G.O.No.462, Dated: 27th December, 2013
(Vijaya, Margazhi-12, Thiruvalluvar Aandu-2044)

Pension – Medical Aid – New Health Insurance Scheme for Pensioners (including spouse) / Family Pensioners – Implementation of the Scheme- Orders – Issued.

Read the following:-

1. G.O.Ms.No.562, Finance (Pension) Department, dated: 11.07.1995.
2. G.O.Ms.No.378, Finance (Pension) Department, dated: 13.10.2005.
3. G.O.Ms.No.128, Finance (Pension) Department, dated: 12.04.2007.
4. G.O.Ms.No.50, Finance (Pension) Department, dated: 19.02.2008.
5. G.O.Ms.No.423, Finance (Pension) Department, dated: 25.11.2010.
6. G.O.Ms.No.188, Finance (Pension) Department, dated: 9.05.2008.
7. G.O.Ms.No.7, Finance (Pension) Department, dated: 6.1.2012.
8. G.O.Ms.No.474, Finance (Pension) Department, dated: 30.09.2009.
9. G.O.Ms.No.475, Finance (Pension) Department, dated: 30.09.2009.


In the Government Order first read above, the Government have constituted a fund called Tamil Nadu Government Pensioners Health Fund with effect from 1.7.1995 to provide financial assistance to pensioners for undergoing specialized treatment/ surgery when they are affected by major ailments and the maximum limit entitled for the pensioner is Rs.1.00 lakh or 75% of the actual cost of the treatment whichever is less. Subsequently, the above concession was extended to the spouse of the Pensioner with effect from 17.2.2009.

2. In the Budget Speech 2013-2014, the Hon’ble Minister for Finance has announced in the floor of the House to launch a separate Health Insurance Scheme in line with the Government Servants Health Insurance Scheme to reduce the burden of the health related expenses of the pensioners.

3. The Government after careful examination has decided to launch the New Health Insurance Scheme for the Pensioners (including spouse) / Family Pensioners. Accordingly, the Government direct that New Health Insurance Scheme for the Pensioners (including spouse) / Family Pensioners shall be formulated on the following basis:-

i) the New Health Insurance Scheme shall operate on a CASHLESS basis and it shall be made compulsory to all the Pensioners (including spouse) / Family Pensioners.

ii) the quantum of assistance shall be fixed as Rs.2.00 lakh for both Pensioners (including spouse) and Family Pensioners for a block period of four years from the date of the launch of the scheme.

iii) if the spouse of the pensioners is also a pensioner, the recovery of subscription shall be effected from one person only, based on the option exercised by them.

iv) the New Health Insurance Scheme shall be implemented by the Insurance provider finalised from among the Public Sector Insurance provider by following due tender procedure.

v) the New Health Insurance Scheme shall be implemented through the Commissioner of Treasuries and Accounts as is being done in the case of New Health Insurance Scheme for the Government Employees.

vi) the amount of the Pensioners contribution to the scheme will be decided after the selection of the Insurance Company and finalisation of the costs.

4. Further modalities / terms and conditions for the New Health Insurance Scheme for the Pensioners (including spouse) / Family pensioners will be issued separately.