Goa Mediclaim Scheme

For citizens who have been residing in Goa for 15 years or more and have an annual income of less than Rs.1.5 lakh, they can opt for the Goa mediclaim scheme. The Goa Mediclaim Scheme offers financial coverage of Rs.1.5 lakh for illness and various other super specialities which are even sometimes not available in State Government hospitals. The scheme offers coverage for medical expenses in the case of hospitalisation and even post-hospital expenses. With the Goa Mediclaim certificate, the resident of Goa can receive medical treatment at any of the listed hospitals in the state and some located outside the state of Goa as well. Listed below are the coverages of the Goa mediclaim scheme as well as the documents that are required to avail the coverage at the time of treatment or hospitalisation.

What is covered under the Goa mediclaim scheme:

Listed below are some of the coverages of the Goa mediclaim scheme:

  • Any sort of major illness or disease.
  • Coverage of radiotherapy expenses.
  • Coverage for plastic surgery.
  • Coverage for kidney transplant.
  • Coverage for replacement of joints.
  • Coverage for cardio-thoracic surgery.

Documents required for the Goa mediclaim scheme:

In order to avail the sum assured for the coverage of medical expenses of hospitalisation and treatments, the policyholder will have to submit the below-listed documents:

  • Form C and Form D.
  • Recent passport-size photographs.
  • Copy of the election card of the policyholder or insured person.
  • Medical certificate along with Form A. Form A has to be attested by the medical superintendent of the Goa medical college if the patient has to receive treatment at a listed hospital not located in the state of Goa.
  • Form B along with the income certificate of the individual.

Listed hospitals under the Goa mediclaim scheme:

Mentioned below are some of the listed hospitals under the Goa mediclaim scheme:

City/District Hospital
Vasco Salgaonker Medical Research Centre
Bambolim Saida MRI Scan Centre
Margao Apollo Victor Hospital
Dona Paula Goa Manipal Cancer & General Hospital & research Centre
Margao Grace Intensive Cardiac Care Centre
Chicalim Vivus SMRC Heart Centre
Miraj Swasthya Pratisthan Fracture & Orthopaedic Hospital
Bengaluru Wockhardt Hospital
Mumbai Bombay Hospital & Medical Research Centre
Chennai Shankara Nethralaya Hospital

Based on the terms and conditions of the Goa mediclaim scheme, if the insured person is receiving treatment outside the state of Goa, and does not have the mediclaim scheme certificate, then a recommendation letter from Director of Health, Goa, will suffice. Under the scheme, the insured person is insured up to a maximum of Rs.3 lakh in the case of an open heart surgery, up to Rs.5 lakh in the case of cancer, Rs.8 lakh in the case of a bone marrow transplant, and up to Rs.3 lakh in the of a kidney transplant and neurosurgery. In addition, if the insured person is receiving treatment at the Goa medical college for cases such as cancer, hip replacement, or knee replacement surgeries, the cost of chemotherapy as well as the cost of medicines will be reimbursed by the Goa mediclaim scheme up to 60% of the cost.

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