Deen Dayal Swasthya Seva Yojana (DDSSY)

What is Deen Dayal Swasthya Seva Yojana?

Deen Dayal Swasthya Seva Yojana (DDSSY) is the Government of Goa's own health insurance scheme, run by the Directorate of Health Services under the Health Services Department. Goa launched DDSSY to take medical services for its people a step further than what state hospitals alone could deliver, by paying for diagnosis, hospitalisation and surgery at both government and private hospitals on a cashless basis.

According to the scheme guidelines published on goa.gov.in, DDSSY provides insurance cover of up to Rs 2,50,000 per year for a family of three or fewer members and up to Rs 4,00,000 per year for a family of four or more members. Under no circumstance can a family draw more than Rs 4,00,000 in a single year. The cover is a family floater, so it can be used entirely by one sick member or split across several members during the year.

Main features

• Cashless treatment at Empanelled Health Care Providers (EHCPs) across Goa.
• 447 procedures are covered under the scheme.
• No income ceiling on basic eligibility, unlike the older Goa Mediclaim Scheme.
• Cards are issued per family, based on the ration card as the family definition.
• Enrolment and renewal are handled online through the state services portal goaonline.gov.in.
• A beneficiary may separately buy higher private cover at his own cost without affecting the DDSSY entitlement or access to government facilities.

Who is eligible for Deen Dayal Swasthya Seva Yojana?

You can apply if:

• You are a resident of the State of Goa.
• You have resided in Goa continuously for a minimum of five years or more.
• Every family member you wish to add above 5 years of age has an Aadhaar number or an Aadhaar enrolment acknowledgement slip.
• You can prove the family relationship, normally through a ration card.

You are not eligible if:

• You cannot show five continuous years of residence in Goa through a passport, residence certificate, election card or driving licence issued in Goa at least five years earlier.
• You are a visitor or short-term resident in the state.
• You are applying to renew a card that is not active. The renewal service on goaonline.gov.in works only for existing active members; a lapsed or non-member card cannot apply through the renewal route and needs a fresh application instead.

Family composition matters as much as residence. DDSSY defines the family through the ration card. Where no ration card exists, the department accepts a marriage certificate for a spouse, a birth certificate or school leaving certificate for each dependent child, and a signed declaration that dependent parents are not employed.

What documents are required for DDSSY?

How to apply for DDSSY online

1. Open the Goa state services portal at goaonline.gov.in.
2. Click Register and provide your email ID, mobile number, name, address and date of birth, then complete the OTP authentication to finish registration.
3. Log in with your new credentials and verify your Aadhaar number under the user profile section.
4. Go to the Services menu, select All Services, and under DDSSY choose the Deen Dayal Swasthya Seva Yojana service you need. Existing card holders select DDSSY - Renewal.
5. Confirm that you are an active member, since non-members cannot use the renewal service.
6. Enter your DDSSY card number and search for the associated member details.
7. Click Generate OTP, receive the code on your registered mobile number and validate it.
8. Fill in all mandatory fields marked with an asterisk and upload the relevant documents if you are renewing with updates.
9. Click Proceed to Pay and complete the payment for the renewal.
10. Note down the acknowledgement number shown after successful payment. A confirmation message is also sent to your registered mobile number.

How to use your DDSSY card at a hospital

1. Check the published list of Empanelled Health Care Providers and confirm that the hospital you plan to visit is empanelled for the procedure you need. Empanelment is procedure-specific, so a hospital on the list may not be approved for every treatment.
2. Consult the doctor at that hospital. If the surgery is covered under DDSSY and is available there, take your DDSSY card to the DDSSY Sahayak posted at the hospital.
3. The Sahayak raises a pre-authorisation request with the pre-authorisation doctor of the insurance service agency (ISA).
4. Once pre-authorisation is granted, the treatment proceeds cashless up to the annual limit on your card.

If you already know exactly which procedure you need, you can reverse the order: check the empanelment list first to see which hospitals perform that procedure, then visit the hospital of your choice from that list.

How much does DDSSY pay, and how?

DDSSY does not reimburse the patient. The benefit is delivered cashless, directly between the empanelled hospital and the insurer, up to the family's annual coverage limit:

• Rs 2,50,000 per annum for a family of three or fewer members.
• Rs 4,00,000 per annum for a family of four or more members.
• Rs 4,00,000 is the absolute annual ceiling for any family.

