• Rajasthan

    BJP 7
    Cong 14
    RLM 0
    OTH 0
  • Madhya Pradesh

    BJP 4
    Cong 5
    BSP 0
    OTH 0
  • Chhattisgarh

    BJP 2
    Cong 2
    JCC 0
    OTH 0
  • Telangana

    BJP 0
    TDP-Cong 2
    TRS-AIMIM 4
    OTH 0
  • Mizoram

    BJP 0
    Cong 0
    MNF 0
    OTH 0

* Total Tally Reflects Leads + Wins

Modicare gets cabinet approval: 5 key things to know about world’s most ambitious health insurance scheme

By: | Published: March 22, 2018 10:05 AM

The government's most ambitious healthcare program dubbed Modicare, which seeks to provide a health insurance cover of Rs 5 lakh per family per year to 10 crore families received cabinet approval on Wednesday. Here are 5 things to know about Ayushman Bharat, NHPS.

Modicare, National Health Protection Scheme (NHPS), Ayushman Bharat MissionThe world’s largest and India’s most ambitious healthcare program dubbed Modicare that seeks to provide a health insurance cover of Rs 5 lakh per family per year to 10 crore families received cabinet approval on Wednesday. (Image: PTI)

The world’s largest and India’s most ambitious healthcare program dubbed Modicare that seeks to provide a health insurance cover of Rs 5 lakh per family per year to 10 crore families received cabinet approval on Wednesday. The Narendra Modi-led government had announced the government’s ambitious Ayushman Bharat — National Health Protection Mission in Union Budget 2018. Finance Minister Arun Jaitley had announced the National Health Protection Scheme, to cover 40% population by bringing 50 crore people under the scheme. We take a closer look at how the the scheme is expected to function.

Scheme to benefit 10 crore families of poor and vulnerable Indians

According to a tweet by the government yesterday, the target beneficiaries of the proposed scheme will be more than 10 crore families belonging to ‘poor and vulnerable population’ based on socio-economic caste census database. Interestingly, this is around 40% of the population, as per government estimates.

Benefits under the scheme

The mega health insurance scheme aims to raise the mediclaim cover by up to 17 times from the existing Rashtriya Swasthya Bima Yojana (RSBY) that caps it at Rs 30,000 per year. According to the details available currently, Ayushman Bhaat will cover all pre-existing diseases and will be portable across all states and union territories in the country.  Accordingly, a beneficiary covered under the NHPs will be eligible for cashless benefits from public or private empanelled hospitals across the country. Further, the 3 days of pre hospitalisation and 15 days of post hospitalisation are also covered under the scheme.

Cost to be shared by Centre and States

The scheme is proposed a a fully government-funded scheme in which the cost will be shared by the centre and states in the ratio of 60:40. The states will be given a choice to adopt insurance company or a trust model as followed under the Central government health insurance scheme. Currently some states follow their own health insurance schemes. The ambitious project is expected to cost about Rs 10,000-12,000 crore, as per government estimates. Ultimately, all l existing health insurance schemes will be merged with NHPS.

Premium dynamics

However, there has been some debate regarding the premium payments. As per government’s current estimates, the premium per family could be around Rs 1,000-1,200 a year, about Rs 500 higher than it currently pays for Rashtriya Swasthya Bima Yojana (RSBY). Insurance companies have approached the governments saying that they will not be able to bid for the scheme given inadequate premiums, which they expect to be around Rs 2,500. Further, the insurance companies demand that the states will have to pay the premium in advance.

Expected date of rollout

Even though the exact date of rollout of the Ayushman Bharat mission is still unclear, according to reports, the scheme will be effective from October-2018. Sharing the expected timeline, Health Minister JP Nadda told Hindustan Times in a recent interview that the mission is likely to be rolled out by year-end.

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