State Health Insurance Programs

State Health Insurance Programs

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Introduction

The health needs of a person differ from one location to another depending on various factors. Though many National Health Insurance Schemes are available, state health insurance programs play a significant role in addressing specific health issues. The state health insurance programs provide health care support to the below poverty line (BPL) population. Each state has its scheme or relief fund tailored to meet each stateís health and environmental demands. The following are the list of state health insurance programs available in India.
  • Rajiv Aarogyasri, Andhra Pradesh
  • Mukhyamantari Amrutam (MA), Gujarat
  • The Chief Minister's Distress Relief Fund, Kerala
  • Chief Minister's Relief Fund, Madhya Pradesh
  • Rajasthan's Chief Minister's Relief Fund, Rajasthan
  • Chief Minister's Comprehensive Health Insurance Scheme, Tamil Nadu

Rajiv Aarogyasri, Andhra Pradesh

This scheme was launched on 1st April 2007 to support the BPL population. It covers a sum Rs. 2 lakhs to treat serious ailments, which require a hospital stay and surgery inclusive of 938 treatments under Rajiv aarogyasri. The primary objective is to improve access to BPL families and also provide auditory verbal therapy for children under six years of age.

Rajiv aarogysri provides coverage for systems like lung, liver, heart, pancreas, kidney and cancer treatment (surgery, chemotherapy, radiotherapy ). High-end procedures like hip and knee replacement, bone marrow and diseases such as TB, HIV/AIDS, infectious diseases covered by national programs are uncovered under this scheme. It is cashless and makes it easier for a BPL person to access medical services at any hospital.
BPL families are identified with ration card photograph and civil supplies department database. Rajiv aarogysri is a family floater scheme with reimbursement of Rs. 1.50 lakhs to be availed individually or collectively with an additional buffer of Rs. 50,000/-. The trust reimburses a maximum of Rs. 6.50 lakhs per case for cochlear implant surgery inclusive of auditory verbal therapy.

Mukhyamantari Amrutam (MA), Gujarat

Families are forced to move towards the below poverty line due to high expenditure of their income on health care. MA was launched in Gujarat to address and control this issue. This scheme with healthcare providers targets to improve medical support to BPL families living in Gujarat. It also covers surgical and medical procedures. Surgeries covered under this system are:
  • Cardiovascular Surgeries
  • Neurosurgeries
  • Burns
  • Poly Trauma
  • Cancer (Malignancies)
  • Renal (Kidney)
  • Neonatal (newborn) diseases

The Chief Minister's Distress Relief Fund, Kerala

This distress relief fund provides support to people affected by natural calamities such as flood, drought, and fire. It also provides treatment for cancer, cardiac surgery, kidney transplantation, brain tumor, liver, and multi-organ failure. The Kerala state governmentís focus is to provide immediate relief to affected people by collecting funds from the public.

The donations are 100% exempted from tax under section 80G(2) (iii hf) of the Income-Tax Act, 1961. Contributions to this fund can be gifted as a cheque /draft in the name of principal secretary finance. The taluk office and collectorate will receive the money.

Chief Minister's Relief Fund, Madhya Pradesh

The aim of this scheme is more similar to the scheme in Kerala which covers medical ailments and also focus on providing immediate relief to those affected in Madhya Pradesh (MP) due to natural calamities.

The donations as a cause of humanity can be made through cheque/drafts and money order. The contributions made are 100% exempted from tax under section 80-G (2)(a)(v) of the Income Tax Rule-1961. The MP government has also introduced two new relief funds such as ďFarmerís Relief FundĒ and ďNepal earthquake tragedy.Ē

Rajasthan's Chief Minister's Relief Fund, Rajasthan

The Rajasthanís chief minister relief fund delivers assistance to the victims of accident and severe diseases. This resource covers people affected by natural calamities from 13.12.2007. A premium of Rs. 50,000 to the deceased dependents, Rs. 10,000/- to severe injuries and Rs. 2,500/- to regular injuries will be provided.

The sum is collected from the district collector office by filling an application form and attaching injury, postmortem and FIR report for evidence. People in Rajasthan suffering from a severe disease such as cancer, heart and kidney diseases are benefited with a super specialty hospital treatment. This condition only applies to people with annual income less than Rs.1 Lakh.

Chief Minister's Comprehensive Health Insurance Scheme, Tamil Nadu

The Chief Ministerís comprehensive health insurance scheme is lofty and the Tamil Nadu state government launched this scheme through United India Insurance Company Ltd. People with annual income less than Rs. 72,000 per year can benefit with surgical and medical treatments from both government and private hospitals under the certification of Village Administrative Officers in Tamil Nadu.

This scheme works on a floater basis and attempts to provide cashless facility cover up to Rs. 2,00,000/- per family for specific hospitalization procedures. The other benefits are follow-up treatment and additional diagnostic procedures.

Free health camps are conducted on a yearly basis, with one camp each month to identify the people who require treatment. Network hospitals manage these fields as directions given by the Project Director of Tamil Nadu Health Systems Society.

A unique feature of the chief ministerís comprehensive health insurance scheme is that a 24-hour call center is set with toll-free helpline 1800 425 3993 with a competency to answer queries in Tamil.

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Why other states not been taken?
What was the success rate in covered states?
It should be for lower income, middle income groups too although, yes, with higher premiums

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