CMCHS, Tamil Nadu’s main mass health insurance plan, has won the “e-India Jury Award” 2012 for best practices in health insurance using IT enabled solutions. PD TNHSP and officials received the award.
How can I get government medical insurance in Tamilnadu?
The CMCHIS enrolling process is straightforward. If the applicant has all of the necessary documentation, it can be completed quickly. The documents are also straightforward to obtain. The following are the steps to enroll:
Obtain a certificate of income from the Village Administrative Officer/Revenue Department.
Your biometric information, such as fingerprints, a photograph, an eye scan, and so on, will be collected next.
Who is eligible for Kapitu thittam?
Permanent residents of Tamil Nadu are eligible to apply for the scheme. It is available to unmarried people, children under the age of 25, and parents of a family.
Ayushman Bharat Yojana:
The government of India’s Ministry of Health and Family Welfare has launched Ayushman Bharat, a universal health insurance scheme. PMJAY was established to give free healthcare to more than 40% of the country’s population. The plan includes a Rs 5 lakh health cover.
Medicines, diagnostic charges, medical care, and pre-hospitalization costs are all covered under this plan. This healthcare initiative will aid India’s poorest families.
Pradhan Mantri Suraksha Bima Yojana:
The Pradhan Mantri Suraksha Bima Yojana intends to offer citizens in India with accident insurance coverage. This scheme is available to those between the ages of 18 and 70 who have a bank account.
This policy offers a total disability and death benefit of Rs 2 lakh per year, as well as a partial disability benefit of Rs 1 lakh. The policy premium is deducted from the policyholder’s bank account automatically.
Aam Aadmi Bima Yojana (AABY):
This is one of the most recent National Health Insurance programs, having been launched in October of 2007. It primarily applies to those between the ages of 18 and 59. All citizens living in the upcountry and rural areas are eligible for the AABY insurance system.
It also includes tenants who are landless and live in both urban and rural locations. It also entails providing scholarships to youngsters from low-income families.
Essentially, this program protects the family’s head of household or the earning member. The state and the national governments split the annual reward of 200 rupees evenly. The family gets paid with 30000 rupees in the event of a natural death. The family gets reimbursed at 75,000 rupees if the death is caused by a lifelong impairment.
Central Government Health Scheme (CGHS):
This system, which was established in 1954, provides comprehensive health care to central government officials and retirees living in cities. Kolkata, Mumbai, Lucknow, Delphi, Nagpur, and Pune are among the cities where this scheme is in operation.
The persons who are covered by this scheme must live in India. This is a National Health Company Online Renewal program that provides beneficiaries with the benefit of health education.
The following are the primary components of this scheme: all dispensary-related services, including domiciliary care. Furthermore, members of this program have the option of being hospitalized whenever they become ill.
On the other hand, if you need an X-ray or a laboratory examination, you will be able to get these for free under this plan. The most significant benefit of this National Health Insurance program is that it gives free specialist consultations at both hospital and dispensary levels.
Employment State Insurance Scheme:
Because it provides social security as well as socio-economic protection to all Indian employees, this is a multifaceted National Health Insurance Scheme. It also provides the same benefits to individuals who rely on workers who are covered by the scheme.
Every worker is covered by this insurance system from the first day of insurable employment. They are also supplied with comprehensive medical insurance for themselves and their family.
On the other side, those who are covered by this system (mostly workers) are eligible to a variety of monetary benefits. They include money at times of bodily discomfort, such as disease or the possibility of becoming crippled, whether temporarily or permanently.
In addition, any woman who loses her ability to work or the dependents of those injured in work-related accidents are entitled to a monthly pension known as dependents benefits.
This method does not apply to everyone or every business. It only applies to permanent factories with a workforce of more than ten people. The program has recently been expanded to include enterprises with more than 20 employees, such as stores, restaurants, road and motor vehicles, and newspapers.
Janshree Bima Yojana:
The Janshree Bima Yojana is intended for underprivileged people between the ages of 18 and 59. Women SHG Groups and Shiksha Sahyog Yojana are two unique characteristics of the scheme. There are 45 occupational groups covered by this scheme at the moment.
