Benefit cover for hospitalization expenses upto Rs. 5.00 lakh per family per year
Kohima, July 23 (MExN): Recognizing the importance of increasing access to critical health services for achieving Universal Health Coverage, the Department of Health & Family Welfare, Nagaland is preparing to launch the Ayushman Bharat National Health Protection Mission (AB-NHPM).
The ongoing Rashtriya Swasthya Bima Yojana (RSBY) and Senior Citizen Health Insurance Scheme (SCHIS) will be subsumed under AB-NHPM, according to a DIPR report.
The aim of the scheme is to improve access to quality healthcare and reduce the out-of-pocket expenditure on hospitalization, thereby protecting beneficiary families belonging to poor and vulnerable sections from impoverishment due to health-related expenses.
The selection of beneficiary is decided on the basis of family being figured in Socio Economic & Caste Census (SECC) 2011 database. Further, currently enrolled beneficiaries under RSBY who are not in the SECC database will also be eligible for AB-NHPM.
The beneficiary families will be entitled to a benefit cover for hospitalization expenses upto Rs. 5.00 lakh per family per year (on a family floater basis) with no cap on family size and age of the family members.
About 1,350 health packages comprising of secondary and tertiary services are included under AB-NHPM. The benefit will also include pre- & post-hospitalization as well as cover all pre-existing conditions from beginning of the policy. The benefits will be cashless and paperless and can be availed from any of the empanelled hospitals across the country, it was informed. For effective implementation of the Mission, public hospitals with inpatient facilities from Community Health Centre (CHC) and above shall be deemed to be empanelled. Private Healthcare Providers (both for profit and not for profit) subject to fulfillment of empanelment criteria shall be eligible for empanelment under AB-NHPM.
All public hospitals from CHC and above and interested private health care providers have been requested to apply for empanelment through an online application on the web portal- www.abnhpm.gov.in. Existing Empanelled Health Care Providers (EHCP) under RSBY will be exempted from the verification process but will require to apply online.
The process of the empanelment will be as per the AB-NHPM Guideline on Processes for Empanelment of Hospitals. Various Guidelines of the Scheme can be downloaded from https://pmrssm.gov.in/download-documents.html. For any queries, contact through email to nagaland.nhpm@gmail.com.
