The low health insurance penetration of India has resulted in only 27% of its citizens’ availing health cover. This was one of the biggest reasons behind the announcement of National Health Pension Scheme (NHPS) by the government in the 2018 Union budget which shall hit the market either on 15th August or 2nd October. This scheme proposing to bring 40% of the Indian population under its the health coverage by generating substantial growth in insurance premium comes allows co-payment by beneficiaries. Today, Ashish Bhalla shall take you through the NHPS scheme and the expectation we can keep from the same. We will end the article by discussing about the pre-existing health insurance schemes available in the market which can also be utilised to your benefit.
•Coverage
With a projected cost of 12000 crore INR, the total expenses under NHPS scheme shall be borne by both central and state government in the ratio of 60:40. The insured shall be provided with cashless hospitalization facility under the health insurance scheme so that they do not have to worry further about the treatment expenses. Ashish Bhalla speaks about certain selected private hospitals and state hospitals where the treatment can be availed by the insured. Expenses incurred during the initial hospitalization, secondary medical care (involving treatment from dermatologists, urologists, cardiologists etc. during a short stay at the hospital) as well as tertiary medical care (involving burn treatment, plastic surgery and cardiac surgery done on inpatients) are covered under NHPS.
•Targeted Section Of The Society
50 crore beneficiaries and 10 crore vulnerable families falling below the poverty line shall be benefitted by the flagship health insurance scheme. Each such family shall receive an annual health cover of 5 lakh INR for catering to their medical treatment. Ashish Bhalla expects that this health coverage initiative aimed at increasing the spread of health care facilities in smaller villages and towns shall replace the RSBY.
•Taking A Look At The Existing Health Schemes
Employees’ State Insurance Scheme (ESIC)
Under this scheme, employees as well as their dependants are provided complete medical cover from the very first day of employment. Ashish Bhalla adds that dependents of the insured person are also entitled to monthly pension on the event of death or injury of the insured. Specialist consultation and domiciliary treatment expenses are also covered under this scheme. Specialised medical care is also provided to permanently disabled and retired insured persons and their spouses.
Rashtriya Swasthya Bima Yojana (RSBY)
This health insurance scheme run by the government caters to the impoverished section of our society. Since its launch in 2008, the RSBY has been providing coverage to households below poverty line against the towering financial expenses which can arise out of hospitalization. Annual health coverage up to 30000 INR can be availed by the beneficiaries who will also enjoy the benefit of cashless hospitalization in a large array of empanelled hospitals. Ashish Bhalla further adds that people can get themselves registered to this scheme by paying just 30 INR as registration fee while the central and state government takes care of the premium portion.
Central Government Health Scheme (CGHS)
Launched under the Ministry of Health and Family Welfare in 1954, the CGHS aims to encompass pensioners as well as current employees of the central government enrolled under this scheme with comprehensive medical care. Homoeopathic, Allopathic and AYUSH systems of medicine are accredited to the beneficiaries under this scheme as revealed by Ashish Bhalla.
Universal Health Insurance Scheme (UHIS)
This scheme serves both the impoverished and affluent sections of our society in the form of accidental death coverage worth 25000 INR paid after the demise of the family’s sole bread earner, reimbursement of medical expenses up to 30000 INR available on hospitalization of the entire family and compensation on loss of earning member for 15 days at 50 INR per day.
Aam Aadmi Bima Yojana (AABY)
Launched in the year 2007, this social security scheme applies to below poverty line or marginally above the poverty line families having a sole bread earner. Both central and state government share the responsibility of premium payment equally and a sum assured of 30000 INR gets paid upon natural death of the insured. Ashish Bhalla further reveals that 75000 INR becomes payable on accidental death or disability of the insured within the term of insurance.
If the National Health Protection Scheme gets implemented effectively, it will ensure equitable and accessible health care to the vulnerable and marginalized sections of our society. However, proper regulation has to be implemented for ensuring that medical malpractices and overcharging in certain sectors do not render the cover ineffective as pointed out by Ashish Bhalla.
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