Aarogyasri

Aarogyasri or ntr Vaidya seva is a program of the Government of Andhra Pradesh. It covers those below the poverty line. The government issues an Aarogyasri card and the beneficiary can use it at government and private hospitals to obtain services free of cost.^[1]^[2]^[3]

History

The unique program was started in Mahabubnager district on 1 April 2007 by the then Chief Minister of Andhra Pradesh, Late Sri. Y. S. Rajasekhara Reddy. The government created Aarogyasri Health Care Trust and allocated Rs.5000 crores in the first year.

The Programme

Rajiv Aarogyasri is the flagship scheme of all health initiatives of the State Government with a mission to provide quality healthcare for the poor. The aim of the Government is to achieve "Health for All". In order to facilitate the effective implementation of the scheme, the State Government set up the Aarogyasri Health Care Trust under the chairmanship of the Chief Minister. The trust is administered by a Chief Executive Officer, an IAS Officer. The trust runs the scheme, in consultation with specialists in the field of healthcare.

Health cover

The scheme provides financial protection to families living below the poverty line up to Rs. 2 lakhs in a year for the treatment of serious ailments requiring hospitalization and surgery.

938 treatments are covered under the scheme in order to improve access of BPL families to quality medical care for treatment of identified diseases involving hospitalization, surgeries and therapies through an identified network of health care providers. The scheme provides coverage for the systems like heart, lung, liver, pancreas, kidney, neuro-surgery, pediatric congenital malformations, burns, post-burn contracture surgeries for functional improvement, prostheses (artificial limbs), cancer treatment (surgery, chemotherapy, Radio therapy ), polytrauma (including cases covered under MV Act) and cochlear implant surgery with auditory-verbal therapy for children below 6 years (costs reimbursed by the trust on case to case basis).

All pre-existing cases of the above mentioned diseases are covered under the scheme.

Enrollment

The beneficiaries of the scheme, the members of Below Poverty Line (BPL) families, as enumerated and photographed in BPL Ration Card and available in Civil Supplies Department database.

Extent of Cover

The benefit to the family is on a floater basis i.e. the total reimbursement of Rs.1.50 lakhs can be availed individually or collectively by members of the family. An additional sum of Rs 50,000 is provided as a buffer to take care of expenses if it exceeds the original sum i.e. Rs 1.50 lakhs per family. Excepting cost for cochlear implant surgery with auditory-verbal therapy is reimbursed by the trust up to a maximum of Rs.6.50 lakhs per case.

All transactions are cashless for covered procedures. A BPL beneficiary can go to any hospital either public or private and come out without making any payment to the hospital for the procedures covered under the scheme. The same is the case for diagnostics, if eventually the patient does not end up in undergoing the surgery or therapy.

Hospitals are mandated to conduct free health camp, thereby taking advanced evaluation at the doorstep of patient.

Point of Contact

All the Primary Health Centers (PHCs) which are the first contact point, area/district hospitals and network hospitals, are provided with help desks manned by AAROGYA MITHRAs to facilitate the illiterate patients. The Aarogyamithras were selected by the Zilla Samakhyas and Mandal Samakhyas under Indira Kranti Patham (Self Help Groups).

Excluded Treatments

The diseases specifically excluded from the list are high end diseases such as hip and knee replacement, bone morrow, cardiac and liver transplantations, gamma-knife procedures in neuro surgery, assisted devices for cardiac failures etc; and diseases covered by national programmes viz., TB, HIV/AIDS, leprosy, infectious diseases,malaria, filaria, gastroenteritis, jaundice etc.

To the extended RAS covers the treatments, it would no longer be permissible for the BPL holders to apply for relief for medical purposes under Chief Minister Relief Fund (CMRF).

Controversies

There is widespread misuse of the programme by hospitals.

External links

References

This article is issued from Wikipedia - version of the Thursday, April 21, 2016. The text is available under the Creative Commons Attribution/Share Alike but additional terms may apply for the media files.