VIJAYAWADA: The State government will launch a health insurance scheme offering up to Rs 25 lakh per family annually, Minister for Health, Family Welfare, and Medical Education Satya Kumar Yadav announced on Friday.
Speaking to the media at the Secretariat, he recalled that the NDA had promised this scheme during the election campaign.
Stating that the health scheme is a cashless initiative, Yadav emphasised that Chief Minister N Chandrababu Naidu had, in principle, approved the proposal to involve insurance companies in delivering the health insurance scheme, fulfilling another key election promise.
He explained that the Health Ministry had held multiple discussions with experts and submitted the proposals to the Chief Minister’s Office (CMO).
Yadav said, “The objective of adopting a ‘hybrid model’ for providing health insurance is not to reduce the financial burden on the government, but to ensure the professional implementation of the scheme.”
All 3,257 procedures to be included in new scheme
He further explained that the execution of the cashless healthcare service would reduce administrative delays and boost stakeholder confidence, particularly among network hospitals. Moreover, he noted that the involvement of insurance companies in the scheme would streamline processes by reducing the pre-authorisation time for hospital services from 24 hours to six hours.
This initiative is also expected to enhance fraud detection and expedite the processing of claims, thereby ensuring better service delivery at hospitals. All 3,257 procedures currently covered under Dr NTR Vaidya Seva will be included in the new scheme, with the potential addition of new procedures.
Clarifying the financial provisions of the scheme, he explained that if total claims are lower than the agreed-upon premium, the unspent amount will be refunded to the government. If claims exceed the premium amount, the insurance provider will cover up to 15 per cent of the excess, with any remaining costs shared between the government and the insurer.
The quantum of premiums to be paid for Above Poverty Line (APL) individuals seeking health insurance is currently being worked out, the Minister added. Additionally, he stressed that the scheme will enhance public trust and encourage more people to take advantage of the State’s healthcare services.