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Insurance helping mitigate health woes in Arunachal

Itanagar: In most parts of India, Prime Minister Narendra Modi’s ambitious health insurance scheme for the financially backward sections of society has not reached the desired results it had sought to.

A report published by the Public Health Foundation of India and the US-based Duke Global Health Institute last year revealed that the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) did not live up to expectations across much of the country to deal with the Covid-19 pandemic.

However, in Arunachal Pradesh, a different scenario was panning out.

Unlike in other states, in Arunachal Pradesh, the state government rolled out free Covid-19 care for its residents.

The free Covid care along with the parallel implementation of the PM-JAY and the Chief Minister Arogya Arunachal Yojana (CMAAY) have helped mitigate health care services across the state.

The two schemes provide enhanced coverage of Rs five lakh for each family.

The CMAAY also provides cashless treatment for financially weaker families in what it calls is the “Assurance Mode” and replaced the previous CM’s Universal Health Insurance Scheme (CMUHIS).

The CMUHIS did not reach its stated goals for several reasons, including the hesitancy from several private hospitals, especially outside the state.

However, the CMAAY hopes to address some of the earlier issues and provide for better health coverage for the people of the state.

The CMAAY is aimed at providing cashless hospitalisation to poor and vulnerable groups for up to Rs five lakh per family per year. Under this scheme, the government will provide Rs one lakh for secondary care and Rs four lakh for tertiary care. All the beneficiaries can avail benefits of this health assurance scheme in any empanelled hospitals through a new web portal (https://cmaay.com/CMAAY_home.aspx). The stated aim of the scheme is to ensure “Health for All”.

Those eligible for coverage under the scheme are people of the Arunachal Pradesh Scheduled Tribe (APST), non-APST residents of Changlang, Lohit, Namsai possessing resident certificate (RC) who are people with permanent land holding documents, and state government employees and their dependents.

So far, under the CMAAY, 1,11,030 families with 4,78,803 individuals have registered for the insurance scheme across the state.

Apart from providing cashless service for major health issues, the CMAAY also provides coverage for pre-hospitalization up to three days and post-hospitalization for up to ten days. Another key component of the CMAAY is that it also provides coverage for pre-existing diseases, which major insurance policies often do not.

Data from the health department reveals that while the Tomo Riba Institute of Health and Medical Sciences (TRIHMS) tops the list of the top ten empanelled hospitals, its services are greatly being availed across the state and outside the state.

The other hospitals that have seen widespread usage of the CMAAY are the Bakin Pertin General Hospital in Pasighat; Khan Drowa Zangmo District Hospital in Tawang; B Baruah Cancer Institute in Guwahati; Christian Medical College Vellore in Tamil Nadu; and NEIGRIHMS in Shillong.