The Deen Dayal Swasthya Seva Yojana Scheme has been rolled out in the State with effect from 01/09/2016. The Scheme provides health coverage to the entire resident population of the State who reside in Goa for five years and more. Benefits under this scheme is on a cashless basis to the beneficiaries upto the limit of their annual coverage providing cover of upto Rs. 2.50 lakhs per annum for a family of three or less members and cover of upto Rs. 4.00 lakhs for a family of four and more members. The insurance benefits can be availed individually or collectively by members of the family.
The Scheme was run with United India Insurance Company Ltd. till 31st May, 2018. The DDSSY Scheme has runs departmentally through the TPA – Paramount Health Services & Insurance TPA Pvt. Ltd. and presently from 01/11/2019, the scheme is run through new TPA MD India Health Insurance TPA Pvt. Ltd . Payments are made directly by the DDSSY Cell of the DHS.
A total of 447 medical procedures are covered under the Scheme. A total of 35 private hospitals and 6 Government Hospitals , 1 Government aided Hospital in Goa and 10 private Hospitals outside Goa have been empanelled.
The Budgetary provision for the Financial year 2020-2021 under the Head of Account: 2210 – Medical & Public Health, 80 – General, 800 – Other Expenditure, 25 – Din Dayal Swasthya Suraksha Yojana (P), 50 – Other Charges is Rs. 90.00 Crores.
List of Hospitals Under DDSSY Scheme
Sr. No | DISTRICT | BLOCK | NAME OF HEALTH FACILITY | Grade | ADDRESS WITH PHONE NUMBER |
PRIVATE HOSPITALS – GOA (35) | |||||
1 | SOUTH GOA | SALCETE | ROYAL HOSPITAL | C | OFF POWER HOUSE ROAD, AQUEM: 9822933147 |
2 | NORTH GOA | TISWADI | CAMPAL CLINIC | C | Opposite Parade Ground, Campal, Panaji, 403001 |
3 | SOUTH GOA | SALCETE | BORKAR NURSING HOME, MATERNITY, SURGICAL & GENERAL HOSPITAL | C | Abade Faria Road Margao : 9823129004 |
4 | NORTH GOA | TISWADI | MENEZES POLYCLINIC | C | Altinho Panaji: 9637246138 |
5 | SOUTH GOA | SALCETE | APOLLO VICTOR HOSPITALS | A | Malbhat Margao : 8698690756 |
6 | SOUTH GOA | PONDA | SAVAIKAR CLINIC & NURSING HOME | B | Warkhandem Ponda : 9423889002, 9423889004 |
7 | SOUTH GOA | MARMUGAO | PAI HOSPITAL | C | Vaddem Vasco: 7798973345, 0832 2513641 |
8 | NORTH GOA | BARDEZ | GAUNS CHILDCARE HOSPITAL, N.I.C.U & PREMATURE CARE UNIT | A | Dangui Colony Mapusa: 9422437898 |
9 | NORTH GOA | PERNEM | REDKAR HOSPITAL & RESEARCH CENTER | C | Oxelbag, dhargal, pernem : 9890350170 |
10 | SOUTH GOA | SALCETE | NAGARSENKAR’S CLASSIC HOSPITAL | B | Malbhat, Next to Apollo Hospital, Margaon : 9923070742 |
11 | SOUTH GOA | SALCETE | GRACE INTENSIVE CARDIAC CARE CENTRE & GENERAL HOSPITAL | C | Pajifond Margao : 9850815566 |
12 | SOUTH GOA | PONDA | USGAONKER’S CHILDREN HOSPITAL, CLINIC & N.I.C.U. | A | Sadar Ponda Goa : 9822120955 |
13 | NORTH GOA | TISWADI | HEALTHWAY HOSPITALS PVT.LTD | B | Near Peoples High School Mala Fontainhas Panaji Goa : 0832- 2424966 |
14 | NORTH GOA | TISWADI | Healthway Hospitals Old Goa | A | Plot No 132/1 (Part), Ella Village, Kadamba Plateau, Tiswadi Taluka, Tiswadi, Goa 403402 |
15 | NORTH GOA | TISWADI | MANIPAL HOSPITAL, GOA | A | Dr E. Borges road Dona Paula : 9503566117 |
16 | NORTH GOA | BARDEZ | VISION MULTISPECIALITY HOSPITAL | B | DULER, MAPUSA: 9822131128 |
17 | NORTH GOA | BARDEZ | CHODANKAR NURSING HOME & RESEARCH CENTER | C | NXT TO HDFC BANK, NH17, ALTO- PORVORIM,9822589291 |
18 | NORTH GOA | BARDEZ | DHUMASKER GENERAL HOSPITAL | C | Tivim, Goa, 403502 |
19 | NORTH GOA | BICHOLIM | MARDOLKAR HOSPITAL | C | Nagzarwada, Bicholim, Goa 0832-2298592 |
