The world's largest insurance scheme, National Health Protection Scheme, is estimated to benefit 10 lakh families and will cover for more than 1300 kinds of treatment, except organ transplant, health minister J.P. Nadda told reporters at a press briefing today.
The ministry is preparing 1347 types of treatment packages that will be covered under the scheme, and the operational guidelines for the scheme will be launched by next month.
Sharing details of the timeline, Nadda said that by June, states would be done with hospital empanelments and would also be rolling out the tenders for the scheme. By July-end, the National Health Protection Scheme, announced by finance minister in his budget speech, should be in its “testing phase”. “The final date of launch will be decided by the PMO,” said Nadda.
The minister also said that the Centre has decided to set aside Rs 10,000 crore for the insurance scheme, but remained evasive on the premium amount per family. “Funds will not be an issue for this scheme, and the exact amount of premium is being worked out,” he said.
The beneficiaries will be identified according to the Socio-Economic Caste Census (SECC), 2011 data and the Union ministry of health and family welfare would also “validate” the list of the prospective beneficiaries through the gram panchayats.
In rural areas, the different categories will include families having only one room with kutcha walls and kutcha roof; families having no adult member between age 16 to 59; female headed households with no adult male member between age 16 to 59; disabled member and no able-bodied adult member in the family; SC/ST households; and landless households deriving major part of their income from manual casual labour. For urban areas, 11 defined occupational categories will be entitled to get benefit under the scheme.
However, a ministry official said that the SECC data was old, and only those included in it would be able to benefit from the scheme.
States would be encouraged to follow the trust "not-for-profit" model, as opposed to the private insurance company model, a ministry official in-charge of the scheme, said. Private insurance companies, however, would be encouraged to bid for a lower premium because the government would cover them to "some extent" if their costs exceeded the initial estimates.
The scheme would also have robust mechanisms to prevent fake beneficiaries and monitor claims, he said.