Office Memorandum (OM) from BSNL Corporate Office dated January 23, 2025, regarding clarifications on BSNL Medical Reimbursement Scheme (BSNLMRS).

 

1. Office Memorandum (OM) from BSNL Corporate Office dated January 23, 2025, regarding clarifications on BSNL Medical Reimbursement Scheme (BSNLMRS).

   Key Points from the Document:

   1. Treatment at Government Hospitals:

      • BSNLMRS beneficiaries can avail consultation, investigations, and treatment procedures from any Government Hospital (Central/State).
      • The definition of a "Government hospital" includes:
        • Central/State Government hospitals
        • Hospitals under Government Departments (Railways, Atomic Energy, etc.)
        • Public Sector Undertaking (PSU) hospitals (e.g., SAIL, Coal India)
        • Hospitals under Municipalities
      • If a government hospital charges for certain treatments, reimbursement can be claimed as per CGHS rates.

   2. Reimbursement Policy:

      • Reimbursement will be based on ward entitlement similar to CGHS norms.
      • If only General ward/Nursing home facilities are available in the hospital, those eligible for a semi-private or higher ward can get treatment in a Nursing Home ward.
      • Implants: Reimbursement is capped at CGHS prescribed ceiling rates.
      • Special hospitals like ILBS Delhi, NIMS Hyderabad: Reimbursement will be as per CGHS rates.

   3. Medical Claims Submission:

      • Pensioners & ex-MPs: Submit claims through CGHS Wellness Centers.
      • Serving Employees: Submit claims through respective Ministry/Department/Office.
      • Members of Parliament (MPs): Submit claims to Rajya Sabha/Lok Sabha Secretariat.
      • Autonomous body employees: Submit claims to the concerned body.

   4. Dual Reimbursement System (Insurance + BSNLMRS):

      • BSNL employees can claim medical expenses from both an insurance company and BSNL.
      • The process involves:
        1. First, claim reimbursement from the insurance company (original bills required).
        2. The insurance company issues a certificate of the reimbursed amount.
        3. Then, submit the photocopies of bills, duly certified by the insurance company, to BSNL.
        4. BSNL's reimbursement is restricted to the remaining eligible amount (as per approved package rates), ensuring that the total reimbursement does not exceed the actual expenses.

   5. Annexures (Prosthetics & Orthotics):

   • The document includes a detailed annexure listing approved reimbursement rates for various prosthetic and orthotic devices, including:
   • Lower extremity prosthetics (e.g., below-knee, above-knee prostheses).
   • Upper extremity prosthetics (e.g., below-elbow, above-elbow prostheses).
   • Spinal orthotics (e.g., lumbar braces, cervical collars).
   • Mobility aids (e.g., wheelchairs, walkers, crutches).\
   •