20 | SOUTH GOA | SALCETE | DR. MADKAIKAR’S CITY HOSPITAL | C | Ashirwad Bldg, 1st floor, Opp Minaxi Hotel, Margao -Goa, 403601 |
21 | NORTH GOA | BARDEZ | RG STONE UROLOGY & LAPAROSCOPY HOSPITAL | C | PDA Colony, Panjim-Mapusa Highway, Goa -403521 |
22 | SOUTH GOA | SALCETE | MOTHER CARE MULTI-SPECIALITY HOSPITAL | C | Near St. Joaquim Chappel, Borda, Margao, Goa -403601 08322700103 |
23 | SOUTH GOA | SALCETE | ORTHOPAEDIC HOSPITAL FOR SUEGERY | A | Rosadel Enclave, Next to Distict Court, market, Margao – Goa, 403601 |
24 | SOUTH GOA | SALCETE | KCRC’S HORIZON ICU& HOSPITAL | C | Rau De Saudades, Pajifond, Margao, Goa – 403601 08322711111 |
25 | SOUTH GOA | SALCETE | MY EYE HOSPITAL | B | NH-17, GOUNLOY, NUVEM, SALCETE, GOA 403604 |
26 | SOUTH GOA | SALCETE | DR. GRACIAS MATERNITY HOSPITAL | C | 14/289, NEXT TO POLICE STATION, MARGAON. GOA 403601 |
27 | SOUTH GOA | SALCETE | A.V. DA COSTA MEMORIAL CLINIC | C | No. 672, padre feriao road, fatorda, margao, goa |
28 | SOUTH GOA | SALCETE | ASTER HOSPITAL | B | MONTE HILL ROAD , MARGAO-GOA |
29 | SOUTH GOA | MARMUGAO | VISHWASANJIVANI HEATH CENTRE | B | mapsekar building, vasco da gama |
30 | SOUTH GOA | SALCETE | Ashirwad Urology & laparoscopy Hospital | B | Malbhat, Margao, Goa 403601 :0832 273 6460 |
31 | SOUTH GOA | SALCETTE | Dr. Lawande’s Hospital & Medical Research Centre | C | Near Powerhouse, Aquem, Margao. |
32 | NORTH GOA | BICHOLIM | Mahatme Nursing Home | C | Bicholim Goa. |
33 | SOUTH GOA | MARMUGAO | V.M. Salgaocar Hospital. | A | Airpot road, chicalim , Goa |
34 | NORTH GOA | BARDEZ | VISION MULTISPECIALITY HOSPITAL : Opthalmology | A | DULER, MAPUSA: 9822131128 |
35 | SOUTH GOA | MARMUGAO | Vaatsalya Hospital | C | 2nd floor, leela Plaza, Near bank of Baroda, Vasco Da Gama |
PRIVATE HOSPITALS – OUTSIDE STATE (10) | |||||
36 | Belgaum | Belgaum | KLE Society’s Belgaum Cancer Hospital | A | Ashok ngar, Belgavi, – 590016 |
37 | Belgaum | Belgaum | KLES Dr. Prabhakar Kore Hospital & Medical Research Centre | A | Nehru Nagar, Belgavi – 590010 |
38 | Bangalore | Bangalore | Healthcare Global Enterprises Ltd. | A | HCG Towers, 8, P.Kalinga Rao road, Sampangi Ram Nagar, Bangalore – 560027 |
39 | Sangli | Sangli | Wanless Hospital Miraj – Miraj Medical Centre | A | Miraj-Pandharpur Road, Miraj – 416 410. |
40 | Bangalore | Bangalore | ASTER CMI HOSPITAL, BANGALORE | A | #43/2 NEW AIRPORT ROAD, NH07, SAHAKARA NAGAR, HEBBAL BANGALOR, KARNATAKA, 560092 |
41 | Bangalore | Bangalore | MANIPAL HOSPITAL | A | 98, HAL Airport Road, Bengaluru, Karnataka 560017. phone: 1800 3001 4000 |
42 | Dakshina Kannada district | Manguluru | MANGALORE INSTITUTE OF ONCOLOGY | A | Pumpwell Circle, Near Indiana Hospital., Mangaluru, Karnataka 575007 . PHONE : 0824 424 9999 |
43 | Bangalore | Bangalore | NARAYAN HRUDAYALA LTD | A | 10/7 umiya landmark, next to chancery hotel, lavelle road, bangalore: 560001, phone: 8884416553 |
44 | KARNATAKA | UDUPI | Prasad Netralaya Super Speciality Eye hospital | A | A.J Alse Road , behind Alankar , theatre Udupi |
45 | KOLHAPUR | KOLHAPUR | ATHAAYU MULTI-SPECIALITY HOSPITAL | A | 44/1, NH- 4, UJAIWADI, KOLAHPUR. MAHARASHTRA |
GOVERNMENT HOSPITAL, GOA(6) | |||||
46 | NORTH GOA | TISWADI | Goa Medical College Hospital | A | BAMBOLIM, GOA |
47 | NORTH GOA | BARDEZ | North District Asilo Hospital | C | MAPUSA |
48 | SOUTH GOA | PONDA | SubDistrict Hospital Ponda | C | PONDA |
49 | SOUTH GOA | SALCETE | Hospicio Hospital | C | MARGAON |
50 | SOUTH GOA | CANACONA | Community Health Center, Canacona | C | Canacona |