Chief Minister’s Comprehensive Insurance Scheme:
Tamil Nadu’s state government runs the Chief Minister’s Comprehensive Insurance Scheme. United India Insurance Company Ltd partnered with the company to launch it. It is a family floater policy that was created to assist consumers with high-quality health-care services. This plan covers over a thousand different medical procedures.
You can claim up to Rs 5 lakh in hospitalization charges under this coverage. This system allows the beneficiary to choose between private and government hospitals. Residents of Tamil Nadu who earn less than Rs 75000 per year are eligible to participate in this scheme.
Universal Health Insurance Scheme (UHIS):
This type of program was created to assist families who are living in poverty. It covers the medical expenses of each and every family member. A cover is provided in the event of death as a result of an accident.
The four public sector general insurance companies that have been driving the Universal Health Insurance Scheme have been doing so with the goal of improving healthcare for India’s disadvantaged and notably economically challenged citizens.
This scheme may help with medical bills of up to 30,000 rupees if a family member is hospitalized. When the family’s breadwinner is admitted to the hospital, however, the Universal health insurance system reimburses a total of 50 rupees each day for a maximum of 15 days.
As a result, we may claim that this insurance plan is intended for low-income households.
West Bengal Health Scheme:
In the year 2008, the West Bengal government introduced this scheme for its employees. The service is also available to retirees. Up to a total insured of Rs 1 lakh, this coverage is available on an individual and family floater basis. According to the policy terms and conditions, the policy covers OPD treatment and medical operations.
Yeshasvini Health Insurance Scheme:
The Yeshasvini Health Insurance Scheme is promoted by the Karnataka State Government. This program is beneficial to peasants and farmers who are members of a co-operative group. This health-insurance plan covers approximately 800 medical treatments, including neurology, orthopaedics, and angioplasty, among others.
Farmers are assisted in enrolling in the Yeshasvini Health Insurance Scheme via cooperative associations. Health care services are available to beneficiaries through network hospitals, and coverage benefits are extended to beneficiaries’ family members.
Mahatma Jyotiba Phule Jan Arogya Yojana
This health insurance coverage was developed by the Maharashtra government for the benefit of the people of the state. The plan is aimed at farmers in Maharashtra and will benefit those living below the poverty line.
For specified ailments, the policy provides a family health cover of up to Rs 1.5 lakh. The best aspect about this policy is that it has no waiting period and can be claimed on the first day of coverage, unless otherwise stated in the policy terms.
Mukhyamantri Amrutam Yojana
The Gujarat government launched the Mukhyamantri Amrutam Yojana in 2012 for the welfare of the disadvantaged people of Gujarat. The scheme is open to anyone who fall into the lower middle-income bracket and are below the poverty line.
It’s a floater health insurance policy for families that covers up to Rs 3 lakh in coverage. The policyholder has access to private and government hospitals, as well as trust-run hospitals, for medical treatment.
Karunya Health Scheme:
This scheme was created by the Kerala government in 2012 to provide health coverage for a list of chronic conditions. It’s a poor person’s critical illness plan that covers serious illnesses including kidney disease, cancer, cardiovascular disease, and so on.
This program is open to people who are poor or on the verge of becoming poor. For this, the beneficiary must give a copy of their income certificate as well as their Aadhaar card.
Telangana State Government Employees and Journalists Health Scheme:
This scheme was created by the Telangana government for its journalists and staff. Employed people, retirees, and pensioners all benefit from it. The participant of this scheme can receive cashless treatment at any of the participating hospitals. Beneficiaries are not required to rush to secure funds for unexpected medical bills.
Dr YSR Aarogyasri Health Care Trust:
The Andhra Pradesh government, in collaboration with the Dr. YSR Aarogyasri Trust, has launched four health-care initiatives. These plans provide medical coverage to a variety of people and assist them in the event of a medical emergency. The following are the schemes:
- Working Journalists’ Health Plan, which covers certain treatments with no out-of-pocket costs.
- State government employees are covered under the Employee Health Scheme.
Where can I find my NHIS number?
If you want to join the NHIS plan, you must first enroll in one of the programs offered by the organization. Registration is determined on the program selected.
