Kolkata based National Insurance Company(NIC) has managed to retain the Ayushman Bhart account of Maharashtra, that generates second largest health insurance premium after Tamil Nadu.
The state has paid a premium of Rs 713 crore for the scheme, starting from Jan 1, for six months and would like to extend it for the whole year afterwards.
Negotiations for the scheme on behalf of the state with the NIC, were carried out by Sudhkar Shinde,chief executive officer, State Health Assurance.
“ We have worked relentlessly on prevention of frauds during last few months therby bringing down the cost and premium for the scheme. NIC has agreed to run scheme with premium of Rs 640 per family per year . Due to this,there will be prospective saving of Rs 111 crore annually for the state government,’’ said Shide to Asia Insurance Post..
Earlier, Maharashtra was paying a premium of Rs 690 per family.
NIC has been the insurer of state’s flagship scheme Mahatma Jyotiba Phule Jan Arogya Yojana, that provides cover for Rs 1.5 lakh, since 2012 and has given benefit to more than 21 lakhs beneficiaries till date.Since November 2016 the premium for the scheme was increased from Rs 333 per family per year to Rs 690 per family per year over a period of five years. . .
The scheme provides cover to 2.25 crore family in the state.The scheme will now include 83 lakh family who would be now eligible for the facilities under Ayushman Bharat.scheme.
The Mahatma JyotibaPhule Jan Arogya Yojna gives benefit of 971 procedures distributed in 30 specialties through 492 empaneled hospitals in state.
The grand Ayushman Bharat Scheme known as Modi Care or Pradhan Mantri Jan ArogyaYojana (PM-JAY), providing Rs 5 lakh cover to 10 crore family, launched in September,2018 was a much promising business for the insurers, but most of the states have gone for the Trust Model where they are the managing the business by themselves without involvement of insurers.
The premium or expenses for the Rs 5 lakh cover was designed to be borne by the central and state government in the ratio of 60:40.
Some state like Gujrat, Chattishgard have gone for hybrid system where a part of the R 5 lakh cover will be insured by insurance companies.
While the state of Nagaland has been awarded to Apollo Munich Health Insurance at Rs 444 per family, some states like Gujarat and Chhttishgarh have opted for a hybrid model- mix of insurance and Trust model- to implement the Modi government’s flagship health insurance scheme, National Health Protection Scheme, that offers Rs 5 lakh health insurance cover to poor and vunerable population for free.
Bajaj Allianz General Insurance, has bagged the Ayushman Bharat , account for the entire state of Jammu & Kashmir at a premium of Rs 775 per family for a cover of Rs 5 lakh.
Jharkhand has opted for a hybrid account where insurers NIC will provide cover fpor Rs 1 lakh while the rest will be managed by the state government.
NIC has signed MoU with the Government of Jharkhand to extend health insurance to 57 lakh families for a total premium of Rs 535 crores. The PSU genereal insurer is charging a premium of Rs 900/- per family per annum in the state..
Billed as the world's largest government healthcare programme, Ayushman Bhart is meant for poor and deprived rural families and identified occupational category of urban workers' families, 8.03 crore in rural and 2.33 crore in urban areas, as per the latest Socio-Economic Caste Census (SECC) data, and will cover around 50 crore people.There is no cap on family size and age in the scheme ensuring that nobody is left out.