51 | NORTH GOA | SATTARI | Community Health Center, Valpoi | C | Valpoi |
AYURVEDIC HOSPITAL (1) | |||||
52 | SOUTH GOA | PONDA | Kamakshi Arogya Dham | N.A | SHIRODA |
List of the hospitals recognized under for Goa Mediclaim Scheme, Medical Reimbursement and the treatment covered under each hospital.
HOSPITALS WHERE CREDIT FACILITY IS AVAILABLE:-
Sr. | Name of the Hospital | Diagnosis (Treatment) |
1 | Fortis Hospital, Bangalore | Cardio- vascular surgery, Paediatric Cardiology and other such high end treatments which are not available at Goa Medical College. |
2 | Manipal Hospital, Bangalore | Cardiology, Cardio-thoracic Surgery, Nephrology, Urology |
3 | Sagar Apollo Hospital, Bangalore | Open Heart Surgery and By-Pass Surgeries, Angioplasty and coro-stenting, Neurosurgery, cat-scan, MRI for which treatment is not available at GMC, Bambolim. |
4 | Chodankar Nursing Home, Porvorim. | Pediatric Surgery and Endoscopic surgeries. Cardiac City angiography Thoracic and Vascular Surgery Procedure. |
5 | Ruby Hall Clinic, Pune | Those superspecialties which are not available in GMC and other Hospitals under state Govt. |
6 | Manipal Goa Cancer & Gen. Hosp., Dona Paula | Only for cancer treatment like radiotherapy and other types of anti-cancer treatment which are not available in GMC. Dialysis. Thoracic & Vascular surgery |
7 | Apollo Victor Hospital, Margao | Cardiac procedures and Urological procedures Gastoentrology Thoracic & Vascular Surgery, Nephrology and Laproscopic procedure and Kidney dialysis. |
8 | Gomantak Ayurvedic Mahavidyalaya Shiroda, Goa | Snchama, Svedana, Parisheka, Dhara, Vamana, Verichana, Nasya, Basti, Siddha Basti, Rakta Mokshna and allied Procedures for which treatment is not available in GMC and other hospitals under DHS |
9 | K.L.E.S.Hospital, Belgaum | Cardiovascular surgery, Neurological disorders, Cardio-thoracic surgery, kidney transplantation. Plastic surgery, Radiotherapy, Total replacement of joints and other major disease / illnesses for which treatment facilities as certified by the Medical Superintendent, GMC are not available in the Govt. Hospital in the State of Goa. |
10 | Kasturba Hospital, Manipal | Cardiovascular surgery, Neurological disorders, Cardio-thoracic surgery, kidney transplantation. Plastic surgery, Radiotherapy, Total replacement of joints and other major disease / illnesses for which treatment facilities as certified by the Medical Superintendent, GMC are not available in the Govt. Hospital in the State of Goa. |
11 | V.M. Salgaonkar Medical Research Centre, Vasco | Cardiovascular surgery, Neurological disorders, Cardio-thoracic surgery, kidney transplantation. Plastic surgery, Radiotherapy, Total replacement of joints and other major disease / illnesses for which treatment facilities as certified by the Medical Superintendent, GMC are not available in the Govt. Hospital in the State of Goa. Haemodialysis for the patient within the state of Goa , Cochlear implant surgery w.e.f 9/6/2016 |
12 | Grace Intensive Cardiac Centre and General Hospital, Margao | Haemodialysis for the patient within the state of Goa, gastroentrology |
13 | Children’s Orthopaedic Centre, Mumbai | Paediatric facilities which are not available in G.M.C., |
14 | Campal Clinic, Panaji | Thoraic Vascular surgeries, Trauma care, Neonatal Intensive care unit, Intensive care unit, paediatric Intensive care unit. |
15 | Shankara Netralaya Hospital, Chennai | Super specialties in Ophthalmic care |
16 | Belgaum Cancer Hospital Pvt. Ltd. Belgaum | Linear Aceleration based treatment and Intracavitary Radiotherapy |
