Cashless health card for gujarat govt employees 2025

Gujarat Government Launches “Karmyogi Swasthya Suraksha Yojana” for Employees and Pensioners In a major decision taken during a cabinet meeting chaired by Chief Minister Bhupendra Patel, the Gujarat government has announced the launch of the “Karmyogi Swasthya Suraksha Yojana”, a comprehensive health security scheme for all state government employees and pensioners.

Cashless health card for Gujarat govt employees 2025

Topic	Details
Scheme Name	Karmyogi Swasthya Suraksha Yojana (KSSY)
Launched By	Gujarat State Government
Card Type	“G” Series AB-PMJAY-MAA Card
Coverage	Up to ₹10 Lakhs per Family per Year (Cashless)
Eligibility	State Govt Employees, Pensioners, AIS Officers
Hospital Network	2658 Empanelled Hospitals across Gujarat
Treatment Packages	2,471 Pre-defined Treatments Covered
OPD Treatment	Not Included (Monthly Allowance Continues)
Reimbursement	Available under Medical Rules 2015 for special cases
Contact Agency	State Health Agency (SHA)

Cashless Health Coverage of Up to ₹10 Lakhs Per Family Annually

Providing details of the scheme, State Government Spokesperson and Minister Rishikesh Patel stated that the new health insurance initiative will offer cashless treatment benefits similar to the existing PMJAY-MA Yojana. All eligible beneficiaries will receive a "G" series AB-PMJAY-MAA card, issued by the State Health Agency (SHA), which acts as the nodal authority under the PMJAY scheme.

Under this scheme, employees and pensioners along with their dependent family members will be entitled to cashless treatment of up to ₹10 lakhs annually per family at empanelled government, government-aided, and private hospitals listed under PMJAY.

OPD Treatment Excluded, Medical Allowance to Continue

The scheme does not cover Out-Patient Department (OPD) treatment. However, the existing monthly medical allowance of ₹1,000 will continue as is.

For cases where treatment exceeds ₹10 lakhs or involves procedures not covered under AB-PMJAY-MAA, and for hospitals not empanelled under PMJAY, beneficiaries will still be eligible for medical reimbursement under the current Gujarat State Services (Medical Treatment) Rules, 2015.

Over 2600 Hospitals and 2400+ Treatment Packages Covered

Currently, 2,658 hospitals across Gujarat are affiliated with the PMJAY-MA scheme, offering a wide range of 2,471 predefined medical packages, ensuring comprehensive treatment options for beneficiaries.

Who Will Benefit from the Scheme?

The new health scheme will benefit:

• Officers and pensioners of the All India Services (AIS)

• State government officers and employees

• Government pensioners and their dependent family members

• Employees currently eligible for medical reimbursement under existing policies

An estimated 4.20 lakh employees and 2.20 lakh pensioners, totaling 6.40 lakh beneficiaries, will gain access to enhanced healthcare facilities through this initiative.

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2. Key Features

• Annual cashless treatment limit: ₹10 lakhs per family

• Card-based access through “G” series AB-PMJAY-MAA card

• Applicable to government and equivalent private empanelled hospitals

• Covers 2,471 types of medical treatments

• Monthly medical allowance of ₹1,000 remains unchanged

• Reimbursement available for non-covered services

Who is Eligible?

• All State Government employees

• All State Government pensioners

• AIS (All India Services) officers serving in Gujarat

• Dependents of above categories

• Employees already eligible for reimbursement under existing rules

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Step-by-Step Process to Avail Benefits

1. Ensure Eligibility

2. Apply for the “G” Series AB-PMJAY-MAA Card

3. Choose an empanelled hospital from the PMJAY network

4. Use your card at the hospital desk for cashless admission

5. Hospital coordinates with SHA for claim processing

6. No payment required up to ₹10 lakhs per family/year

How to Apply for AB-PMJAY-MAA “G” Series Card

• Visit your department’s HR or health welfare office https://ma.gujarat.gov.in/

• Submit necessary identity and employment documents

• SHA (State Health Agency) will process your application

• Receive the physical or digital health card

List of Empanelled Hospitals

• Over 2,658 hospitals across Gujarat

• Includes government, semi-government, and private hospitals

• Access full hospital list on the PMJAY Gujarat portal

What is Covered and What is Not?

Covered:

• In-patient treatment

• Surgeries, hospitalization, ICU, etc.

• 2,471 pre-defined packages

Not Covered:

• OPD (Out-Patient Department) visits

• Cosmetic or experimental treatments

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Reimbursement Beyond ₹10 Lakhs

• Apply under Gujarat State Services (Medical Treatment) Rules, 2015

• Submit detailed hospital bills and documents

• Reimbursement applicable for non-covered procedures or non-empanelled hospitals

Required Documents

• Government ID proof

• Employment/pension certificate

• Dependent family proof

• Existing health card (if any)

• Recent passport-size photo

Important Link

→Official Paripatra :- Download Here

→Check Here Official Website:- Click Here

FAQs

• Can retired employees apply? – Yes

• Is OPD treatment free? – No

• Can private hospitals be used? – Only empanelled ones

• What if the card is lost? – Contact SHA for reissuance