Health Insurance Government Scheme II

 

In this Health Insurance Government Scheme II,  we will cover few more Health Insurance run by Government (Central or State). Below is the Health Insurance Government Scheme which is to be discussed

• Janashree Bima Yojana
• Chief Minister’s Comprehensive Health Care Scheme (Amma Health Insurance)

Janashree Bima Yojana

Janashree Bima Yojana (Health Insurance Government Scheme II) was launched on August 10, 2000 with the help of Central Government and LIC. This is a Government sponsored Insurance Scheme that offers Life Insurance coverage/protection to rural and urban people below and marginally above poverty line.

This Scheme covers 45 occupational groups and is mentioned below

Anganwadi workers and helpers	Agriculturists
Beedi Workers	Brick Kiln Workers
Carpenters	Cobblers
Coconut Processors	Construction Workers
Chemical products like candle manufacturing company workers	Earthen toy manufacturers
Fire cracker workers	Fishermen
Foodstuffs like khandsari/sugar company workers	Forest Workers
Hamals	Handicraft Artisans
Handloom Weavers	Handloom and khadi weavers
Hilly Area Women	Kotwal
Lady Tailors	Leather Tannery Workers
Manufacturer of Food Products	Manufacturer of Leather Products
Manufacturer of Paper Products	Papad workers attached to SEWA
Physically handicapped self-employed persons	Plantation workers
Power loom workers	Primary milk producers
Printing Press Workers	Rickshaw Pullers/Auto drivers
Rubber and Coal Producers	Rural Poor
Safai karamcharis	Salt Producers
Scheme for Urban Poor	Sericulture
Sheep Breeders	Tendu Leaf Collectors
Textile	Toddy Tappers
Transport drivers Association	Transport karamcharis
Women associated with SHG

Salient Features of Janashree Bima Yojana

Some of the Salient features of this scheme is as follows

• The Beneficiary of this scheme have to pay a Premium of Rs. 200 per head. 50% of the Premium (Rs. 100) will be paid by the Nodal Agencies (They are basically Self-Help Group, NGO, Panchayat or any other institutional arrangement) or State Government or Members while submitting the proposal. The Remaining 50% of the Premium (Rs. 100) will be paid from Social Security Fund.

• Women SHG (Self Help Group) Groups

Janashree Bima Yojana offers a special scheme to Women Self Help Group workers to assist their Children                           Education. It also provide/offer a term insurance plan with a coverage of Rs. 30,000 on a premium of Rs. 200 per                  annum in which Premium Rs. 100 is given by Self Help Group Member and the other Remaining Premium (Rs.                    100)  is given by LIC.

• Shiksha Sahyog Yojana

As the name suggest, it is basically related to Shiksha (Education). This   Yojana/Scheme  is available for Children of            the Parents who are covered under the Janashree Bima  Yojana. Here a Scholarship amount of Rs.600 is paid every             6  months to students who  is studying in IX to XII. It also includes ITI Students. This benefit is given to only two                 children for every family.

Eligibility Criteria for Janashree Bima Yojana

The people must meet the criteria for receiving benefit of Janashree Bima Yojana

• The person must be aged in between 18 and 59 years.
• The person must be either below poverty line or marginally above poverty line.
• The person must belong to 45 occupational group mentioned above or member of nodal agency approved occupation.
• The minimum membership size should be 25

Benefits of Janashree Bima Yojana

Some of the Benefits of this Yojana is as follows:

• If the Person suffers from Partial Permanent Disability during accident, compensation of Rs. 37,500 will be given
• If a person suffers from total permanent disability or death then compensation of Rs.75,000 will be given to the beneficiary.
• During Natural death, compensation of Rs. 30,000 will be given to the Beneficiary

Chief Minister’s Comprehensive Insurance Scheme

As the Central Government launches several Health care schemes to benefit people nationwide. State Government also starts several Insurance schemes to their State people.  Chief Minister Comprehensive Insurance Scheme is one of them set up by the Tamilnadu Government for the people of Tamilnadu. It is also called Amma Health Insurance.

The CM comprehensive Insurance Scheme was launched in 2009 by the DMK party. This scheme gets wide and massive coverage in 2012 when AIADMK comes into power. This is a health Insurance Scheme designed for the underprivileges people of Tamilnadu.

 Area covered in this Insurance Scheme

There are certain areas covered in this scheme so that Beneficiary can tackle up the medical emergencies very well.

• Hospitalization expenses up to Rs. 1.50 lac can be covered for general medical treatment or specified surgical treatment.
• There are lot of Diagnosis are also done before the actual treatment. This Scheme also covers the expenses Diagnosis test.
• Amma Health Insurance also covers expenses of Follow up treatment thus reduces the financial burden of medical treatments even further.

Diseases covered under this CM Comprehensive Insurance Scheme

 Below are the List of Medical procedures that is taken care of from this scheme

Bariatric surgery	Cardiology	Cardiothoracic surgeries	Dermatology
ENT	Endocrine surgery	Endocrinology (follow up procedure)	Gastroenterology
Genitourinary surgery	Gynaecology	Obstetric surgery	Hematology
Hepatology	Infectious diseases	Interventional cardiology	Interventional radiology
Medical oncology	Neonatology	Nephrology	Neurology
Neurosurgery	OFMS	Ophthalmology surgeries	Orthopedic trauma
Paediatric intensive care	Paediatric surgeries	Paediatrics plastic surgery	PMR
Psychiatry	Pulmonology	Radiation oncology	Rheumatology
Spine	Stemi	Surgical gastroenterology	Surgical oncology
Thoracic medicine	Vascular surgeries	Surgical oncology

Salient Features of this Scheme

There are several features for this scheme mentioned below

• This scheme is a Family Floater health insurance in which all registered member (spouses, dependents children/parents) of the family can take health insurance benefits under this plan. They don not have to worry about future medical emergencies when enrolled under this scheme.
• This scheme covers cashless treatments at empaneled hospitals across the state.
• This Scheme ties up with United India Assurance which offers the coverage.
• This Scheme covers 1027 treatments, 154 follow up procedures and 38 diagnostic procedures.
• Empaneled hospitals under this scheme also offers free medical check up to the beneficiaries.
• There is a phone line set up/active 24*7 call center set up to answer queries.
• It also provides high coverage of Rs.5 lakhs to each family for every policy year.

Eligibility criteria to enrolled in this Scheme

This scheme is created for the underprivileged families who cannot take care of medical emergencies.

The candidate should meet the criteria for becoming the beneficiary of this scheme.

• The Family must be residents of Tamilnadu.
• The member name must be mentioned in the ration card of the family.
• Annual income must be less than Rs. 72,000/
• The applicant may be Sri Lankan refugees with proof of citizenship
• The people who came from other state must have a migration certificate from an authorized authority and must be in residing in Tamilnadu for at least 06 months.
• Orphans or Rescued girl children from any registered or unregistered organizations.

Documents required to apply this Scheme

These are the main documents to attach with the application form to get into this scheme.

• Ration card (Original and Photo copy)
• Income certificate
• Self-declaration from the head of the family

Some other documents are required for this scheme are as follows.

• Address Proof
• Identity Proof
• PAN card
• Aadhar Card