17 | Gauns Child Care Hospital, Mapusa | Paediatric ICU, Neonatal Intensive Care Unit |
18 | Vision Multispeciality Hospital, Mapusa | (1)Intensive Care Unit, Surgical Intensive Care Unit, Gastroenterology Procedure & Thoracic and Vascular Surgeries. (2)Vitreo retinal Services and orbit/Oculoplasty Services (3) Haemodialysis Keratoplasty surgery under organ transplant Act 14/01/15 |
19 | Vintage Hospital and Medical Research Centre Pvt. Ltd, St. Inez, Panaji-Goa | Ventilatory Care and Haemodialysis |
20 | Usgaonkar’s Children Hospital and NICU, Ponda | Paediatric ICU, Neonatal Intensive Care Unit |
21 | R.G. Stone Hospital, Porvorim Goa | Haemodialysis in the Renal failure cases. |
22 | Savoikar Clinic and Nursing Home, Ponda | Haemodialysis in the Renal failure cases. |
23 | Classic hospital, Margao | Neonatal intensive care |
24 | Vishwa Sanjivani Health Centre, Multispeciality hospital, Vasco-da-Gama | Haemodialysis in the Renal failure cases. |
25 | Royal hospital, Margao | Haemodialysis in the Renal failure cases. |
26 | Mangalore Institute of Oncology Hospital, Mangalore | Medical Oncology, Surgical Oncology and radiation Oncology |
27 | Aster CMI Hospital, Banglore | Bone Marrow Transplant |
HOSPITALS WHERE CREDIT FACILTY IS NOT AVAILABLE.
28 | Madras Medical Mission Hospital, Chennai | Cardiovascular surgery, Neurological disorders, Cardio-thoracic surgery, kidney transplantation. Plastic surgery, Radiotherapy, Total replacement of joints and other major disease / illnesses for which treatment facilities as certified by the Medical Superintendent, GMC are not available in the Govt. Hospital in the State of Goa. |
29 | Jaslok Hospital, Mumbai | -do- |
30 | Wanless Hospital, Miraj | -do- |
31 | KEM Hospital, Mumbai | -do- |
32 | Bombay Hospital, Mumbai | -do- |
33 | P.D. Hinduja Hospital, Mumbai | -do- |
34 | Sion Hospital, Mumbai | Cardiovascular surgery, Neurological disorders, Cardio-thoracic surgery, kidney transplantation. Plastic surgery, Radiotherapy, Total replacement of joints and other major disease / illnesses for which treatment facilities as certified by the Medical Superintendent, GMC are not available in the Govt.Hospital in the State of Goa. |
35 | Wadia Hospital, Mumbai | -do- |
36 | J.J. Hospital, Mumbai | -do- |
37 | Johari Nursing Home, Mumbai | Paediatric facilities which are not available in Goa Medical College |
38 | B.L. Kapur Memorial Hospital, 5, Pusa Road, New Delhi | Cardiology, Cardio thoracic and Vascular Surgery, Surgery, Nephrology, Neonatology, Paediatrics, Paediatric Surgery, Nuclear Medicine, Bone Marrow Transplant treatment. |
39 | Wockhardt Hospital, Mumbai | Pediatric Cardiology, Pediatric Cardiac Surgery, Specialties in Ophthalmic surgery viz Cornea & Keratoplasty, Vitrioretinal Services & Glaucoma Services along with General cardiology & Cardiothoracic Surgery |
40 | Tata Memorial Hospital, Mumbai | Cancer treatment |
Eligibility Criteria: Person should be permanent residents of Goa for last 15 years and figuring in the voters list and holding permanent ration card. Family Income should be less than 1.5 lacs per annum. Facilities not available in the Government hospital including Goa Medical College, Bambolim and District Hospitals (except for NICU, Ventilatory Support and Kidney Dialysis for which patient may opt for any empanelled hospital even if the facilities are available in Government hospital). Hospital should be recognized under Mediclaim Scheme. Retired State Government Employees shall also be entitled for the scheme. They are exempted from monetary income ceiling.
