The state government of Madhya Pradesh launched the health insurance scheme, Deen Dayal Antyodaya Upchar Yojana to provide financial aid to the underprivileged families of the state so that they can get the necessary medical treatment they require. The scheme was created after it was observed that many needy families could not afford hospitalisation for medical treatments. When the scheme was introduced in September 2004, it was restricted to only the scheduled castes and scheduled tribes. It was later extended to the Below Poverty Line (BPL) families too.
The objective of this health insurance scheme is to provide free medical treatment along with free investigation facilities to the beneficiaries hospitalised in government hospitals. The idea of the scheme is to ensure the state’s commitment to providing social security is maintained and the marginal classes of the society are prevented from suffering from debts.
Eligibility for the Deen Dayal Antyodaya Upchar Yojana:
The following citizens are covered under the state health insurance scheme of Madhya Pradesh:
- Below poverty line families. No restriction on the number of family members that can be covered.
- Families that hold the Nirman Shramik card and the Mukhya Mantri Mazdoor Suraksha card can also be covered under this health insurance scheme.
- Primitive tribal groups. The economic status of the families is not considered for this category.
Benefits of the Deen Dayal Antyodaya Upchar Yojana:
The benefits of the government-funded health insurance scheme are:
- Medical treatments and investigation facilities are covered up to Rs.20,000 per family on an annual basis.
- The sum assured limit is extended to Rs.30,000 in case of serious illnesses.
- Only hospitalised patients can avail benefits under the scheme.
- Cost of medicines is covered.
- All diseases and severe health conditions are covered without any exclusions.
- Deliveries are also covered under the scheme.
- Beneficiaries can avail the benefits of the scheme from state government hospitals. Additionally, services such as X-rays or pathological tests taken in private healthcare facilities are covered under the scheme.
Family health card for Deen Dayal Antyodaya Upchar Yojana beneficiaries:
The beneficiaries of the state health insurance scheme have to produce the family health card when they want to avail medical services in network hospitals. The details of the health card are:
- Individuals whose names are mentioned in the BPL list prepared by the urban local body or the Panchayat are eligible to receive the family health card.
- The health card will have the photograph of the head of the family and details of the members of his/her family.
- The health cards are distributed by the chief medical and health officer or the block medical officer.
- The printing of the family health cards are done at the state level and then provided to the district and block officers.
- The cost of the material, investigation conducted, or medicines bought are entered in the card when one of the beneficiaries is hospitalised.
- There is no need for renewal of the family health card.
- In case a new name needs to be added to the health card, the same can be done by providing the necessary documents.
FAQs on Deen Dayal Antyodaya Upchar Yojana:
- What is the average expenditure per family per annum under the scheme?
- The complete sum assured amount of Rs.20,000 p.a. is not used up by all families. On an average, Rs.1,000 is utilised by each family every year.
- How is the implementation of the Deen Dayal Antyodaya Upchar Yojana being carried out?
- The State Department of Public Health and Family Welfare takes care of the implementation of the scheme. The health officers of each district and the Chief Medical Officer will manage the issuance of family health cards, fund flow, purchase of medicines, and overall monitoring of the scheme.
- On what basis are the names of family members added to the family health card?
- The names of the family members are added as per the ration card. In case no ration card is available with the individual, a competent authority is required to provide a certificate as a replacement to the ration card.
- Do beneficiaries have to bear any charges for enrolment?
- No, the state government will bear all charges such as the cost of the family health card and the cost of the photograph.
- Are there any exclusions of the health insurance scheme?
There are no exclusions in terms of the procedures conducted in the hospital. However, charges such as the physician’s fee or bed charges are not covered under the scheme and are required to be borne by the beneficiary.