With a day left for the roll-out of world’s biggest health insurance scheme – Ayushman Bharat from the lands of Bhagwan Birsa Munda, the Jharkhand State Aarogya Society under Department of Health, Medical Education and Family Welfare signed an MoU with the National Insurance Company here on Friday.
In the presence of Minister, Department of Health, Medical Education and Family Welfare, Ramchandra Chandravanshi, , Principal Secretary of Health Department Nidhi Khare, Nodal Officer of the Aarogya Society Divyanshu Jha, including senior official of National Insurance Company, the MoU was inked which would provide health insurance cover up to Rs 1 lakh to the beneficiaries. The claims over and above that would be paid by the trust formed by the State Government since Jharkhand has chosen for hybrid model to implement the scheme.
“The sum insured in respect of the risk cover for each beneficiary family unit shall be Rs 1 lakh per family per annum on floater basis. Over 57 lakh beneficiaries of State identified and covered under National Food Security Act (NFSA) and beneficiaries excluded from the Jharkhand National Food Security Act (NFSA) database but is part of the Socio-Economic Caste Census (SECC) database of Jharkhand can avail the benefit,” said Nodal Officer, Jharkhand State Aarogya Society, Divyanshu Jha during the Media briefing.
“The insurance contract shall be for a period of maximum three years. The SHA may choose not to renew the policy by giving a prior written notice to the insurer at least three months in advance of the expiration of the on-going policy cover period,” the press communiqué read.
Elaborately discussing about the role of the State and Central government in this major scheme that gives an universal health coverage of Rs 5 lakh to each BPL card holders, the Nodal Officer further added, “Under Ayushman Bharat –Pradhan Mantri Jan Aarogya Yojana and Mukhyamantri Swasthya Bima Yojana, the State will reimburse 40 per cent of the total money incurred on the treatment to the beneficiaries while rest 60 per cent amount will be borne by the central government for those falling in the criteria of the baseline, set up by the GoI.”
The figures suggest that 25 lakh beneficiaries have been covered in accordance to the criteria of GoI whereas 32 lakh beneficiaries are those identified by the State government, whose cost of treatment will be fully borne by the State Government. According to officials, additional financial burden of Rs. 540 crore has been incurred upon the State Government.
Under this National Health Protection Scheme – Ayushman Bharat which will be launched on September 23, the facility of free health insurance up to Rs 5 lakh will be provided to 10 crore households of the country. The insurance will cover 1350 packages over 23 surgical and medical specialties.
The benefits under this scheme will be available through Government hospitals and private empanelled health care providers. The Principal Secretary, Department of Health and Family Welfare stated that over 338 private hospitals have been empanelled by the State agency with the scheme. Similarly, 144 Single Specialty Hospitals and 112 Multiple Specialty Hospitals have been empanelled under this scheme till September 20 and are likely to increase further.
Furthermore, the benefits within this scheme under the risk cover are to be provided on a cashless basis to the beneficiaries up to the limit of their annual coverage which includes hospitalization expense benefits, day care treatment benefits, follow-up care benefits, pre and post hospitalization expense benefits, new born child/children benefit. The beneficiaries can avail the facilities at any hospital of national status across the country.