One of the biggest deficiencies in India is the lack of a public healthcare system. When there is no social scheme to take care of medical expenses of the people, it ends up pushing people into poverty because they have to borrow funds to keep up medical treatments. The Government introduced Rashtriya Swasthya Bima Yojana did little to change the numbers and provide quality medical treatment to people.
To improve the delivery of healthcare in the country, the Government introduced the Ayushman Bharat scheme. The Ayushman Bharat scheme aims to provide health insurance coverage of up to Rs. 5 lakhs for each family. The family is identified as being vulnerable by the Socio Economic Caste Census database. The scheme aims to cover over 10 crore vulnerable and poor families all across India. The beneficiaries under Rashtriya Swasthya Bima Yojana are also automatically enrolled in this scheme.
In this scheme, the Government sets rates for different medical procedures and the hospitals will be reimbursed at those rates by the Government and insurance companies. Once the beneficiary is empanelled under the scheme, he or she can opt for benefits in any hospital that provides treatment under the Ayushman Bharat scheme. The scheme covers pre and post hospitalization expenses.
The Ayushman Bharat scheme is like a public health insurance scheme. The premium for the same is shared between the Central Government and the State Government. The sharing ratio differs based on the states. For most states and UT’s with legislature, the sharing is 60:40. For North East states, Himachal Pradesh and Uttarakhand, the sharing ratio is 90:10. The Centre pays 100% of the premium for UT without legislature.
However, to be a part of the Ayushman Bharat scheme, the State Government has to finalize a memorandum of understanding with the Central Government. Out of 28 states, 14 have signed agreements to be a part of the scheme.
The premium paid by the Government is used by insurance companies to offer a family floater medical insurance policy. Claims made against this scheme will be paid out by the insurance company directly to the hospital at the pre-decided rates for medical procedures.
Some of the ailments that have treatment under the Ayushman Bharat scheme are cardiovascular problems, caesarean and other delivery expenses, hip replacement, knee replacement, hysterectomy for removal of uterus, putting a stent in arteries, kidney treatment. The scheme also covers treatment for cancer which is a boon for people in the economically weaker sections. Good quality treatment for cancer is costly and through this scheme, people get access to quality treatment.
The Ayushman Bharat scheme is a scheme that aims to boost healthcare services and health insurance in the country.
- ArjitChalmela's blog
- Log in or register to post comments