Dec 162015
 

Mukhyamantri Swasthya Bima Yojana in Uttarakhand

Providing medical facilities, at low cost has always been an agenda of BJP government. Keeping in line with the central government policy, the state government of Uttarakhand had launched a new program that has been named the Mukhyamantri Swasthya Bima Yojana. With this, the state authority will provide medical insurance and cashless treatment facility for the needy.

Name Mukhyamantri Swasthya Bima Yojana
Launched By Chief Minister of Uttarakhand, Trivendra Singh Rawat
Phases Of the scheme First  phase was done on  April, 2016 and the second phase was announced on August, 2016
Supervised by Department of Health & Family Welfare
Sub-supervised by Bajaj Allianz General Insurance for providing the policies
Official site http://www.ukhfws.org/
Helpline 1800 233 2530, 104 and 1800 180 1200

Key features of Mukhyamantri Swasthya Bima Yojana

  1. Ensuring free medical treatment for needy – Under the scheme, all eligible candidates will be able to enroll and get a medical insurance. The insurance will ensure that they get treatment in the selected hospitals for free.
  2. For both BPL and APL – This is the only scheme of its kind that has not only been implemented for the individuals who fall under the poverty level but for also those who belong above the poverty level.
  3. Providing cashless treatment – If any individual registers under the scheme, then he/she will acquire the benefit of getting treatment without having to pay for the medical care. The bill will be covered by the medical insurance provided by the government.
  4. For the entire family – Apart from the main policy holder, the MSBY smart card will provide coverage to the health requirements of other 5 members of the family for a period of one year.
  5. Total number of beneficiaries – According to state government reports, the scheme has been able to bring 1359849 people under its umbrella.
  6. Reported claims – As of now, the total number of claims that have been made is 45454.
  7. Claim amount – It has been announced that the government has been able to settle claim amounts of 368586849.
  8. Diseases and medical procedures covered – Under the scheme, the government will assist the poor by covering 790 medical procedures, 1206 diseases and 458 critical diseases. Apart from this, any policy holder will be able to get cashless 1159 surgical procedures in the selected hospitals.
  9. Empaneled hospitals – The individuals who have registered under the medical insurance scheme will be able to get the get cashless treatment in 770 medical institutes. The list contains both government and private medical institutes.
  10. Tertiary care – Apart from providing the people of the urban areas with cashless hospitalization facilities, the people living in the remote and rural locations will acquire tertiary medical care as well.
  11. Promoting accountability – With the assistance of the medical policies, the government will be able to monitor the treatment framework and reduce the pressure of paying for medical bills from the shoulders of the poor.
  12. Choosing the institute – As the number of hospitals and health care centers, enlisted under the medical insurance policy is long, there is no way of monopolizing the sector. People can settle for the institute of their choice.
  13. Access to health care facilities – Poor people are often denied medical facilities by the private hospitals. With the implementation of the scheme, this issue will be resolved adequately.

Phases of the scheme

The Mukhyamantri Swasthya Bima Yojana in Uttarakhand has been implemented in two phases.

The 1st Phase – It was announced on the 1st April, 2016. During the implementation of this phase, it was decided that the medical policy will provide each registered family a medical coverage of Rs. 50,000.

The 2nd Phase – Shortly after the announcement of 1st Phase, the state government made some changes in the program. Thus, the amended version was announced on the 1st August, 2016. It was done to provide better medical security to the poor families. As per the guidelines of the second phase, the coverage amount was increased from Rs. 50,000 to Rs. 1.25 lakhs. Apart from the 1206 diseases, an additional 458 critical diseases were added to the list.

Eligibility criteria of the scheme

  1. Residents of Uttarakhand – The implementation of the scheme has been done only for the people who are residents of the state. Anyone else or any person, who belongs to other state but is staying in Uttarakhand for the time being, will not be able to enroll.
  2. Must be of BPL category – Like most scheme, it too has been developed for providing monetary assistance for the poor. Thus, the BPL candidates will be given preference.
  3. APL candidates can also enroll – The medical insurance scheme is also open for the candidates who do not belong to the BPL category.
  4. Non-tax payers – Only those APL candidates will be able to enroll under the scheme who do not come under any income tax payment slab.
  5. Government pensioners or salaried person cannot apply – It has been mentioned in the scheme that any person who is drawing a salary from the central or state government or is getting a monthly pension form either of the two authorities will not be allowed to enroll under this state scheme.

Important documents required for the scheme

  1. Residential documents – Since only the residents of the state will be able to get the benefits of the scheme, the candidate will have to provide residential proof documents for registering.
  2. Income certificate – As people belonging to a certain income group will be able to get the benefits of the scheme, production of the income certificate is a must. It will also help the authority in verifying whether the person has taxable income or not.
  3. Aadhar card – The central government has made the production of the Aadhar Code mandatory for taking part in any center or state sponsored scheme. It will also assist in the collection of the biometric details of the person. Apart from this, it will also work as an address proof.
  4. BPL certificate – The state wants to cater mainly to those who fall below the poverty level. Thus, the attachment of the BPL certificate is a must.
  5. Bank account details – As the settlement of the medical insurance amount will be done via the bank account, the candidate will have to attach photocopy of the passbook so that the authority can get the account number and other associated details.
  6. Photograph – To provide the identification proof, the form must also contain a passport size photograph of the candidate. It will be matched with the picture on the Aadhar card for verification.

Registration process

  1. For getting the benefits of the scheme, the interested candidates will have to get an application form and fill it up with the data that has been asked for.
  2. The application forms are available at any of the special enrollment centers. No money will be charged from the candidates.
  3. To get the address of the enrollment center, one will have to click on the official link of the website. The link is http://rsbycg.nic.in/healthrsby/common/KioskOperators.aspx. The http://rsbycg.nic.in/healthrsby/common/HelpdeskOperators.aspx will assist the candidate in acquiring the help desk details of the hospitals.
  4. Once the form has been filled, the candidates will have to attach the required documents and the passport sized photograph. Then the form needs to be submitted at the appropriate office of the authority.

MSBY Smart Card

All the candidates who will be selected by the authority, for getting the benefits of the welfare scheme, will be given a smart card. It is called the MSBY Smart Card or the Mukhyamantri Swasthya Bima Yojana Smart Card. When the application of a candidate is approved, the entire family will be represented by this smart card. Just like the Aadhar card, this card will also contain all biometric details of the policy holder. Producing the card at any of the selected hospitals will assist in acquiring the policy benefits, when need arises.

Hospitals and Center List

It has been mentioned that more than 700 hospitals have been enlisted under the scheme. Clicking on http://rsbycg.nic.in/healthrsby/reports/Hospitalslistwithspecialtyforpublic.aspx will provide you with the entire list. Here, you can get the names and contact details of the hospitals that are located in the respective districts. There is a separate search engine that will assist you in getting the names of either the government or the private hospitals.

For getting the list of centers, you need to click on the link http://rsbycg.nic.in/healthrsby/common/KioskOperators.aspx and then select the district and block respectively. As soon as you click on the “Show” button, the contact numbers and names of the center operators will show up.

Financial Contribution by Government

The cost of implementing the scheme will be provided by the state government of Uttarakhand. The state budget has been allocated accordingly. The authority has also declared that more money will be provided if required. For now, the monetary assistance has been increased from Rs. 50,000 to Rs. 1,25,000 per family.

Conclusion

The program has already started catering to the requirements of the poor and needy. Medical facilities are basic requirements and with the improvement of this sector, the government will save the poor people from the pressure of medical bills.

Other Schemes

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