Because some employers enlist their employees, you usually do not need to register for NHIS. However, you can register with the National Health Insurance System (NHIS) by completing the steps below:
Fill in the blanks (Name, Surname, NHIS number, DOB, etc.) and click Submit.
Bottom Line
In a country like Nigeria, an affordable health insurance plan like the NHIS is a luxury that everyone should enjoy. It is recommended that you visit your Health Management Organization for more detailed information on health insurance.
How much is NHIS registration fee?
Prepayment plans are increasingly being implemented in many low- and middle-income nations to provide financial risk protection and equal access to healthcare services for their populations, particularly the poor. 13 If properly implemented, prepayment programs such as social health insurance can reduce out-of-pocket payments (OOP) and the accompanying disastrous impacts on households. 4 Following the adoption of the Sustainable Development Goals (SDGs) by member countries of the United Nations, the drive to ensure equity in access to healthcare services and attain Universal Health Coverage (UHC) has become more urgent. WHO considers equity in prepayment plans to be one of the most important aspects of UHC. 5
Following independence in the 1950s, Ghana enjoyed a free healthcare system funded by general taxes. However, when the economy began to falter, the healthcare system altered, and in the 1970s and 1980s, user fees were largely implemented to offset the costs of providing healthcare services. 68 Although the OOP helped public healthcare providers recoup some of the price of vital medicines and other pharmaceutical items and raise income, it also caused inequalities in healthcare access and, in some circumstances, resulted in preventable deaths. 689 As a result of this circumstance, the National Health Insurance Scheme (NHIS) was established in 2003 to replace OOP and ensure healthcare equity. 10 The National Health Insurance Authority, which is obliged by law to govern both public and private health insurance plans in the country, oversees the NHIS. 11
The NHIS membership is divided into two categories: exempt and non-exempt.
11 Persons under the age of 18, people over the age of 70, pregnant women, indigent (extremely poor), formal sector workers who contribute to the Social Security and National Insurance Trust (SSNIT), and beneficiaries of the Livelihood Empowerment Against Poverty (LEAP) program are among those who are exempt from paying premiums to the scheme. Members of the non-exempt group are those who pay premiums and enrolment processing costs to the plan and are employed in the informal economy. The National Health Insurance Fund, which is based on a 2.5 percent levy on selected goods and services, funds the NHIS. A 2.5 percent deduction from formal sector workers’ SSNIT contributions, premiums from informal sector workers, cash given by parliament, interest from investments, and donor funds and donations are some of the other sources of support. 11 The non-exempt group pays GHS30.00 (US$6.33) per year in premiums and enrolment processing fees. The exempt group, on the other hand, merely pays a processing charge of GHS8.00 (US$1.69) for new enrolment and GHS5.00 (US$1.05) for annual renewal. The NHIS premium and processing charge account for 0.34 percent of GHS8863 (US$2035)12 per capital income. The NHIS premium and processing cost amount to 0.38 percent of the daily minimum wage of GHS10.65 (US$2.25)13 or GHS2769.00 (US$584.18) each year.
Ghana’s health system, like many others across the world, is hierarchical, with the Ministry of Health (MoH) as the apex entity charged with formulating policies to promote the population’s health.
14 About 12 entities make up the Ministry of Health, which includes public, quasi-government, and private health facilities, as well as health education institutions. The Ghana Health Service is the largest agency, and it is responsible for providing healthcare to the public as well as implementing the Ministry of Health’s policy. The Ghana Health Service features a decentralized healthcare delivery system, with a large number of healthcare facilities scattered around the country. The community-based and health planning services compound is at the lowest rung of the healthcare delivery system, whereas tertiary or teaching hospitals are at the top. The number of healthcare facilities and professionals in the country is unevenly distributed, with the bulk concentrated in urban areas. 15 16 On the other hand, many private healthcare facilities, particularly faith-based ones, are located in rural areas, where they supply roughly 40% of the population’s healthcare.14
In its brief life, the NHIS has achieved progress in population coverage and contributed to the utilization of healthcare services and the expansion of healthcare facilities.
