Mukhyamantri Amrutum

Mukhyamantri Amrutum

Application Form

“Mukhyamantri Amritam” announced for the state of Gujarat Covering treatment of BPL households for tertiary care.

• Free-of-Cost treatment up to Rs.2 Lakhs per BPL Family
• Up to 5 Members of the BPL family can be covered under MA Yojana.
• New born will be covered from day one as 6th Member.
• Approximately 38 Lakhs eligible BPL Families will be covered.

Coverage Areas 

 Predefined medical procedures and packages would be provided on a complete cashless basis.

• Procedures covered under the Scheme. – 1 Burns (a total 12 Benefit Packages)

• Cardiovascular Surgeries (a total 153 Benefit Packages)

• Renal (a total 21 Benefit Packages)

• Neurosurgeries (a total 49 Benefit Packages)

• Poly Trauma (Not covered by Motor Vehicle Insurance) (a total 8 Benefit Packages)

• Neo-natal diseases (a total 23 Benefit Packages) – 7 Cancer (Surgical Oncology, Chemotherapy & Radiation Oncology) (a total 210 Benefit Packages)  

• Cancer (Surgical Oncology, Chemotherapy & Radiation Oncology) (a total 210 Benefit Packages)

Coverage

• In addition, there will be no pre-existing condition exclusions. Pre-existing diseases are also covered from day one which means that any illnesses existing prior to the inception of the Scheme shall also be covered.
• Provision for transport allowance of Rs.300 per visit subject to an annual ceiling of Rs.3000 shall be a part of the total coverage of Rs 2,00,000/- per family.

ELIGIBLE HEALTH SERVICES PROVIDERS:

• All Private hospitals who qualify in two stage Bid process.
• All Government/Grant in Aid hospitals as decided by the State Government shall be empanelled.
• For new enrollment and updation of old card taluka kiosk will be established
• BPL beneficiary can visit the kiosk for

             – Modifying the name on card if erroneous
             – Add/Delete member to be enrolled under MA Yojana
             – Migration details
             – New Enrolment – for left outs during enrolment drive
             – Split Card application
             – Card Hot-listing for lost/damaged Card

• Provisioning of Mobile Kiosks for updation/enrolment @ Village Levels

Scheme Launching- Planning
   • Mega Health Camp and Screening Camp Plan;

• Diagnosis and Primary treatment during the camp
• Screening of beneficiaries of beneficieries
• Referal of beneficieries
• IEC of the scheme
• MA Card distriution.
• Venue and dates is to be finalised.

Roles of District Authorities
Distribution of Cards to the beneficiaries through District Health Authorities.
Designating Govt. Health Officer for beneficiaries verification during the enrolments at village level and at the taluka kiosk.
Functionalising the Grievance Redressal Committee.
District Advisory & Grievance Redressal Committee (DAGRC):

• District magistrate- Chairman
• District Development Officer- Co- Chairman
• Regional Deputy Director –Member
• Chief District Medical Officer- Convener
• Chief District Health Officer- Co- Convener
• Representative of ISA.
• Parties with grievances (Beneficiary/hospital/ISA/District)

Organising Mega Health Camps at the Regional/District/M. Corporation level.
To prepare District IEC plan and to ensure its implementation.
Monitoring hospital empanelment, claims, monthly health camps, timely grievance redressal in coordination with ISA.
Supervising and reviewing the functions of District Kiosk/Taluka kiosk.
Organising District and Taluka Workshops.
Arogyamitra acts as a facilitators for beneficiaries.

Following are list of various activities of Arogyamitra:

• Counseling the patients at their work location.
• Participate in Health Camps.
• Follow up of patients for treatment.
• Spot Verification of patients.
• To assure Cashless transaction & coordinate with ISA for approval.
• Arrange transportation amount for the patient.
• Facilitating Hospital in sending CD along with claim documents containing photo of beneficiary (counseling) with scar image of surgery at the time of discharge.
• To provide super specialty services for identified catastrophic illness.
• Sign MOU with the ISA.
• Set up of ‘MA’ help desk at Hospital Campus.
• Designates 2 Hospital Arogya Mitra (HAM) at the hospital.
• Sending request for preauthorization ISA.
• To conduct Health Camps as per the schedule designed by the District Authority/ISA/SNC.

State Workshop:

Workshops on scheme details, roles of the stakeholders and implementation methodology with
– Representatives of various other departments,
– Implementing districts,
– ISA and service providers (Smart Card agency, Hospitals, NGOs, etc.)
Organization of District Workshops:

– Workshop for field officers, Health workers,ASHA
– Workshop with the Public and Private Hospitals