Purchase
The Paripoorna Mediclaim Ayush Bima policy will be available shortly through:
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New India Assurance Company Limited offices
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The company’s online platform
CGHS beneficiaries are encouraged to explore and adopt the scheme based on their healthcare and financial planning needs.
Conclusion
The launch of Paripoorna Mediclaim Ayush Bima marks a progressive reform in employee welfare by bridging gaps in healthcare coverage for Central Government staff. By combining affordability, flexibility, modern treatment options, and AYUSH coverage into one policy, the DFS has created a comprehensive insurance solution that enhances the existing CGHS framework. The initiative reflects the Government’s broader commitment to inclusive healthcare access, financial protection, and long-term well-being of its workforce.
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Source: PIB
