The scheme covers hospitalisation expenses of Rs1.50 lakh per family on a floater basis annually in empanelled hospitals.
Widening the scope of its ambitious medical insurance scheme for underprivileged sections, the state government is planning to include new procedures, such as hip and knee joint replacements and even physiotherapy, in the ambit of the Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY).
"Our broad thinking includes… covering other procedures — hip and knee joint replacements — in the RGJAY," state health minister Dr Deepak Sawant told dna. He added that cases of snakebites were also proposed to be covered under the medical insurance scheme. Presently, only those snakebite cases which require ventilator support are included in it.
The RGJAY aims at providing health care access to socially disadvantaged sections and provides cashless health insurance in 30 specialised categories and 971 procedures and 121 follow-up packages for beneficiaries covered under the above poverty line (APL) and below poverty line (BPL) categories and those who hold Antyodaya and Annapurna ration cards.
The scheme covers hospitalisation expenses of Rs1.50 lakh per family on a floater basis annually in empanelled hospitals.
"We are also planning to cover kidney donors under RGJAY. Presently, only recipients get benefits," said Sawant, adding that all types of physiotherapy, including post-operative physiotherapy, was proposed to be covered. However, the inclusion of new procedures and categories will depend on the state's negotiations with the public sector National Insurance Company in this regard.
"We are also planning to merge the Rashtriya Bal Swasthya Karyakram's aid for cochlear implants in this," said Sawant, adding that the state health department proposed to increase the number of stents implanted in patients from one to three, considering the lower costs for the procedure in the programme. Suggestions have been sought from stakeholders on procedures and therapies which can be included in the scheme.
The erstwhile Congress-NCP-led state government had launched the RGJAY in 2013 in eight districts of Maharashtra — Mumbai city and suburbs, Amravati, Nanded, Dhule, Gadchiroli, Solapur and Raigad — covering 49,03,140 families of which a majority (over 18 lakh) were in Mumbai alone.
This replaced the state government's previous Jeevandayee Yojana which covered just four procedures related to diseases of the brain, heart, kidney and cancer. Later, the scheme was extended to districts across Maharashtra, covering over 2.05 lakh families.
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