Key Revisions to Bank Group Medical Insurance Scheme (GMIS) Effective November 2026

Introduction

The Group Medical Insurance Scheme (GMIS) for bank employees and officers is set to undergo significant enhancements starting November 1, 2026. These revisions, stemming from a recent Memorandum of Understanding (MoU) between bank unions and the Indian Banks’ Association, aim to provide improved medical coverage and financial support for a range of treatments and hospitalizations. The updates reflect a commitment to better healthcare benefits for both serving and retired personnel.

Revised Hospitalization Limits

A key aspect of the GMIS revisions involves increased allowances for hospital room rent and intensive care unit (ICU) charges. For admissions in major metro cities – Delhi, Mumbai, Chennai, and Kolkata – the hospital room rent cap has been elevated to ₹7,000 per day. Similarly, ICU bed charges in these metropolitan areas will now be capped at ₹9,500 per day. For other centers, the existing limits of ₹5,000 for room rent and ₹7,500 for ICU charges will remain in place, ensuring a tiered approach to coverage based on location.

Enhanced Maternity and Infertility Coverage

The scheme now offers significantly improved benefits for maternity expenses. Normal deliveries will be covered up to ₹100,000, while Caesarean sections will have a higher limit of ₹150,000. These revised figures are inclusive of child care and vaccination expenses for the child up to one year of age, consolidating previous provisions. Furthermore, a new provision has been introduced for infertility treatments, specifically for IVF procedures, with a dedicated limit of ₹200,000. The premiums for both maternity and infertility treatments will be managed separately and are to be borne by the banks.

Increased Support for Critical Illness and Specific Treatments

In recognition of the financial strain associated with critical illnesses, the ex-gratia payment to employees upon diagnosis of a critical illness has been raised to ₹200,000. This provides a crucial financial cushion during challenging medical times. The scheme also introduces a higher limit of ₹50,000 per eye for cataract treatment, ensuring better access to vision correction procedures.

Dependents’ Eligibility and Other Inclusions

The income threshold for dependents to be eligible under the GMIS has been increased to ₹24,000 annually. This adjustment aims to broaden the scope of coverage for family members. It is important to note that this higher income criteria specifically applies to the GMIS and does not alter the existing ₹18,000 income limit for dependents as defined in other bipartite settlements. Additionally, the policy now includes more treatments under Day Care and Domiciliary treatment categories. Day care provisions now encompass treatments like Albumin Infusion, Peritoneal Dialysis, and expenses related to oral chemotherapy. Domiciliary treatment coverage has been expanded to include vector-borne diseases such as Dengue and Chikungunya, as well as rare diseases classified by the Ministry of Health & Family Welfare.

Ongoing Union Demands and Future Discussions

While the recent MoU addresses several key improvements, bank unions continue to advocate for further enhancements. Among the pressing demands are for banks to fully fund the insurance premiums for all employees, including retired staff, and for a waiver of Goods and Services Tax (GST) on these premiums for retirees. Unions also emphasize the need for greater transparency regarding hospital rates, improved cashless facility availability, and more efficient claim settlement processes through Third Party Administrators (TPAs). Discussions are ongoing to explore the feasibility of these additional suggestions with insurance providers.

Important Information

Conclusion

The forthcoming revisions to the Group Medical Insurance Scheme signify a positive step towards enhancing the healthcare benefits available to bank employees and officers. The increased limits for hospitalization, maternity, infertility, and critical illnesses, coupled with expanded treatment coverage, aim to provide greater financial security and peace of mind. Continued dialogue between unions and management is expected to address further welfare measures.

Frequently Asked Questions

What is the effective date for the revised Group Medical Insurance Scheme (GMIS)?

The revisions to the GMIS are effective from November 1, 2026.

What are the new room rent limits in metro cities?

The room rent limit in metro cities (Delhi, Mumbai, Chennai, Kolkata) has been increased to ₹7,000 per day.

How much is the enhanced coverage for maternity expenses?

Maternity expenses are now covered up to ₹100,000 for normal delivery and ₹150,000 for Caesarean section.

Is there new coverage for infertility treatments?

Yes, a new limit of ₹200,000 has been introduced for infertility treatments like IVF, with the premium being borne by the bank.

What is the updated limit for critical illness ex-gratia?

The ex-gratia payable in case of a critical illness has been increased to ₹200,000.

What is the new income threshold for dependents under GMIS?

The income limit for dependents has been raised to ₹24,000 per annum, specifically for GMIS eligibility.

Are ICU charges also revised for metro cities?

Yes, ICU bed charges in metro cities have been increased to ₹9,500 per day.

What specific treatments are now included under Day Care?

Day Care now includes treatments like Albumin Infusion, Peritoneal Dialysis, and expenses related to oral chemotherapy.

What are some of the ongoing demands from bank unions regarding GMIS?

Unions are pressing for bank-funded premiums for retirees and GST waivers on these premiums.

Will the existing limits for non-metro cities change?

No, for other centers, the existing limits of ₹5,000 for room rent and ₹7,500 for ICU charges will continue.