20th July 2009 : The BPL families in Himachal Pradesh have all the reasons to smile. The State Government had launched an ambitious scheme H.P. Swasthaya Bima Yojna in Kangra & Shimla district last year to provide health cover to the families living below poverty line. The scheme soon caught the imagination of poor and downtrodden as more than one lakh families got the insurance cover within first year of its launch. Owing to the success of scheme, the area of National Health Insurance Scheme has been extended to rest of the ten districts of the State to cover 2,98,291 BPL families in the State from 2009-10.
The Swasthaya Bima Yojna envisages to provide health insurance to the BPL families in view of the marginal socio-economic conditions of such families apart from improving public health infrastructure. The scheme is being implemented by H.P.Swasthaya Bima Yojna society of the department of Health & Family Welfare, which has been nominated as nodal agency for the implementation of this scheme.
Under this scheme, a beneficiary will be ensured for Rs. 30,000 per families per annum on a family floater basis. The BPL family unit will comprise of maximum 5 members irrespective of age.
The BPL family will not be required to pay any premium for the insurance cover however, the beneficiary will be required to pay Rs 30 per annum as registration fee/renewal fee. Each beneficiary will be issued Smart Card at a cost Rs 60 free of cost. Insurance money will be payable only if the beneficiary gets indoor treatment in the hospitals empanelled to the State Government. The scheme provides cashless coverage of all health services in the insured package.
So far, 1,00,547 families have been covered under Rashtriya Swasthaya Bima Yojna in Shimla & Kangra district. The New India Insurance Company, being the insurance provider has issued 80,242 Smart Cards of which 54,511 are from Kangra and 25,731 from Shimla district. Till date as many as 310 BPL patients i.e. 82 in Shimla and 228 in Kangra district have received medical treatment free of cost from the empanelled hospitals under this Bima Yojna.
Under Rashtriya Bima Yojna, most common illness including hospitalization expenses with a few exclusion as possibly. A provision for regional pre and post hospitalization expenses has also been made. The scheme also covers the services of surgical nature which can be provided on a day care basis apart from covering all pre-existing diseases. The transportation cost of patients to the hospital have also been covered under the scheme with a maximum limit of Rs 100 per visit and over all Rs one thousand.
The scheme is being implemented by the State Government with the assistance of Government of India. While the Government of India will spend Rs. 491.13 per BPL family per annum on the health insurance cover, the share of the State Government will be Rs 143.70. A provision of Rs 19 crore approximately has been made for the implementation of the scheme in all the 12 districts in the State.
In order to expand the area of more benefits to the BPL families, the State has submitted a proposal for new schemes as well. Under the proposed scheme the cover for critical illness expenses the scheme shall provide an additional coverage of upto Rs one lac for meeting expense of hospitalization and surgical procedures of beneficiary members in case of hospitalization for treatment of Heart Ailments Transplant Surgeries, Spinal Surgeries and Neurosurgery. The Cover for Maternity expenses aims to provide an additional cover of up to Rs 10 thousand for maternity care including normal deliveries, caesarean section deliveries and new born cases.