Required Documents to avail the Scheme:
In order to avail this facility, the concerned person/individual has to apply to the Director of Health Services, Panaji, Goa in the prescribed Form C & D (Annexure VII & VIII) enclosing there with:
OR
OR
concerned Mamlatdar in original or Certified copy of
the P.P.O. Retired State Government Employee
(15 years Residence certificate).
Goa Medical College, Bambolim alongwith Photo copy.
Form ‘C’ or Form ‘D’ alongwith Declaration Form.
card either of the parent.
Affix passport size
recent Photograph of
the patient
F O R M ‘C’
( Application for self for treatment under Mediclaim Scheme)
Name : …………………………………….
Address : …………………………………….
: …………………………………….
Dated : …………………………………….
Phone No. : …………………………………….
To,
The Directorate of Health Services,
Mediclaim Cell,
Campal, Panaji, Goa.
Sub: Treatment under the Mediclaim Scheme.
Sir,
I have to proceed to ………………………………………………….. (place) for medical treatment at ……………………………………………………………… (name of hospital) as required under the scheme. I am submitting herewith the following certificates:-
OR
Certified copy of the P.P.O. bearing No. …………………………… confirming that the patient is a retired State Government employee.
I shall be obliged if a letter recommending me for medical treatment at ………………… …………………………………………………………………. (name of the hospital) be kindly issued to me immediately for admission in the hospital.
Yours faithfully,
Affix passport size
recent Photograph of
the patient
F O R M ‘D’
( Application for treatment under Mediclaim Scheme to be submitted on behalf of the patient as the patient is a minor)
Name : …………………………………….
Address : …………………………………….
: …………………………………….
Dated : …………………………………….
Phone No. : …………………………………….
To,
The Directorate of Health Services,
Mediclaim Cell,
Campal, Panaji, Goa.
Sir,
My …………………………… (relationship) …………………………………………. (name of the patient) is to be taken to ………………………………………………………. (place) for medical treatment at ……………………………………………………………… (name of hospital) as required under the scheme. The following certificates are submitted:-
OR
Certified copy of the P.P.O. bearing No. …………………………… confirming that the patient is a retired State Government employee.
I shall be obliged if a letter recommending him/her for treatment at …………………………………………………………………………. (name of the hospital) ……………………………………….. (place) is kindly issued to me immediately for admission in the hospital.
Yours faithfully,
Affix photograph |
DECLARATION
Place: _________________________
Signature of the patient/
Date: Thumb Impression duly attested
Witnesses:
(1) Name with address:__________________________ ___________________
__________________________ Signature
(2) Name with address:__________________________ ___________________
__________________________ Signature
* Strike out which ever is not applicable.
Note: In case any patient has gone to the recognized Institute for treatment which is not available in Government Hospitals in Goa, without Mediclaim certificate, he/she shall apply directly to the Director of Health Services alongwith the relevant papers. The Director of Health Services, after the required scrutiny shall submit such cases for the approval of the government in relaxation of the prescribed procedure.
