Health Insurance Government Scheme IV

In this Health Insurance Government Scheme IV,  We will describe welfare schemes run by Gujarat Government.

•       Mukhyamantri Amrutam (MA)Yojana

 

Mukhyamantri Amrutam (MA) Yojana

Mukhyamantri Amrutam Yojana (Health Insurance Government Scheme IV) is a Holistic healthcare scheme launched by The State Government of Gujarat in Sept 04, 2012. Initially, it was launched for the Below Poverty Line but after that it extended his program for lower middle-class families as well (means Beneficiaries can be even lower middle-class families). This scheme is all inclusive approach that covers/pays the entire medical circumstances that is, from diagnosis to post-hospitalization

                                 

Features of Mukhyamantri Amrutam Yojana 

This Health care scheme is a perfect example for created for the benefit of the people. Some of the Salient features for this Scheme are as follows:

• The Beneficiaries of this scheme do not have to pay any amount for premium. This is completely State funded.
• ASHA workers who help BPL families to get register in this scheme get a Rs. 100 per family as a bonus/incentive.
• This Scheme provides up to Rs. 3 lakhs to each family annually. Maximum of 5 family members can take this benefit
• Health Camps are conducted on district level every month and it is carried by empaneled Government and Private hospitals.
• All data are stored and managed by dedicated Data centers and servers with the help of an IT agency called (n) code solutions.
• There is a paperless environment for processes like claims and other services.
• If you are eligible, you can be enrolled in this scheme any time as there is no specific time duration for enrolment and you are enrolled in Civic Centre and Taluka Kiosks.
• In the entire process from being enrolment to claims, there is no mediator involved

 

 Benefit of Mukhyamantri Amrutam Yojana (MA)

Some of the Benefits of Mukhyamantri Amrutam Yojana are given below:

• The policy covers all the benefits given under the PMJAY Scheme.
• This Scheme provides up to Rs. 3 lakhs to each family annually.
• The scheme provides benefits up to Rs. 5 Lakh for Liver Transplant, Kidney Transplant, Kidney + Pancreas Transplant procedures.
• It also provides coverage for Burns, Renal diseases, Cardiovascular diseases, Polytrauma, Cancer, Liver and Kidney + Pancreas Transplant, Neurological diseases, Neonatal diseases, Knee & Hip Replacement, and 600+ other procedures.
• The QR coded card (It contains Biometric thumb impressions, photos, unique Registration number, district and taluka name) is given to every beneficiary.
• The Scheme/Policy also cover for travel charges of up to Rs. 300 per hospitalization.
• The Scheme/Policy also covers the transportation cost of death patient to take their body from hospital to his/her home or hometown

Diseases and Treatment covered under this Scheme

Below is the list of disease that is covered under this scheme.

 

Burns and plastic surgery	Oral and maxillofacial surgery	Medical oncology
Cardiology	Orthopedics and polytrauma	Neonatal packages
General medicine	Paediatric surgery	Neurosurgery neurology
Genitourinary surgery (renal)	Radiation oncology	Ophthalmology
Knee & hip replacement	Cardiothoracic & vascular surgery	Organ transplant packages
Mental disorder packages	Emergency room packages	Otorhinolaryngology
Nephrology	General surgery	Pediatric medical management
Obstetrics and gynaecology	Interventional neuroradiology	Surgical oncology

 

Diseases that are not covered

Some of the Diseases and Treatment are not covered under this scheme

• Certain non-emergency procedures might not be covered.
• Cosmetic treatments like plastic surgery for beauty is not covered.

 

Eligibility Criteria for Enrolling the Mukhyamantri Amrutam (MA) Yojana

This Scheme is only benefitted to the Below Poverty Line (BPL) families. This list is created by the State Government and all the members must be present during enrolment under this Yojana.

Eligibility Criteria for Enrolling the Mukhyamantri Amrutam (MA) Vatsalya Yojana

This Scheme is benefitted for those who is marginally above the poverty line. Other Beneficiaries can also enroll in this scheme. Some of the criteria for enrolling this Yojana is as follows:

• ASHA workers
• Authorized/Officially recognized Reporters.
• Families annual income up to Rs. 4 lacs
• Unorganized Workers Identification Number (U WIN) Card Holders
• Senior citizen belonging to those families whose annual income is up to Rs. 6 lacs
• The State Government who appointed Employees (Class 3 & 4) and who are on a fixed pay.

 

Enrolment process for this Mukhyamantri Amrutam Yojana

Before going for enrolment, a person should check the eligibility criteria. IF he/she fits the criteria, then the person should have to go to the government authorities like Taluka and Civic centres who maintained the list of such families who is eligible for availing the schemes. Families who income is less than Rs.4 lacs is mostly included in the list. The same list is available in the MA Gujarat website (www.magujarat.com) .  The List is basically generated on the income certificate of each family.

 

Step by Step procedures to Enroll in this scheme

• The eligible beneficiaries must visit the Kiosks at Taluka or Civic centres in their respective area.
• The authorities have all machine/hardware needed for enrolment. Machine is used to capture Biometric such as fingerprint, iris scan and the photos of the beneficiaries (just like Aadhar card).
• The Beneficiaries have to fill the Application form in Gujarati Language with appropriate details required.
• Once the detail Is verified The Mukhyamantri Amrutam Card is given to the Beneficiaries

Documents Required during Enrolment process

Some of the documents are required for being a part of scheme/becoming a beneficiary.

• Income Proof
• Address Proof
• Certificate says/qualifies that you are below poverty line.
• Identification Proof

Renewal Process

• The validity of the MA card is 3 years. It can be renewed by calling the customer care or going to the nearest
• Designated kiosk with the documents like Income Proof & Existing MA card.

 

Claim Process

The Beneficiary can claim the benefit by submitting

• MA card to the network hospital for verification after the treatment is started.
• The entire process is cashless and the claim is settled directly between the insurance company and the hospital once the treatment is over.