Postman Exam - Important Events in the Department of Posts

 Rules, Rights & Rites -85

I usually post all important items related to official rulings, union news, and other general matters on my YouTube channels: Yourskayveeyes (English) and Anbudan Kayveeyes (Tamil).
However, due to the recent spate of orders and the high volume of information being received, I have not been able to convert every item into a video. Therefore, I am introducing these new slots to post current matters and updates that have not yet been published on YouTube. This ensures you stay informed on every detail, even if a video hasn't been made yet …………….Kayveeyes

Central Government Employees and Pensioners Health Insurance Scheme (CGEPHIS)
• The Central Government Employees and Pensioners Health Insurance Scheme (CGEPHIS) is a proposed health insurance scheme for current and retired Central Government employees.   
• The scheme will be compulsory for new Central Government employees and retirees, and optional for existing employees and pensioners.   
• The scheme will cover inpatient and outpatient medical expenses, pre-existing diseases, and maternity and newborn benefits.   
• The sum insured will be Rs. 5,00,000/- per family per year, and an additional sum insured of Rs. 25 Crore shall be provided by the Insurer as Buffer/Corporate Floater.   
• Premiums will be paid annually, with adjustments based on the number of beneficiaries and claims submitted.   
• Health services will be provided by empanelled hospitals and nursing homes that meet certain quality standards.   
• The scheme will provide cashless access to healthcare services through a photo smart card.   
• Existing employees and pensioners covered under CS (MA) Rules can also opt for CGEPHIS on a voluntary basis.   
• In-patient benefits cover all expenses incurred during medical treatment in empanelled hospitals/nursing homes for illnesses, diseases, injuries, and sicknesses.   
• The scheme covers self, spouse, two dependent children, and up to two dependent parents.   
• There are specific definitions and rules regarding dependents, including age and income limits.   Addition and deletion of family members are allowed under certain conditions.   
• The Insurance Company shall also carry out inspection of hospitals, investigations, on the spot verification of inpatient admissions, periodic medical audits, to ensure proper care and counselling for the patient.
• Expenses incurred at a hospital or nursing home primarily for evaluation/diagnostic purposes only during the hospitalized period are excluded.
• Outpatient diagnostic, medical, and surgical procedures or treatments are generally excluded unless necessary for the treatment of a disease covered under day-care procedures or inpatient hospitalization.   
• Free OPD consultation, including pre- and post-hospitalization consultation, is to be provided by empanelled hospitals/nursing homes/day-care clinics to CGEPHIS beneficiaries.