State health insurance scheme to cover diabetic insulin
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05/04/2016
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Herald (Panjim)
Financial bids to be opened on May 25, scheme to be rolled out in a month
PANJIM: For the first time in the country diabetes insulin will be covered under a State health insurance scheme, which is all set to be rolled out by the government in May this year. Information reveals that the Deen Dayal Swasthya Seva Yojana will cover 443 illnesses.
“The financial bids will be opened on May 25 and from there on it should take about a month to put things in place,” Dy Chief Minister Francis D’Souza, who is also the State Health minister said. “We have decided to allow State-run insurance companies like Oriental Insurance, National Insurance, United India Insurance etc to participate in the bidding,” he said, adding that initially the registration of beneficiaries may take some time.
“Registration of beneficiaries by the selected insurance company will help the people in availing the benefits of the proposed scheme,” he said. Further, D’Souza said, the people will get a year to register themselves for the scheme. He said the scheme covers common illness in Goa like diabetes and kidney diseases.
The government has envisaged the scheme to provide quality medical care, hospitalisation and surgery in government and private hospitals. “The scheme will cover 15 lakh population of Goa, which includes three lakh families from the State. Before finalizing the scheme the government is working out the modalities, including effective benefit of this scheme to the people,” D’Souza said, adding finalization of the scheme has been delayed.
The proposed scheme aims to benefit the entire resident population of Goa. “Resident population is defined as a person residing in Goa for five or more years. The unit of enrollment for this scheme is family and the coverage under the scheme would be provided for all the families.”
This would comprise the household head, and other members. For the purpose of the scheme, household head would require to produce residence proof. The insurance cover will be up to Rs 2.5 lakh per annum for a family of three or less members and up to Rs 4 lakh for a family of four and more members. The insurance benefits can be availed individually or collectively by members of the family.
All public health providers are automatically eligible for empanelment. However, in the initial phase, only Goa Medical College, the two district hospitals and the sub-district hospital at Ponda will be covered, whereas the rest of the government hospitals will be included later at the discretion of the government.
Private health providers, which provide hospitalisation and/or daycare services, would be eligible for inclusion under the insurance scheme, subject to fulfillment of such requirements for empanelment as may be agreed between the Goa government and insurer, D’Souza said.
Asked whether GMC will not be hit as people may prefer to go to private hospitals for treatment due to better quality and treatment, D’Souza replied in the negative. “People have trust in GMC and we have the best medical care facilities in Goa,” he said.
He also stated that GMC will make money out of the scheme and as such the facilities can be upgraded as and when required.
The registration fee under the scheme will be Rs 200 for a family of three or less members and Rs 300 for family of four and above. However, concession of 50 percent will be given to OBC category of non-creamy layer, SC/ST categories and differently-abled head of family.
The premium will be paid by the Goa government to the insurance company on receipt of the list of beneficiaries along with the necessary documents from the company.