Phase 1 a success, health insurance for poor to now cover entire state
A total of 972 procedures have been identified along with 121 follow-up packages in 30 specialised categories.
Under the system, several Arogyamitras and other facilitators will be appointed to assist the beneficiaries.
Health officials pointed out that the beneficiaries would have to approach the primary health centre or rural or district hospitals from where they would be referred under the scheme for preliminary diagnosis and basic tests. The pre-authorisation request is sent to the insurance company, which is required to approve it within 12 hours if all conditions are met. Under the scheme, the Rajiv Gandhi Jeevandayee Arogya Yojana Society will pay the insurance premium in installments on behalf of the insured beneficiary families to the insurance company.
In case of renal transplants, the immuno-suppressive therapy is required for a period of one year and here the upper ceiling for renal transplant has been kept at Rs 2.5 lakh.
At present, eight districts of Gadchiroli, Amravati, Nanded, Solapur, Dhule, Raigad, Mumbai and Mumbai (suburban) are implementing the scheme. In Pune, patients from outside the city are being treated under the scheme at Sassoon general hospital. However, the scheme is yet to be made fully functional for beneficiaries in Pune district.