Documents required for
Goa Mediclaim Scheme under Relaxation
Assistant Accounts Officer—1
Accountant—1
Clerical Staff—5
MTS—2
To look after the referral cases of Mediclaim, empanelment of hospitals, preparing of hospitals bills of the patients, ECS payment details of patients and hospitals, maintaining bill register and expenditure register, sanction order, RTI, LAQ’s, Court matter. Overall supervision and work related to Audit. To look after relaxation cases. Maintaining referral register and relaxation register. To look after ECS of all bills relating to Mediclaim Section. Attending to the public and any other work entrusted by the superiors.
Handling overall work of Deen Dayal Swasthya Seva Yojana and SABY typing work of self , attending public , remitting payment to private hospitals, keeping record such as maintaining cash book, bank reconciliation statement , Any other work entrusted by the superiors.
Goa Mediclaim Scheme
Deen Dayal Swasthya Seva Yojana
YEARWISE NUMBER OF PATIENTS INCLUDING RELAXATION
ALLOTMENT & EXPENDITURE UNDER MEDICLAIM
Yearwise | No. of patients | Relaxation cases | Total Number of patients | Allotment | Expenditure Rs. in Crores. |
1998-1999 | 319 | Nil | 319 | ||
1999-2000 | 366 | 8 | 374 | 1.89 | 1.89 |
2000-2001 | 463 | 10 | 473 | 3.05 | 3.05 |
2001-2002 | 618 | 16 | 634 | 4.00 | 4.00 |
2002-2003 | 1002 | 58 | 1060 | 6.05 | 6.05 |
2003-2004 | 1080 | 26 | 1106 | 8.86 | 8.86 |
2004-2005 | 1395 | 47 | 1442 | 12.00 | 12.00 |
2005-2006 | 1559 | 182 | 1741 | 13.97 | 13.97 |
2006-2007 | 1475 | 159 | 1634 | 15.63 | 15.63 |
2007-2008 | 1891 | 143 | 2034 | 12.14 | 12.14 |
2008-2009 | 1399 | 239 | 1638 | 17.39 | 17.39 |
2009-2010 | 1405 | 122 | 1527 | 17.34 | 17.34 |
2010-2011 | 1308 | 153 | 1461 | 15.20 | 15.20 |
2011-2012 | 1307 | 155 | 1462 | 19.30 | 19.30 |
2012-2013 | 1317 | 108 | 1425 | 16.67 | 16.67 |
2013-2014 | 1255 | 206 | 1461 | 18.48 | |
2014-2015 | 544 | 203 | 747 | 14.95 | 13.63 |
2015-2016 | 549 | 36 | 585 | 11.35 | 9.64 |
2016-2017 | 337 | 58 | 395 | 12.98 | 8.33 |
2017-2018 | 201 | 33 | 234 | 5.00 | 3.21 |
2018-2019 | 121 | 34 | 155 | 3.41 | 2.64 |
2019-2020 | 102 | 45 | 147 | 5.15 | 1.71 |
2020-2021 Up to September | 21 | 16 | 37 | 5.65 | 0.33 |
DDSSY cards & Beneficiaries count | |||
SrNo | Policy Year (1st September to 31st August) | Active cards | No of beneficiaries |
1 | 2016-17 | 218613 | 7106 |
2 | 2017-18 | 248172 | 10312 |
3 | 2018-19 | 235575 | 8724 |
4 | 2019-20 | 227874 | 8583 |
5 | 2020-21 till 30/09/2020) | 215714 | 2526 |
DDSSY Yearwise Expenditure
|
| |
2016-17 |
|
|
Paid to Insurance Company | 377500000 | 377500000 |
|
|
|
2017-18 |
|
|
|
|
|
Paid to Insurance Company | 721100000 | 721100000 |
|
|
|
2018-19 |
|
|
|
|
|
Paid to Insurance company | 106300000 |
|
|
|
|
Paid to Empanelled Private hospitals | 269946831 |
|
|
|
|
Paid to TPA | 6915029 | 383161860 |
|
|
|
2019-2020 |
|
|
|
|
|
Paid to Empanelled Private hospitals | 339977735 |
|
|
|
|
Paid to TPA | 25738725 | 365716460 |
|
|
|
|
|
|
2020-2021( up to Sept.’20) |
|
|
|
|
|
Paid to Empanelled Private hospitals | 190858200 |
|
|
|
|
Paid to TPA | 442852 | 191301052 |
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