Ensuring health in Tamil Nadu

With the launch of the Comprehensive Health Insurance Scheme (CHIS) in January for families with annual income less than R72,000, the Tamil Nadu government is trying to step up efforts to provide medical cover to its poor. A majority of the state’s 801 hospitals empanelled in 32 districts are government-owned and the treatment cost reimbursed towards in-patient treatment is to be divided in the ratio 15:85 between the hospital staff and the hospital infrastructure development corpus.

As per the CHIS scheme, the sum assured for each family would be R1 lakh every year for a total period of four years amounting to a total cover of R4 lakh. The sum insured for certain treatments of a critical nature could be enhanced to R1.5 lakh. The scheme operates on a floater basis (insuring the entire family) and covers 1,056 diseases, 1,016 procedures, 113 follow-up procedures and 23 diagnostic procedures. There is no restriction on the number of times a benefit is availed. The unutilised entitlement will lapse at the end of every policy year. The total number of benefitting families, as per the cashless hospitalisation scheme, has been identified at around 1.34 crore, of which, 1.07 crore families have already received insurance cards.

“Claims to the tune of R279 crore have been disbursed to the hospitals and (these) are utilising the funds to improve their infrastructure and overall maintenance,” says Dr J Radhakrishnan, health secretary, government

... contd.