The benefit can be availed individually or collectively by members of the same family, which is what makes the family floater useful when one member has a long treatment course in a single year.

Why DDSSY claims and applications get rejected

• Residence proof is younger than five years. The election card, driving licence or residence certificate must itself have been issued at least five years earlier in Goa; a recently issued document does not prove five years of residence.
• Aadhaar missing for a family member above 5 years. Every such member needs Aadhaar or the enrolment acknowledgement slip.
• Family composition not proved. Without a ration card, the marriage certificate, children's birth certificates and the declaration for dependent parents are all required, and a missing one holds up the whole card.
• Renewal attempted on a non-active card. The online renewal service works only for active members.
• Hospital not empanelled for that specific procedure. Empanelment is by procedure, not by hospital as a whole.
• Pre-authorisation not obtained before the procedure. Cashless benefit depends on the Sahayak filing pre-authorisation with the ISA doctor first.
• Annual limit already exhausted by earlier treatment in the same year for any member of the family.

Key dates and renewal

DDSSY has no annual application window. Cards are issued and renewed through the year, and the date that matters is the expiry date printed on your own card. Renewal should be started before the card lapses, because the online renewal service is available only while the membership is active. Renewal is a paid service on goaonline.gov.in, and the acknowledgement number generated after payment is the reference for tracking.

Who to contact for DDSSY help and grievances

According to the scheme guidelines, the nodal officers for DDSSY are:

Card and portal problems are best taken to the Goa Electronics Ltd. contact, since DDSSY enrolment runs on the state's online services platform. Medical and pre-authorisation disputes go to the Directorate of Health Services, and claim processing questions to the insurance TPA.

How DDSSY differs from the Goa Mediclaim Scheme

Goa runs two health assistance routes and applicants often confuse them. DDSSY is an insurance scheme with no income ceiling, requiring five years of residence, and it pays hospitals cashless for 447 listed procedures. The Goa Mediclaim Scheme is a financial assistance scheme for super-speciality treatment not available in Goa's government hospitals, requiring 15 years of residence and, for most applicants, family income below Rs 1,50,000 a year. The Mediclaim application form itself asks whether the patient holds a DDSSY card, so the two are meant to be read together rather than as alternatives.

How to check your DDSSY application status

DDSSY does not have a separate public tracking number system like a grievance portal does. What you track depends on which stage you are at: enrolment or renewal on goaonline.gov.in, or a pre-authorisation request already filed at a hospital.

If you just submitted an enrolment or renewal on goaonline.gov.in:

1. Log in at goaonline.gov.in with the same credentials you used to apply.
2. Go to My Applications (or the equivalent applications list under your profile) and locate the DDSSY service request by the acknowledgement number you noted after payment.
3. The status shown against the request tells you whether it is still being processed or has been approved and the card generated.
4. If the status has not moved for several days, use the acknowledgement number to raise the issue with the Goa Electronics Ltd. IT contact for the portal (Assistant Manager, IT, 8411004910), since card generation and portal processing are handled on that side.

If you are waiting on a pre-authorisation request at a hospital:

1. Pre-authorisation status is tracked through the DDSSY Sahayak posted at the empanelled hospital where you sought treatment, not through the goaonline.gov.in portal.
2. Ask the Sahayak to check the status of the pre-authorisation request with the insurance service agency (ISA), since it is the Sahayak who filed the request on your behalf.
3. If the hospital cannot get a response, the escalation point for pre- authorisation and claim processing questions is the insurance TPA contact, Dr. Ralph Araujo, Senior Manager, MD India Health Insurance TPA Pvt. Ltd., 9325963691.

If your question is about your card itself (whether it is active, when it expires, or whether a family member is correctly listed on it), the first point of contact is the Directorate of Health Services nodal officer, Dr. Yogesh Potdar, at 0832-2225646 extension 256 or 7447797582, since medical management and card eligibility questions are handled there rather than by the portal helpdesk.

Keep the acknowledgement number from your online application and, once issued, your DDSSY card number on hand before calling any of these contacts. Both numbers are what each office uses to pull up your record.