New Delhi: In a big boost to healthcare for the poor, the Modi government hopes to cover 100 diseases under the centrally-sponsored Ayushman Bharat, the National Health Protection Mission. Dubbed Modicare, the scheme will provide health insurance cover of Rs 5 lakh per eligible family per year.
According to sources, the government is finalising a list of 70 preventive diseases and around 30 terminal diseases to be covered under the scheme.
“There are talks of covering 70 preventive diseases under the scheme and around 25 terminal diseases. That can go up to 30 as well. However, discussions on terminal diseases are still going on. That is yet to be finalised,” said an official on condition of anonymity.
The Ministry of Health and Family Welfare is also looking to fix a price ceiling on the cure of relatively more serious diseases. “The government will cap the total money required to cure bigger diseases. For example, when somebody requires a stent in the heart, hospitals charge lakhs of rupees. That will no longer happen. Similarly, in the case of more serious diseases that incur relatively higher expenses, the government will fix a maximum bill for the same,” the official added.
The Cabinet on Wednesday approved the National Health Protection Mission that marks the rollout of the mega scheme. The beneficiaries of the proposed scheme will be more than 10 crore poor families, based on the Socio Economic and Caste Census database.
Rashtriya Swasthya Bima Yojana, which provided a health cover of Rs 30,000, and the Senior Citizen Health Insurance Scheme will be subsumed into the new healthcare scheme.
A government statement on Wednesday said this cover will take care of almost all secondary care and most tertiary care procedures.
"To ensure that nobody is left out (especially women, children and elderly), there will be no cap on family size and age in the scheme. The benefit cover will also include pre- and post-hospitalisation expenses. All pre-existing conditions will be covered from day one of the policy," the government said in the statement.
The Ayushman Bharat scheme will also have a defined transport allowance for each time a person is hospitalised.
The different categories in rural areas include families with only one room with kaccha walls and kaccha roofs, families having no adult member between age 16 to 59, and female-headed households with no adult male member between age 16 to 59, among others.
Also, families with disabled members and no able-bodied adult member, SC/ST households, and landless households deriving major part of their income from manual casual labour, will be entitled under the scheme.
For urban areas, 11 defined occupational categories are entitled under the scheme. The beneficiaries can avail benefits in both public and empanelled private facilities.
All public hospitals in the states under the scheme will be deemed empanelled for the scheme. As for private hospitals, they will be empanelled online based on a defined criteria.
To ensure that the funds reach state health agencies (SHAs) on time, the transfer of funds from the central government will be done through an escrow account directly.
Though the government is yet to come out with a fixed date, sources have confirmed that the scheme will be rolled out from August 15.
Comments
0 comment