Modi Care – a National Health Insurance scheme was announced in Union Budget 2018 by Finance Minister Arun Jaitley on Feb 1. Actually, It is National Health Protection Scheme (NHPS) which is being dubbed as ‘Modi Care’ or ‘Namo Care’ by Mr. Jaitley. The mega health insurance scheme is intended to offer an annual health cover of ₹ 5 Lakh to 100 million poor families.
Modi Care – National Health Protection Scheme (NHPS)
The Scheme will target upto 500 million individuals from financial vulnerable households, a demographic that accounts for 41.3 percent of the population, according to census data.
Under National Health Protection Scheme, four in ten Indians can avail of secondary and tertiary care in government and private hospitals, within the insurance cap earmarked per family.
Secondary healthcare services include those provided by skilled medical practitioners, for outpatient treatment or a brief stay at a hospital for serious illness. Tertiary care is for those patients who are admitted to hospitals for longer bouts of illness and require the attention of specialist doctors. Tertiary care is extended to patients who are suffering from acute pain or terminal illness.
The mega health care scheme is expected to be launched on either August 15 or October 2 on Gandhi Jayanti.
National Health Agency
Under this scheme, a National Health Agency will be instituted to oversee its implementation at the state level. Beneficiaries will be identified as per 2011 round of the socio economic caste census.
How Modi Care is different from Rashtriya Swasthya Bima Yojana ?
Rashtriya Swasthya Bima Yojana (RSBY) is an existing healthcare scheme which offer an health insurance cover os ₹ 30,000/- for a family comprising of at most 5 members.
Central Government pay 75 percent of the expense while rest is borne by the states. RSBY is targeted at Below Poverty Line (BPL) families and has been implemented in 15 states.
Whereas under Modi Care, Health Insurance cover has been increased by almost 1500 percent from ₹ 30,000/- to ₹ 5 Lakh. The number of beneficiaries will also increase.
Under NHPS, Government will pay the premium with state’s share. For this, a fund of ₹ 2000 crore has been allocated in Budget. However, it may be noted that central and state government split expenditure in any health care programme is in 60-40 ratio.
Under the scheme, free health insurance of Rs 5 lakh will be provided every year to those who fall below poverty line or BPL families.
Modi Care – Will it be cashless or reimbursement one ?
Finance Minister Arun Jaitely has already announced that it will be a cashless scheme, not a reimbursement one.
He also said that the scheme takes care of hospitalisation, the secondary and tertiary care. It will involve various state hospitals and selected private hospitals. It can be on trust model, it can be on insurance model. It’s not on reimbursement model because too many complaints come on the reimbursement model.