NTR Vaidya Seva Trust to Administer Extended Health Cover
The government of Andhra Pradesh is preparing to implement an extended health insurance scheme under the NTR Vaidya Seva Trust (Arogyashri). The Medical and Health Department has prepared a proposal. The draft is now being considered by the Finance Department.
Health Cover for All Families, Irrespective of Income
The plan seeks to provide free medical treatment to every family in the state. This covers families above and below the poverty line (APL and BPL). There are around 1.43 crore families presently below the poverty line. Besides, 19 to 20 lakh families above the poverty line will also be covered with insurance benefits, without any restrictions.
Insurance Plan Details
Under the scheme:
- Each family will get medical coverage of ₹2.5 lakh annually free of cost.
- NTR Vaidya Seva Trust will provide free cost of treatment up to ₹25 lakh under a hybrid model.
- The 26 districts of the state will be categorized into two zones.
- Companies for insurance will be chosen through a tender.
Now, the Trust already offers free treatment worth ₹25 lakh annually for eligible beneficiaries.
New IT System to Monitor Claims
The NTR Vaidya Seva Trust will implement the 'NHA IT Application' Suite. The same system is implemented by the National Health Authority. So far, the Trust utilized software developed in 2007.
The new system will be equipped with artificial intelligence. It will identify anomalies in test reports and claim forms from the time a patient is admitted until the time of discharge. Social audits are also being conducted to verify service quality and prevent abuse.
Treatment Categories and Insurance Split
There are 3,257 medical treatments available under the scheme. They cover 30 specialties of medicine. The treatments are divided into two categories:
- 2,250 treatments under the insurance policy.
- 770 treatments provided directly by the Trust.
The 770 treatments not included under insurance are treated as non-essential. This is done with a view to minimizing unnecessary expenditure.
Tender and Contract Terms
The 26 districts of the state will be divided into two zones for the purpose of the administration of insurance providers. Initially, a one-year tender will be released. Subject to approval, the insurance company contracts will be extended for an additional two years. All processes will be completed after Chief Minister Chandrababu Naidu approves.
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