Chief Minister Comprehensive Health Insurance Scheme in Tamil Nadu

 

Chief Minister Comprehensive Health Insurance Scheme in Tamil Nadu

A new insurance scheme has been introduced by the government in Tamil Nadu to help many with handling their medical expenses. This new scheme is called the Chief Minister Comprehensive Health Insurance Scheme. It is designed to assist people around the state with getting the help they require for managing insurance costs.

Chief Minister Comprehensive Health Insurance Scheme in Tamil Nadu

This is one of the more prominent schemes to have come out of Tamil Nadu in recent time. It is a plan that covers about 1.57 crore families in the state. It will also cover migrant workers and undocumented orphans alike. It will also cover more than 300 different medical procedures that different people might have a requirement for.

Launch Details

The new scheme isn’t necessarily new so much as it has been renewed and expanded over time. The scheme was first launched in 2012. It was established under the supervision of the Tamil Nadu government. The state government announced this with support from the United India Insurance Company. This was made as a means of helping people around the state with getting the most out of their insurance demands without being at risk of potential harm from being unable to afford medical services.

The Tamil Nadu government is responsible for organizing the scheme and keeping it functional. At least 90 percent of the funds that come from the scheme will be provided by the government. This means that the impact that it will have on typical taxpayers throughout the state of Tamil Nadu will be minimal.

What It Replaces

This scheme in particular is designed to replace the Kalaignar Insurance Scheme. This was used in Tamil Nadu from 2009 to 2012. This scheme was operated by the Star Insurance company. It was designed for use in private facilities only. This was restrictive in that it did not help many people with getting the coverage they need.

The Chief Minister Comprehensive Health Insurance Scheme is different in that it offers support for public and private hospitals alike. This allows more people to get the coverage they need in a variety of places. This is especially needed for those who are aiming to get the general coverage that they require in a variety of ways.

Eligibility Rules

The key eligibility rule for the scheme is that all families must have annual total incomes of Rs. 72,000 or less. About 1.34 crore people or 13.4 million will be covered by the scheme. A Village Administrative Officer will be responsible for reviewing individual cases where the scheme may be utilized. This is as a means of ensuring that people who are aiming to get into the program can benefit from it.

The family members involved can be the legal spouse of the head of the household, children who are under the age of 25 and have not been married and dependent parents of whoever is eligible. These standards are being used to ensure that no one tries to abuse the system and use it in any kind of way.

The eligibility standards have made it so a number of people have been properly covered by the scheme. About 250 facilities or outlets have helped to get about 1 crore people to have utilized the scheme so far. The others who have not used it are still able to utilize what it has to offer although it is a necessity to get to a proper facility to apply for the process.

Key Documents

The documents for the Tamil Nadu scheme are very important with regards to enrolling into the scheme to take advantage of what it offers. To quality, a family must get in touch with a proper officer in the area and one of the hundreds of outlets in the state where signups for the program are available in. The program is still available to a majority of people around the state to ensure that they can get the support they need for entering into the scheme in a proper fashion.

Documents relating to the births of individual family members and legal information suggesting that they are part of a family must also be listed. This is to ensure that all people involved can receive the support that they demand for getting into the program. It is also for keeping tabs on the records that people may hold.

All Facility Under the Yojana

The benefits that are to be provided to people through the scheme are designed to help people with covering the many expenses that they may experience over time:

  • Each family that qualifies for the scheme will receive Rs. 1 lakh every year. This will go for a total of four years to provide a family with Rs. 4 lakh.
  • For certain premium procedures, a family can get Rs. 1.5 lakh each year. Details on the particular procedures that may qualify for this part of the scheme are expected to be released in the future but will entail more complicated processes that may cost more to utilize.
  • At least 1,000 different procedures to be covered. This includes around 110 different follow-up procedures plus 23 diagnostic procedures. All costs associated with the tests required for such procedures will also be covered by the government.

The totals are designed to cover a majority of the needs that families hold. Families that qualify can contact their local hospitals and other facilities to see what they can utilize and if they can get coverage from the scheme. This is critical given the extensive variety of treatment options that can be covered by the scheme.

Key Hospital Coverage

The hospital coverage that will be used in the scheme is especially critical to its general success. At least 250 hospitals are to be covered by the scheme at all times. Additional hospitals can also get into the scheme although they may have to contact the state government for help with doing so.

At least six hospitals are to be covered in each district under the policy. More hospitals are clearly going to be covered in some of the more populated parts of the state. These include in areas around Chennai, Coimbatore and Madurai. Other regional areas will certainly be covered by the scheme as a means of supporting many of the functions involved and with getting people to receive the general coverage that they demand.

Considerations About Procedures

The procedures that are being supported by the scheme include many designed to help people in a number of ways. These should work for all members of the family and will cover a variety of treatments for an assortment of demands that patients may hold:

  • The official website for the scheme states that nearly 700 different surgical procedures are covered. These include pediatric, cardiothoracic, vascular and minimal access surgeries in the entire design of the scheme.
  • General medical procedures that are included entail oncology and pediatric intensive care services. These are designed for the treatment of many serious conditions that people may develop in their lives.
  • Interventional radiology is a key component being handled in the procedures listed. These are designed to help review individual conditions that a patient may develop and can be supported in many ways.
  • The follow-up procedures that are covered include many treatments for reviewing how different surgical procedures are managed. These are to be held regularly based on individual conditions and concerns that people may hold.
  • The diagnostic procedures that are covered in the program include bone scans, mammograms and renal scans. These are designed to identify any potential physical issues that a patient might develop over time with regards to one’s body functions.