17 According to an NHIS data from December 2018, the scheme covered 36% (10.8 million) of the population. 18 It includes 166 district offices and a network of approximately 4000 healthcare providers around the country, including both public and private facilities. According to reports, the benefits package covers 95 percent of the population’s illness conditions. Outpatient services, inpatient services, oral health, vision care, maternity care, and emergency are all covered. 19 Preventive care, such as immunization, and services that may constitute a sustainability risk are not included in the benefit package. 9 11
In Ghana, there are few research on the NHIS that are focused on equity. In a mixed-method analysis of NHIS enrolment equity in two regions (Central and Eastern), researchers discovered that more males than females had enrolled, and households in the richest quintile were substantially more likely to enrol than those in the poorest quintile. 1 The study also discovered that NHIS enrolment was substantially associated with age, higher education, female-headed households, and perceived NHIS advantages. Another mixed-method study that looked into why the NHIS isn’t reaching the poor used the same two regions and found that poverty and policymakers’ and implementers’ lack of commitment to the NHIS’s equity goal resulted in less poor people being covered. 20 In their study of the affordability of NHIS contributions, Kusi et al21 examined three districts from Ghana’s southern, middle, and northern ecological zones, and discovered that the rich were enrolled in the NHIS much more than the poor. These three studies looked at enrolment equity using bivariate and logistic regression analysis between 2008 and 2011. Using data from the 2008 Ghana Demographic Health Survey, other research that looked at equality in NHIS enrolment used concentration curves and logistic regression to find that coverage was highest among the educated, households in the richest quintile, and urban inhabitants. 22 and 23
This study looks at equality in NHIS enrolment in Ghana in order to inform policy decisions towards attaining UHC. To examine key NHIS policy modifications adopted in recent years to make the program more appealing to the general population, it is now vital to study equity. One such policy is intersectoral collaboration with state-owned social protection institutions, such as the Ministry of Gender and Social Protection, the Ministry of Education, the LEAP Secretariat, and the Savannah Accelerated Development Authority, in order to increase the number of poor and vulnerable people in the NHIS and improve equity. The findings of this study can be used to guide policy on UHC attainment and add to the body of knowledge on NHIS equity and progress toward the SDGs.
Which government health insurance is best?
The following are some of the most popular government health insurance plans in the country for clients from various socioeconomic groups:
Aam Aadmi Bima Yojana (AABY)
This national health insurance program was established in 2007 and covers anyone between the ages of 18 and 59. It is provided to citizens who live in the upcountry or in underdeveloped areas. Scholarships are granted to poor youngsters in rural areas, as well as tenants in urban and rural communities, under this initiative. This policy insures the health of the family’s head of household for a yearly premium of Rs. 200. The family is given Rs. 30,000 for support in the event of the insured’s natural death, and Rs. 75,000 in the event of the insured’s death due to permanent incapacity.
Employment State Insurance Scheme
This health insurance plan is only for employees and provides consumers with socioeconomic protection as well as social security. People who are reliant on the workers covered by this scheme are given certain benefits. The policyholders of this scheme receive cash payments, dependent benefits, monthly pensions, and other benefits. It applies only to permanent factories with more than ten employees, and its reach has been expanded to include a few further firms.
Ayushman Bharat Yojana
This government-run health-insurance program is universal, covering more than 40% of the country’s population. It covers roughly Rs. 5 lakhs in medical fees, diagnostic, and hospitalization, among other things. It is especially beneficial to the impoverished people who live in the country because it gives full coverage at a low cost.
Pradhan Mantri Suraksha Bima Yojana
This insurance policy provides accident coverage to Indian nationals between the ages of 18 and 70 who have a bank account. For entire disability, a cover of Rs. 2 lakh is provided, and for partial disability, a cover of Rs. 1 lakh is supplied. The premium is automatically deducted from the policyholder’s bank account under this insurance.
Janshree Bima Yojana
This health insurance system is available to everyone between the ages of 18 and 59, and it mostly assists the impoverished in the country. Special advantages such as women’s SHG groups, shiksha sahyog yojana, and others are also provided under this government scheme, which covers over 45 occupational categories.
What is a government insurance plan?
Government health insurance refers to government-subsidized medical health insurance offered to qualified persons. These health insurance policies could be offered for free or at a reduced cost, allowing individuals to obtain high-quality health care at a low cost.