Mumbai: Although the state government has hiked the insurance cover from ₹1.5 lakh to ₹5 lakh under Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY), 2.22 crore beneficiaries cannot avail the scheme for more than two months as the government has issued a tender to incorporate policy changes. The process is likely to be completed in two-three months.
Premiums to be changed
Under the new scheme, the premium paid to the insurance company is going to change, for which tendering is being done. “We have started the tender process for a new policy which is likely to be completed in the next two to three months. Moreover, premiums will be changed depending on the current health insurance cover. We have also identified beneficiaries who actually require treatment under this scheme,” he said.
There was a growing clamour among patients that the empanelled hospitals aren't doling out the increased insurance cover. Considering the grievances, the state government issued a government resolution (GR) on July 27, warning hospitals about stern action if they fail to implement the new scheme.
Slow pace of action
Speaking on the condition of anonymity, a health official said, “The premium for this existing scheme is paid to the State Health Insurance Society at the rate of Rs855 per family. For that, the government gives Rs1,770 crore annually to this company. According to the state health inspection report, 2.22 crore have been selected as beneficiaries for this scheme.” Meanwhile, a senior health official said that the health cover was increased so that the patients do not have to shell out money from their pockets. However, the new MPJAY has gone for a toss due to the (slow pace of action on part of the) authorities, added the official.
As per official data, there are 1,000 hospitals across Maharashtra which are empanelled under MPJAY while the scheme can be availed by families having either a ration card or domicile certificate.