A pilot programme of India’s largest health insurance scheme was announced by Prime Minister Narendra Modi in his Independence Day address on Wednesday, 15 August.
The states and union territories selected for the pilot run of the Pradhan Mantri Jan Arogya Abhiyan National Health Protection Mission are:
Chhattisgarh, Uttarakhand, West Bengal, Chandigarh, Himachal Pradesh, Daman and Diu, Nagaland, Manipur, Haryana and Andhra Pradesh.
Seven states, including two union territories, have opted for the insurance model.
Twenty states opted to set up trusts or subsidy pools with 60:40 contribution by central and state governments. Funds will be granted at a flat premium of Rs 500 a family for the first six months.
Under the mixed model—opted by eight states—claims of up to Rs 1.5 lakh will be covered by an insurer and anything exceeding that will be settled by the trust.
How it Works?
- A cover of Rs. 5 Lakhs per family per year for secondary and tertiary care
- There is no restriction on family size, age or gender
- All members of eligible families as present in SECC database are automatically covered
- No money needs to be paid by the family for treatment in case of hospitalization
- All pre-existing conditions are covered from day one of the policy. The benefit cover will include pre & post hospitalisation
- You can go to public or empanelled private hospitals across the country and get free treatment
- You need to carry any prescribed ID to receive treatment at the hospital