You might soon be able to benefit from a state medical insurance scheme, which covers 972 medical procedures. The scheme, the Rajiv Gandhi Jeevandayi Arogya Yojna, got a nod from chief minister Prithviraj Chavan on Thursday and will soon come up before the state Cabinet for approval.
The paperless and cashless scheme will involve issuing health cards that will be linked to the Unique Identification number that the Centre has launched for every citizen. A call centre and kiosks in designated hospitals will govern the functioning of the scheme.
The state has kept aside Rs1,000 crore for the insurance scheme. This amount will be used to pay the insurance premium for 2.6 crore people earning less than Rs1 lakh a year and holding yellow and saffron ration cards.
“Right now, the premium that we have worked out for the existing population is Rs500 per person. But if all goes well, then I have asked for the scheme to be extended to everyone, including white ration card holders [those with family income of more than Rs1 lakh] who can pay the premium themselves, just that it might be a little higher,” health minister Suresh Shetty said after the meeting with Chavan.
Shetty said the scheme covers medical procedures related to cancer, orthopaedics, paediatrics, cardiology, and all major diseases and ailments.
A person insured under the scheme will get a health card. In the case of an ailment or medical emergency, the person can go to the nearest empanelled hospital and flash the health card at the kiosk in the hospital.
Then, through the online system, the person sitting at the kiosk will enter the patient’s requirements, which will go to the call centre.
The call centre will pass this information to doctors, who, after studying the case, will get the patient admitted to the right medical facility and advise the treatment.
“We will ensure that every hospital, which is empanelled, keeps 10% of its beds for people insured under the scheme. This includes private hospitals,” Shetty said.
Technicians and doctors will get a percentage of the insurance amount as an incentive. This, the state hopes, will encourage hospitals to participate in the scheme.
The government will be floating tenders and finalising the hospitals to be empanelled once the proposal gets a nod from the Cabinet.