What is the Rajasthan Government Health Scheme? All you need to know about Ashok Gehlot’s Ayushman Bharat-like programme implemented from May 1

The Rajasthan government has claimed that in the MM Chiranjeevi Scheme, almost 75 per cent of the population will have to pay no premium.

While many states have opted for the Modi government’s ambitious healthcare scheme Ayushman Bharat Yojana since it was launched in 2018, states ruled by opposition parties like the Congress and the Trinamool Congress decided to roll out their own schemes on similar lines. While the West Bengal government led by Mamata Banerjee came out with the Swasthya Sathi scheme way back in 2016, last month, Rajasthan also came out with a similar scheme called Chiranjeevi Yojana. Telangana also has a similar scheme called Aarogyasri Health Insurance Scheme. Naveen Patnaik led Odisha also has been providing healthcare benefits to citizens under Biju Swasthya Kalyan Yojana. The scheme was launched just before the Ayushman Bharat Yojana. Let’s take a brief look at Ayushman Bharat, Chiranjeevi Yojana and other such schemes:

Centre’s PM-Jan Arogya Yojana – Ayushman Bharat Scheme

* Health insurance cover of up to Rs 5,00,000 per family per year
* All families listed in the SECC database as per defined criteria will be covered
* No cap on family size and age of members
* Priority to a girl child, women and senior citizens
* Free treatment available at all public and empanelled private hospitals
* Covers secondary and tertiary care hospitalization
* 1,350 medical packages covering surgery, medical and daycare treatments, cost of medicines and diagnostics.
* All pre-existing diseases covered. Hospitals cannot deny treatment
* Cashless and paperless access to quality health care services
* Hospitals will not be allowed to charge any additional money from beneficiaries for the treatment.

Rajasthan’s Chiranjeevi Yojana

* Annual cashless insurance cover of Rs 5 lakh to every family in the State
* Free registration for those who are covered under the National Food Security Act, Socio-Economic Caste Census, small and marginal farmers, contractual workers and those who have received COVID-19 ex-gratia assistance
* Those who do not fall in these categories will be required to pay Rs 850 as 50% of the annual premium
* Covers 1576 treatment packages for various diseases including Covid
* Treatment in government as well as the private empanelled hospitals
* Covers medical expenses for 5 days before hospitalisation and till 15 days of discharge

Odisha’s Biju Swastya Kalyan Yojana

* Free health services for all irrespective of income, status or residence in all government hospitals
* Additional facility of free healthcare beyond District Headquarters hospital level, for over 70 lakh economically vulnerable families
* Annual Health coverage of Rs 5 lakh per family and Rs 7 lakh for the women members of the family
* Biju Krushak Kalyan Yojana cardholders, Rashtriya Swasthya Bima Yojana cardholders, BPL cardholders and Anatodaya Anna Yojana (AAY) cardholders and families with annual income below Rs 50,000 in rural areas and below Rs 60,000 in urban areas are eligible
* All health services are free of cost, including free drugs, free diagnostics, free dialysis, free Cancer chemotherapy, free OT, free I.C.U, free in-patient admission etc
* A total of 4036 packages have been finalized under BSKY

West Bengal’s Swasthya Sathi Yojana

* Basic health cover for secondary and tertiary care up to Rs. 5 lakh per annum per family
* Up to Rs 1.5 Lakh through Insurance Mode and beyond 1.5 lakh to 5 Lakh through Assurance Mode
* Paperless, Cashless, Smart Card based
* All pre-existing diseases are covered
* There is no cap on the family size and Parents from both Spouse are included
* Online Swasthya Sathi Smart card is provided to each family on the day of Enrolment
* Over two crore families covered
* 2092 Swasthya Sathi packages are available in the scheme
* Package includes the cost of Transport Charges of Rs 200 payable to the patient at the time of discharge

Telangana’s Aarogyasri Yojana

* Scheme covers BPL families
* Entire premium is paid by the Government
* All pre-existing diseases covered
* Total reimbursement of Rs 1.50 lakhs, an additional sum of Rs 50,000 is provided as a buffer (Total up to Rs 2 lakh)
* Cost for cochlear Implant Surgery with Auditory Verbal Therapy is paid by the Trust up to a maximum of Rs 6.50 lakhs per case
* Coverage to 949 different treatment modalities for patients
* Insurance coverage to each family from Rs 2 lakh to Rs 13 lakh
* Free Food and transportation

In Rajasthan, according to government data, the Pradhan Mantri Jan Arogya Yojana (PMJAY) covers about 6o lakh families which is about 40 per cent of the total population. The state government now claims to have covered the entire population, though a section will have to pay Rs 850 to get the benefits.

