Health Related Schemes of Himachal Government

Health Related Schemes of Himachal Government :

 To deal with numerous health diseases, the state government of Himachal Pradesh has introduced various health care schemes. These are:

Mukhya Mantri State Health Care Scheme :

The government of Himachal Pradesh launched the Mukhya Mantri State Health Care Scheme (MMSHCS) in 2016. The MMSHCS is intended for those not enrolled under Rashtriya Swasthya Bima Yojna(RSBY) or other schemes of medical reimbursement. The State had focused on providing health coverage under MMSHCS to the most vulnerable population. The beneficiaries of the programme will be more than 2, 00, 000 families. The Scheme primarily covers the following 9 categories:

1. Senior citizens (80 years or older)
2. Ekal Naris
3. People more than 70% of disabilities.
4. Contract staff (government, autonomous bodies, corporations, boards)
5. Part-time employees (government, independent organizations, corporations, and committees)
6. Daily wage workers (government, independent bodies, corporations, and committees)
7. Workers of Anganwadi
8. Helpers of Anganwadi
9. Workers at midday meals

Mukhya Mantri State Health Care Scheme Benefits :

• The beneficiary will be benefited with 30,000 rupees per year under “Basic Package” on family floater bases only for hospitalization (indoor treatment & daycare) in all of the 173 hospitals under RSBY. In the case of critical disease, under “Critical Care Package” (only in Three Hospitals viz. PGI Chandigarh, IGMC, and RPGMC Tanda) the beneficiary will be benefited with Rs. 1, 75,000/-per year on a family floater basis.

• The MMSHCS is entirely cashless, and at the time of registration, you need only to pay Rs. 30/-. The recipient will be allocated a smart card after paying the registration fees. However, the smart card’s validity will be five years; the card should be renewed after three years since the software used has its limitations.

Senior Citizen Health Insurance Scheme :

Himachal Pradesh’s government has launched the State Senior Citizen Health Insurance Scheme (SCHIS) to provide access to therapeutic geriatric health services through additional insurance cover. The scheme will provide all existing Rashtriya Swasthya Bima Yojna smart card holders with top-up coverage of Rs. 30,000 per senior citizen in addition to the basic coverage of Rs.30,000 in Trust / Society mode. Any recipient who is 60 or older and is currently enrolled in RSBY or will be enrolled in RSBY is qualified for such added benefits. If there is more than one senior citizen in any RSBY rolled family, then the additional cover will be multiples of Rs.30,000 per senior citizen to be provided on a floating basis among the senior citizens of the RSBY enrolled family. Thus, if there are two senior citizens in a family, then both senior citizens would have a cover of Rs.60,000 available on a floater basis. Exclusively senior family citizen enrolled in RSBY can take additional benefit. 

The coverage will be provided by the State Nodal Agency HP Swasthya Bima Yojna Society until the beginning of the National Health Protection Scheme and after the start of the National Health Protection Scheme through Insurance Company. Family senior citizens eligible for RSBY but not rolled in this scheme will not receive SCHIS benefit. This package will go beyond the annual box of Rs.30, 000 per RSBY family. It was carried out by a technical committee comprising representatives of the Ministry, governments of the State and technical experts covering cardiology, cardiothoracic surgery, cardiovascular surgery, neurosurgery, polytrauma and repair, burns, surgical oncology, and medical oncology. These two additional covers will be compensated up to Rs.1.75 lakh (up to Rs. 2.25 lakh for cancer) from the existing RSBY critical care supplement. The scheme will be financed under the Insurance Model through insurance and trust models. The estimated annual add-on premium is up to Rs.500 per family to implement SCHIS.

Rashtriya Swastya Bima Yojana ( RSBY ) :

RSBY’s goal is to protect BPL households from financial liabilities resulting from health shocks involving hospitalization. Beneficiaries under RSBY are entitled to coverage for admission up to Rs. 30,000/-for most hospitalization-related diseases. For a large number of interventions, the government has even set the hospital package rates. From day one pre-existing condition will be covered, and there will be no age limit. Coverage extends to five family members, including household head, spouse, and up to three dependents. Beneficiaries only have to pay rupees thirty as registration fee while the central and state government pays the premium to the insurer selected by the government of the state based on a competitive bid.

Matri Seva Yojana :

Himachal Pradesh’s government launched Matri Seva Yojna providing the state’s women who are pregnant, a facility for free organizational delivery in all public health institutions. The scheme was designed to ensure the mother and child’s health. Life-saving drugs are also made available to patients free of charge in addition to free institutional delivery.

Mukhyamantri Vidyarthi Swasthy Karyakaram :

H.P’s school health program will address school children’s health needs in the form of health education, environmental healthcare, nutrition, safe drinking water, gender, and social concerns. H.P’s state will use disease prevention strategies, health promotion strategies as well as underlying disease detection and medical advice on health issues.

H.P. Universal Health Protection Scheme (HPUHPS) :

To improve access, of enrolled beneficiaries and their families to quality healthcare for cashless treatment of diseases involving hospitalization through empanelled healthcare providers. There will be no family cap. Maximum five members can be enrolled in a smart card so if the family size will be more than five, one additional card will be given to the family. Pre-existing conditions/diseases are covered from the first day of the start of Policy. Coverage of health services related to surgical nature for defined procedures shall also be provided on a day care basis. Pre and post hospitalization costs up to 1 day prior to hospitalization and up to 5 days from the date of discharge from the hospital shall be part of the package rates under basic Package. And up to 15 day prior to hospitalization and up to 60 days from the date of discharge from the hospital shall be part of the package rates under critical care Package. The benefit will be provided through only smart card. The Governor, Himachal Pradesh is further pleased to increase the premium from Rs.365/-(Rupees Three Hundred Sixty Five) only per year/per family to Rs. 1,000/- (Rupees One Thousand) only under Himachal Pradesh Universal Health Protection Scheme(HPUHPS). The beneficiary family will pay Rs. 1,000/- (up to unit of five members) at the time of enrolment for getting the cashless treatment benefit up to Rs. 5.00 Lakh per year. 

Mukhyamantri Chikitsa Raahat Kosh Yojana : 

Under Mukhyamantri Chikitsa Rahat Kosh Yojana, the citizens would be able to get 24*7 specialised medical and emergency services. The state govt. will provide financial assistance to all those patients who were not covered under the social security pension scheme.