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Modicare offers cover to 35% less citizens than existing Maharashtra health insurance scheme

State considers asking Centre to let them continue with Mahatma Jyotiba Phule Jan Arogya Yojana

Published on: Feb 6, 2018, 11:28:56 IST
Hindustan Times | By , Mumbai
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The BJP-led state government is in a fix over the announcement of the ambitious health insurance scheme by finance minister Arun Jaitley during the Union budget last week.

The Centre is expecting states to merge their existing health insurance schemes with the one announced in the budget. (Pic for Representation)
The Centre is expecting states to merge their existing health insurance schemes with the one announced in the budget. (Pic for Representation)

According to state officials’ estimate, while the Centre’s scheme will cover around 40% of the state’s population, an existing health insurance scheme of the state covers about 75%. The Centre is expecting states to merge their existing health insurance schemes with the one announced in the budget. This has put the Devendra Fadnavis-led government in a quandary: It will have to take a call on what do for the remaining 35% population. It also faces a tough task of generating its share of funds to implement the Centre’s scheme.

The Centre’s announcement came when the state officials were negotiating premium amount with the insurance companies to expand scope of the existing health insurance scheme Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) that is being implemented in Maharashtra since 2013.

State health officials say the scheme caters to 2.20 crore families or 9 crore people, with health care services of up to Rs1.5 lakh. The state government offers 971 procedures by paying Rs690 as premium per year per family. Sometime ago, state proposed to increase the procedures to 1,100 for which the insurance companies quoted the premium as high as Rs1,796 per family. The high premium quoted by the bidding companies put the state’s plan of widening its scope on hold as it would put an additional burden of Rs2,500 crore on the cash strapped exchequer.

The department has been awaiting more details before going ahead with the expansion of MJPJAY. After it announced to widen the scope of the scheme, the state government invited bids from four public sector insurance companies twice in past two years. The lowest bid by National Insurance Company Limited was Rs1,571 per family in October 2016 during first bidding and has now been quoted at Rs1,796 during second bidding in November 2018.

 
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