Mediclaim Scheme

Mediclaim Scheme offers important financial support to permanent residents of Goa who need super-speciality treatments that are not available in the state government hospitals. It covers advanced care like open heart surgery, kidney transplant, cancer therapy and bone marrow transplant at recognised private hospitals.

Health Services Department, Government of Goa brought this scheme for people who have lived in Goa for at least 15 years. The support is given either for the actual treatment cost or the fixed ceiling limit, whichever is lower. As of August 2026 the scheme is open and applications are accepted throughout the year.

Mediclaim Scheme - Overview

This scheme is meant for any permanent resident of Goa who needs a super-specialty treatment that is not available in the state run hospitals such as Goa Medical College, Bambolim. The list of covered treatments includes dialysis, plastic surgery, ICU care, angiography and angioplasty, open heart surgery, kidney transplantation, neurosurgery, radiotherapy and chemotherapy for cancer, cochlear implants and bone marrow transplants.

The main idea is simple. When a patient has to go out of a government hospital for a costly super-speciality procedure, the department shares the bill up to a fixed limit. This takes the money pressure off the family at a difficult time. The recognized hospitals and the exact medical treatment covered under each hospital are given in the scheme guidelines.

Highlights

Benefits

This scheme covers various life-saving treatments up to fixed financial limits. The amount is either the permitted ceiling or the actual expense of the treatment, whichever is less. The support available for each treatment is given below.

The list of recognized hospitals and the detailed medical coverage for each hospital are available in the official scheme guidelines.

Eligibility

To get the benefit under Mediclaim Scheme, a person should meet these conditions.

• Residence: The applicant should be a permanent resident of Goa, living in the state for at least 15 years. The name should figure in the voters list and the person should hold a permanent ration card.
• Income: The annual family income should be less than ₹1,50,000. Retired state government employees are eligible to apply regardless of their income level.
• Medical Need: The patient should need a facility that is not available in a government hospital of Goa, including Goa Medical College, Bambolim and the district hospitals. For NICU, ventilatory support and kidney dialysis, an empanelled hospital can be chosen even if the facility exists in a government hospital.

Application Process

The scheme is applied offline. A patient or the family can follow these steps.

STEP 1 - First get a Medical Certificate from authorized doctors at Goa Medical College, Bambolim or a recognized district hospital. This certificate should confirm that the required treatment is not available in the state government hospitals.

STEP 2 - Collect the prescribed application form and fill it with the correct details of the patient and the treatment.

STEP 3 - Attach all the required supporting documents along with the filled form. The list of documents is given below.

STEP 4 - Submit the completed application at the Mediclaim Cell, S-37, Second Floor, Directorate of Health Services, Campal, Panaji, Goa.

STEP 5 - For any help, contact the Joint Director of Accounts (Health) at 0832-2225646, Ext-214. This helpline is there to guide applicants through the process.

Documents

Before applying, organize the required documents and keep copies ready as given below.

• Medical Certificate from authorized doctors at Goa Medical College, Bambolim or recognized district hospitals.
• Income Certificate in Form 'B' from the Mamlatdar, or a certified copy of the Pension Payment Order (PPO) for retired state government employees.
• Residence Certificate proving 15 years of stay in Goa.
• Mediclaim Certificate signed by the Medical Superintendent, Goa Medical College.
• Recent passport-size photograph of the patient.
• Signed Declaration Form along with the application.
• Copy of the Election Card or Ration Card.
• Deen Dayal Swasthya Seva Yojana (DDSSY) card and Aadhaar Card.

References

Official Goa Mediclaim Scheme Guidelines

FAQ's

Are retired state government employees eligible for the scheme?

Yes, retired state government employees are eligible and they do not need to meet the income ceiling criteria.

What types of treatments fall under this scheme?

The scheme covers advanced treatments such as CAPD dialysis, plastic surgery, ICU care, open heart surgery, kidney transplants, neurosurgery and cancer therapy.

Can the patient choose any hospital?

No, the treatment should be done only at hospitals recognized under the scheme to claim the benefits.

What is the role of the Medical Superintendent?

The Medical Superintendent of Goa Medical College must verify that the required treatment is not available within the state government hospitals.

What is the limit for cancer treatment?

The scheme provides a maximum financial support of ₹5,00,000 for cancer therapies like radiotherapy and chemotherapy.

What is the financial limit for open heart surgery?

The support limit for open heart surgery, including valve replacements, is ₹3,00,000.

Is cochlear implant surgery covered?

Yes, cochlear implant surgery is included with a maximum financial support of ₹1,50,000.

Are there supports for children?

Yes, treatments for spastic conditions, cerebral palsy and skeletal deformities are covered up to ₹1,50,000.

What is the support limit for bone marrow transplants?

The maximum financial help for a bone marrow transplant is ₹8,00,000.