Medical Reimbursement Form for Maharashtra Government Employees Marathi
Medical Reimbursement is an arrangement under which employers reimburse the portion of the health expenses incurred by the employee. The Income Tax Act allows tax exemption of up to INR 15,000 on medical reimbursements paid by the employer.
It is certified that the case did not require hospitalization but is one of prolonged nature, requiring medicine attendance at the our-patient department spreading over a period of more than 10 days. Download the PDF of Medical Reimbursement Form for Maharashtra Government Employees PDF from below given link.
Medical Reimbursement Form Should be Submitted with Following Documents
1. Annexure – II (with amount, signature of the applicant and attestation)
2. Emergency certificate (with signature and stamp of hospital/treated doctor)
3. Essentiality certificate (with signature and stamp of hospital/treated doctor. The amount in the Essentiality
Certificate should tally with amount in the Annexure-II).
4. Discharge Summary (with signature and stamp of hospital/treated doctor)
5. Out Patient Card if treatment taken as Out Patient.
6. Dependent and Non-drawal certificates (with attestation of the forwarding authority and signature of the
applicant).
7. For every follow up treatment for post operative cases, who requires life long treatments, the concerned patient has to get revalidation of prescriptions once in six months from the specialist Government doctor.
8. In case of accident cases and treatment taken in un-recognised hospitals under emergency, FIR should be
submitted.
9. Legal Heir certificate should be submitted in case of death of the teacher.
You can download the Medical Reimbursement Form for Maharashtra Government Employees in PDF format online from the link given below.
