Health dept planning to bring U- Health card

The health department is planning to bring the U- Health card- the health insurance scheme of the State Government employees- under the trust which would implement the ambitious Ayushman Bharat scheme in the state. The department has selected a ‘Third Party Administrator’ (TPA) for ABY. This TPA would also serve the card holders of the U health card scheme. Under the new format, the U health card scheme would be compulsory for all the state government employees.

The state nodal officer for ABY and the additional director Health Services, Dr Saroj Naithani told The Pioneer that ABY, U- health card and the Mukhyamantri Swasthya Bima Yojana (MSBY) have been brought under the single trust. Under the trust mode, no insurer (Insurance Company) is involved in the scheme and the payment to the panelled hospitals under the scheme is made by the trust. The decision to adopt trust mode for these schemes was taken on the suggestion of the Union health ministry. Dr Naithani said that there were complaints of the panelled hospitals about claim rejection and delay in payments which would not be the case with the trust mode. She further said that the department has sent a draft proposal for the premium to be charged from the state government employees under the U- health card scheme to the government. The premium would be charged on the Grade Pay of the employee. Dr Naithani said that the department has proposed a maximum annual premium of Rs 3600 and minimum of premium of 1200 for the scheme.

The U health Card

To provide the benefit of cashless health insurance to its employees and pensioners the state government launched the U –health card scheme on October 25, 2010. The scheme was made optional for the employees but mismanagement and delay in payment ensured that both the employees and the hospitals preferred to keep a distance from this scheme. At present, there are only eleven hospitals in the state and two located in National Capital Region (NCR)  which are in the panel of the scheme (Medanta Medicity Gurgaon and National Heart Institute New Delhi).

Under the optional scheme, an annual premium of Rs 5000 is charged from the employee having grade pay in excess of Rs 6600 while those getting a grade pay of Rs 4200 to Rs 5400, a sum of Rs 3500 is charged. The employees getting grade pay of Rs 1900 and 1800 pay Rs 1500 while those receiving less are liable to pay only Rs 700 per year.