Gujarat Karmyogi Swasthya Suraksha Yojana : This scheme represents a significant milestone in enhancing the healthcare landscape for state government employees and pensioners. Designed to provide robust medical support, GKSSY aligns with the state’s commitment to the well-being and dignity of its public servants, marking a new era of health security in Gujarat.
Vision and Objectives
The primary objective of the GKSSY is to ensure accessible, high-quality healthcare for government employees, pensioners, and their dependent family members. By offering financial protection and cashless treatment options but the scheme aims to alleviate the medical expense burden, promote preventive care, and improve overall health outcomes. This initiative reflects the Gujarat government’s dedication to fostering a healthier workforce, thereby boosting productivity and morale across public service sectors.
Key Highlights of the Gujarat Karmyogi Swasthya Suraksha Yojana
- Cabinet Approval: The scheme received formal approval from the Gujarat state cabinet, underscoring its official recognition and commitment to implementation.
- Cashless Treatment Limit: Each Karmayogi or pensioner family claims entitlement to cashless medical treatment up to ₹10 lakh annually, covering a wide range of healthcare needs without requiring immediate out-of-pocket expenses.
- Health Card Issuance: Every eligible beneficiary will be provided with an AB-PMJAY-MAA “G” category health card, serving as a gateway to seamless healthcare services across empaneled facilities.
- Extensive Beneficiary Coverage: The scheme is set to benefit approximately 6.40 lakh individuals, including 4.20 lakh active government employees and 2.20 lakh pensioners, ensuring it extends widespread reach across the state.
- Government Financial Support: The state has committed an annual premium of ₹303.3 crore, translating to ₹3,708 per family, to sustain the scheme’s operations and benefits.
Detailed Overview Table of Gujarat Karmyogi Health Security Scheme
| Feature | Details |
|---|---|
| Scheme Name | Gujarat Karmyogi Swasthya Suraksha Yojana (GKSSY) |
| Beneficiaries | State government employees, pensioners, and their dependent family members |
| Card Type | “G” Category AB-PMJAY-MAA Health Card |
| Treatment Coverage | Cashless medical treatment up to ₹10 lakh per family per year |
| Hospital Coverage | 2,658 hospitals (904 private, 1,754 government) |
| Procedures Covered | 2,471 predefined medical procedures under PMJAY-MAA |
| OPD Coverage | Outpatient department (OPD) services are not included |
| Annual Premium | ₹3,708 per family, fully funded by the state government |
| Total Premium Cost | ₹303.3 crore annually |
| Medical Reimbursement | Available for expenses beyond ₹10 lakh or for procedures not covered, as per 2015 Medical Reimbursement Rules |
| Medical Allowance | Existing monthly allowance of ₹1,000 remains unchanged |
| Total Beneficiaries | Approximately 6.40 lakh (4.20 lakh employees + 2.20 lakh pensioners) |
| Excluded Category | Pensioners above 70 years, who are covered under the Vayvandana Yojana |
| Nodal Agency | State Health Agency (SHA) |
Who Can Benefit from the Gujarat Karmyogi Swasthya Suraksha Yojana?
The GKSSY extends its benefits to a diverse group of individuals, ensuring inclusivity within the government workforce:
- All India Services (AIS) Officers: Senior officials serving the state.
- State Employees and Pensioners: Active and retired government staff.
- Dependent Family Members: Spouses, children, and legally dependent relatives of employees and pensioners.
- Fixed-Pay Employees: Those on fixed remuneration, already covered under prior health schemes.
- Exclusion: Pensioners aged 70 and above are not eligible so as they are beneficiaries of the Vayavandana Yojana and a separate health program tailored for aged people.
Extensive Hospital and Treatment Coverage
- Hospital Network: The scheme collaborates with 2,658 hospitals statewide, comprising 904 private institutions and 1,754 government facilities, ensuring widespread access to quality care.
- Treatment Scope: It covers 2,471 specific medical procedures under the PMJAY-MAA framework, ranging from surgeries to chronic disease management.
- OPD Limitation: Outpatient treatments are excluded from the scheme’s cashless benefits.
- Reimbursement Policy: For treatments exceeding ₹10 lakh or those not listed under PMJAY-MAA, reimbursement is available as per the existing Medical Reimbursement Rules, 2015, providing a safety net for extraordinary medical expenses.
Card and Procedure Management
- Card Distribution: The State Health Agency (SHA) is tasked with the creation, issuance, and distribution of “G” category health cards, ensuring every eligible family receives their access tool.
- Cashless Treatment Access: Beneficiaries can avail cashless treatment at both government-approved hospitals and empaneled private healthcare centers and streamlining the process and reducing financial stress during medical emergencies.
Medical Allowance Continuity
- Unchanged Benefit: The existing monthly medical allowance of ₹1,000 for employees and pensioners remains intact, complementing the scheme’s cashless coverage without alteration.
Impact and Significance
The Gujarat Karmyogi Swasthya Suraksha Yojana is a testament to the state’s proactive approach to employee welfare. By integrating with the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY-MAA), and it leverages a robust national health framework while tailoring benefits to Gujarat’s public servants. The scheme not only addresses immediate healthcare needs but also promotes long-term health security, reflecting the government’s vision of a healthier and more productive workforce also .
Conclusion
The Gujarat Karmyogi Swasthya Suraksha Yojana stands as a beacon of health security for Gujarat’s government employees and pensioners in 2025. With its comprehensive cashless coverage up to ₹10 lakh, extensive hospital network, and state-funded premium. And it ensures safer, more reliable, and comfortable healthcare for over 6.40 lakh beneficiaries. This initiative underscores the government’s commitment to its Karmayogis, setting a benchmark for employee-centric policies in the state.
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Frequently Asked Questions (FAQ) on Gujarat Karmyogi Swasthya Suraksha Yojana
GKSSY is a health scheme launched on May 14, 2025, by the Gujarat government under Chief Minister Shri Bhupendra Patel, offering cashless medical treatment to state government employees and pensioners.
The scheme was introduced under the leadership of Gujarat Chief Minister Shri Bhupendra Patel.
The scheme aims to provide accessible, high-quality healthcare and financial protection to government employees, pensioners, and their families, enhancing their well-being.
It covers 2,471 predefined procedures under the PMJAY-MAA framework.
No, pensioners over 70 are excluded as they are covered under the Vayavandana Yojana.
They can use their “G” card at empaneled government and private hospitals for cashless treatment.
