Over the past 10 months, more than 50,000 surgeries have been performed across Maharashtra under the state’s cashless health insurance scheme, Rajiv Gandhi Jeevandayi Yojana (RGJY).
Maximum surgeries have been reported in Mumbai.
With the increase in the number of beneficiaries availing the scheme, National Insurance Company, which insures the scheme, is worried about losses, said sources. The premium amount paid by the state for the last ten months is Rs. 150 crore and the insurance company has to pay Rs. 139 crore to hospitals.
“At present the company is making meagre profits but if the numbers increase at a faster rate, there is a possibility that the company may suffer losses,” said a senior official working closely with the scheme.
According to Dr Mukesh Mohode, program officer, RGJY, around 30,000 surgeries were performed under the scheme between December and March. “When compared to similar schemes in other states, we see that more people have benefited under the scheme in a lesser period,” said K Venkatesan, chief operating officer.
“As far as the insurance company is concerned, we have paid them the premium. We are still in talks with them to replicate the scheme in the entire state.” DR Subodh, deputy general manager from National Insurance Company, said, “We have entered into an agreement for three years which we will fulfill.”