Launching the scheme, Chief Minister Ashok Gehlot said, “The biggest healthcare scheme is aimed at providing medical relief to the residents of the state. The registrations have already begun. This scheme is one more milestone aimed at bringing about a huge difference in the health standards of citizens of the state as it puts health as the focal point of concern. The scheme entitles citizens to avail cashless treatment across all state hospitals.”

When asked whether the Rajasthan government brought this as a counter to the Ayushman Bharat scheme, Aruna Rajoria, IAS, CEO, State Health Assurance Agency, said that Chiranjeevi Yojana is for all but PM-JAY only covers poor and vulnerable families. “The Ayushman Bharat Scheme only covers poor and vulnerable families based on deprivation and occupational criteria as per the SECC database. However, Mukhyamantri Chiranjeevi Swasthya Bima Yojna is for all citizens of the state,” she said.

Rajoria also said that beneficiaries of the Ayushman Bharat are covered under the Chiranjeevi scheme. She said that the Chiranjeevi scheme has all packages offered under the Ayushman Bharat, it also extends several other packages such as those for treatment of Covid-19, Mucormycosis and haemodialysis. She claimed that in the MM Chiranjeevi Scheme, almost 75 per cent of the population will have to pay no premium.

Recently, many hospitals in Rajasthan were found violating the rules and denied treatment under the scheme. However, they were willing to offer treatment if paid in cash and not under the scheme. This raised a serious question on the implementation and compliance part. Aruna Rajoria said that the state government has taken serious note of the issue and strict action has been ordered against such hospitals.

“The state government has ordered strict action against any empanelled hospital which denied services to registered beneficiaries. Many of such complaints are due to misunderstandings between the hospital staff and the insured person. Being a new scheme, at times the patient or even the hospital staff is unclear on several provisions and limits of the offered packages. If money has been taken from any patient of MM Chiranjeevi Swasthay Bima Yojna in relation to covid-19 and mucormycosis (black fungus) between the time period of 1st May to 30th June, then that hospital will have to refund it back to patients. Directions have been given to all the district authorities and we are working on that,” she said.

She said that the state government is planning to establish a help desk in all empanelled private hospitals. “As a pilot project, we started it in ten big empanelled hospitals of Jaipur. We are trying to build a system of referrals too, whereby if a patient does not find his treatment package in a hospital he/she can be referred to a hospital having the treatment package. This shall help better delivery of healthcare services for all citizens,” she stated.

As many 1,33,86,213 families have already registered for the scheme while 1,13,285 people have benefitted so far including COVID-19 treatment cases. Now with a universal healthcare scheme, the state is also working to ramp up medical infrastructure in wake of the third COVDI-19 wave. Speaking about the state’s preparations, Aruna Rajoria said, “Strengthening the health infrastructure is the first step in the direction to tackle the third wave. The state health department is also continuously increasing bed availability at hospitals and health centres. At the beginning of the second wave we increased isolation beds from 42,000 to 48,000 and now intend to increase the number to 60,000. Similarly, the number of oxygen supported beds has been increased from 8243 to 17,000 and will be further raised to 25,550 and ICU beds. The number of ICU beds will be increased to 6,000.”

She claimed that the state government has already been working to augment the availability of oxygen and has added nearly 350 MT tonnes of capacity with nearly 40,000 oxygen concentrators. “In addition work for the installation of 400 oxygen plants at the major hospital has commenced from the second wave. Training and deployment of staff and sanction have been made for the appointment of 26,000 COVID assistants. Also, 1000 MBBS doctors are being deployed as COVID consultants. 332 CHCs have also been identified and are being equipped to work as COVID management centres,” she said.

Rajasthan has so far administered 2,76,41,858 COVID-19 vaccines which includes 2,24,26,945 first dose and 52,14,913 second doses. With vaccination still going at a slow pace amid alleged claims of a supply crunch, the state needs to see that its basic healthcare systems remain active and well placed to contain any surge in the COVID-19 cases.