The Cabinet has approved the launch of Ayushman Bharat -National Health Protection Mission (AB-NHPM) that will provide health insurance to 107.4 million poor and vulnerable families. India has allocated US$1.54 billion for the health programme for the next two financial years, the Health Minister, Mr J P Nadda, said yesterday.
The scheme, announced in the Union Budget in February, provides a cover of up to INR500,000 per family per year. To ensure that nobody is left out (especially women, children and elderly), there will be no cap on family size and age in the scheme. The scheme will cover almost all secondary care and most of tertiary care procedures and include pre and post-hospitalisation expenses.
Benefits of the scheme are portable across the country and a beneficiary covered under the scheme will be allowed to take cashless benefits from any public/private empanelled hospital across the country, reports Press Trust of India.
AB-NHPM will subsume the on-going centrally sponsored schemes —Rashtriya Swasthya BimaYojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
It is proposed to establish an AB-NHPM Agency to manage the new scheme at the operational level.
The premium for the AB-NHPM will be shared between the central and state governments in a specified ratio as per Ministry of Finance guidelines. Total premium payments will depend on the actual market determined premium in states where AB-NHPM will be implemented through insurance companies.
One issue to be settled is the premium rate for the scheme. When the Health Ministry met general insurers, there were no takers for the INR1,082 annual premium for the health cover plan. At this premium, the annual expenditure is estimated at INR100 billion to INR120 billion. The insurers had asked for a premium of INR2,500 in the meeting.
According to government data, in-patient hospitalisation expenditure in India increased nearly 300% in the last 10 years. Out of pocket expenditure in India is over 60%.