Hyderabad: Two years after the launch of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY), the nationwide universal health insurance scheme remains pale in comparison to the scope of Telangana’s Aarogyasri health insurance scheme covering nearly 85 families.
The recent efforts of Health Minister Eatala Rajender to further restructure the Aarogyasri insurance scheme, to introduce reforms that include the rapid audit of medical bills and the release of funds and the encouragement of private hospitals to provide all their healthcare services, instead of just a few, promises to further improve access to health care for beneficiaries.
“Aarogyasri is 100 times better and more efficient than the Ayushman Bharat insurance scheme. We offer coverage for 517 different medical conditions, which is not the case with any other insurance scheme in the country. Nearly 434 treatments covered under Aarogyasri are very expensive and are not offered by any other public insurance scheme. “Aarogyasri offers insurance for rare medical conditions such as bone marrow transplantation and even organ transplantation,” says Rajender.
The rates or costs for treating medical conditions under Aarogyasri are much higher than Ayushman Bharat, who continued to struggle with a limited network of hospitals with a comprehensive range of treatment available. A large number of private hospitals enrolled in the PMJAY scheme also tend to demand prepayment, which is only reimbursed to the patients after the medical bills have been approved by Ayushman Bharat.
The national health insurance scheme also does not cover indirect costs that patients and their family members suffer during hospitalization. In contrast, Aarogyasri also has innovative components such as free food and transportation, free follow-up services and cashless treatment to patients.
In general, the Aarogyasri 949 health insurance scheme offers different treatment methods for patients. The scheme offers insurance cover to every family from Rs. 2 lakh to Rs.13 lakh and in some specialized therapies there is no limit to the cost of treatment.
In addition, there are exclusive health insurance schemes for employees, including ESI, Health Scheme Employee and Journalists (EHS / JHS), health insurance for Singareni employees whereby the authorities provide health cover to another 20 lakh families, amounting to almost one crore family. in the State.
By contrast, Ayushman Bharat intends to extend coverage to families with a limit of Rs.5 lakh. Ayushman Bharat based his selection of beneficiaries on data from the Socio-Economic Census (SECC) in urban and rural areas. In contrast, Aarogyasri does not consider or classify beneficiaries on the basis of occupation and generally covers all families by insisting only on a white card.
‘There is no denying that Aarogyasri offers better rates or cost of treatment than Ayushman Bharat to hospitals with an emblem. Anyone can check this fact by visiting the PMJAY website, where treatment rates are much lower and private hospitals, especially small and medium-sized institutions, cannot survive at the same rate. We also believe that the Aarogyasri scheme can be further improved by ensuring that medical bills are processed and funds are released quickly, ”said Dr T Hari Prakash, secretary, Telangana Aarogyasri Network Hospital Association (TANHA).
Together with Aarogyasri and employee insurance, the state health authorities have also developed unique independent health care initiatives in recent years, including T-dialysis and T-diagnostics that have further strengthened the health care services in Telangana.
Source: Telangana Today