The extensive services that are offered in the program are for the benefit of all people who need assistance with their bodies. This especially comes amid ongoing concerns for how well people can receive the support required for treating many potentially dangerous and deadly conditions that they may hold.

Government Help

The government help that is being provided through the scheme is extensive. The government is covering a majority of the cost associated with getting the scheme to stay operational. There is also support for public facilities within the program with hospitals operated by the Tamil Nadu being responsible for getting many of the key functions in the program running properly.

The government is especially doing this as nearly 70 percent of the general expenses for medical services are borne by the general public. This is a difficult concern around India as it shows that the country’s healthcare system is unfair to the public. By working with this plan for handling expenses, the Tamil Nadu government is aiming to provide people with extra help for the demands they hold.

Renewal Date

The renewal for the scheme was made on 10th January 2017. The renewal was designed primarily to help with covering the added costs that come with trying to get the scheme operational. It is also to include migrant workers and orphans who need assistance with their healthcare demands in general.

There had been some concerns among those in Tamil Nadu who had no proper documentation or proof of an address or residence. Those who do not have any set homes in general are now able to get into the scheme in accordance with this renewal plan. As a result, more people will receive the support they need for managing medical needs.

EMI and Mode of Payment

In accordance with terms that have been introduced in the scheme, the government of Tamil Nadu will help with paying off the expenses associated with services. This is to help people with receiving the general needs they hold with getting different services managed. Proper documentation relating to being in the scheme is required to help with getting the process organized and used correctly.

The payments given to people will also be applicable during the use of actual healthcare services. This ensures that the premiums that are available will be used at the right times based on when people can get the services they need. This is a necessity for keeping people under control with regards to getting the help they demand.

Converge Details

Convergence is designed to help with making it easier for people to get the most out of the medical services that they are aiming to use. This will work through the support of many entities designed to provide people with medical services around the entire area.

The National Health Mission will start by offering free primary health care to people in areas around Tamil Nadu. The Suvarna Arogya Suraksha Trust will also help the poor with managing costs associated with care in general. This is all designed to help with assisting people in getting the most out of their medical services.

By converging the two services, it will be easier for the new scheme in Tamil Nadu to operate appropriately. This especially comes amid concerns over how well people can get the medical services required without having to spend too much. The convergence process ensures that the costs associated with making the scheme work will not be too complicated or otherwise rough for anyone to handle at a given time.

Smart Card Use

Smart cards are to be introduced in the scheme as well. These cards are designed to help people with entering into the scheme. Such cards help to identify people who can use the scheme and can be administered at proper registration outlets. Thousands of such cards have been administered and continue to be the easiest way for people to qualify for the services that they are asking for.

Several points must be used when getting a smart card ready:

  • An assistance center at a facility where medical services are to be used will take in smart cards. This is to help people with getting the coverage they require.
  • A liaison officer will be responsible for confirming the identity of any person looking to use services through the proper card. The officer will analyze the card and confirm a person’s identity as necessary.
  • A pre-authorisation request will be sent by the DMO at the hospital. This will be sent to a cashless facility to get the money involved with the scheme to be linked to the service process.
  • A project office will then confirm the request for using the money in the scheme. This is provided that the identity of a person is confirmed in some way. Also, the procedure in question has to be planned with payment through the scheme in mind if it is to go through properly.

Incentives to Hospital Workers

The scheme will also provide incentives to hospital workers who are responsible for taking care of patients. This ensures that the people working on those who qualify under the scheme will continue to receive a sizeable payment for the functions that they perform. In particular, surgeons and anesthetists will get 4 percent or higher incentives for managing patients in the scheme. Nurses and theatre staff teams will also get about 2 percent coverage.

On the DME side of procedures, surgeons will get 5 percent incentives while the theatre staff team and consultants will get 4 percent coverage. The plans are designed as a means of providing proper bonuses to those who operate on people who qualify for the scheme. It ensures that they will have a desire to participate in the scheme to help patients in many forms.

Procedure Online/Offline

The technical aspects for operating the scheme are designed to keep it operational and functional while keeping all data in check. Remedinet Technologies has been chosen to be the key partner for keeping the online to offline functionality of the scheme in check. This is used to help check on all settlements and claims electronically. By using this support system, it should be easier for information to be handled and for information to be managed right.

Official Website and Other Contact Information

Those aiming to get in direct contact with those responsible for managing the scheme can visit its official website at www.cmchistn.com. People can also contact the official phone line for it at 1800 425 3993. The main office for the scheme is located at No 226, Om Shakti Towers, Kilpauk Garden Road, Kilpauk, Chennai 600010.

Conclusion

Proper health is needed in order to live a better and most positive life. The Chief Minister Comprehensive Health Insurance Scheme will assist those who are poor in Tamil Nadu with attaining the health needs that they require. The services will also work for migrants and orphans alike. It will cover a variety of different procedures.

This scheme will be available for use in a variety of locations around the state. This will especially help people in the state with managing their health needs without worrying about any of the general ongoing concerns that come with affording procedures. It will be critical for all those who need help in some way.

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