Introduction:

There is a felt need to provide financial protection to families living below poverty line for the treatment of major ailments, requiring hospitalization and surgery. In order to bridge the gap in provision of Tertiary care facility and the specialist pool of doctors to meet the statewide requirement for the treatment of such diseases particularly in rural areas the Government of Karnataka has taken the initiative in this direction. Health insurance could be a way of removing the finiancial barriers and improving accessibility to quality medical care by the poor. Government of Karnataka intends to implement Health Insurance Scheme by name Vajpayee Arogyashree for the BPL families of Karnataka in a phased manner.

Objectives:

To improve access of BPL families towa quality tertiary medical care for treatmen identified diseases involving hospitalizat surgery and therapies through an ident network of health care providers.

To Cover Catastrophic Illnesses Universal Coverage of BPL (Rural + Urban) Catastrophic illnesses can wipe out decades of savings of BPL families To protect life time savings of BPL families which would be wiped out in cas catastrophic illness.

Types of Services:

Cardiovascular diseases Cancer Treatment o a) Surgery o b) Chemotherapy o c) Radiotherapy Neurological diseases Renal diseases Burns Poly trauma cases (Not covered by Motor vehicle insurance) Neo-natal cases

Beneficiaries:

The scheme is intended to benefit below poverty line (BPL)families both in urban & r areas in Karnataka, in a phased manner. Identification of these families are based o BPL ration card issued by the Food and Civil Supplies Department. All eligible fam (family of 5 members) in the proposed districts are provided with BPL cards issued Department of Food and Civil Supplies. These BPL ration cards will be basis identification of beneficiary under the scheme until Biometric health cards are issued. District Bidar Raichur Bellary Koppal 4 No. of Talukas 6 5 7 4 22 No. of BPL Cards 212620 257629 289499 178811 9,38,559

Families:

The Health Insurance Scheme will cover 5 members of a family as enumerated photographed on the BPL card. The name/ photograph indicated in the BPL card wil taken as proof of identity of the Beneficiary.

Enrolment:

Department of Food and Civil Supplies, Govt. of Karnataka will provide the details of e BPL family covered under the scheme through the BPL card. This BPL card will be a of enrollment/ identification for availing the health insurance facility

ID Cards:
Vajpayee Arogyasri will distribute ID cards to the beneficiary families.

Payment of Premium:

Government of Karnataka/ Trust will pay the premium on behalf of the BPL beneficia for the insurence.

Benefit Package:

The Benefit Package will cover tertiary care for catastrophic diseases. Sum assured be Rs.1,50,000/- on a family floater basis per year. Additional buffer of Rs.50,000/year for the entire family on a case to case basis (if the total expenditure exceeds m than Rs.1,50,000/-) will be provided. The benifit availed by the family will be on a flo basis for a total reimbursement of Rs.1, 50,000/- which can be availed individuall collectively by members of the family.

Cashless Transaction:

It is envisaged that during each hospitalization the transaction shall be cashless procedures covered under this scheme. Enroled BPL beneficiary can go to a netw hospital and obtain treatment without making any payment to the hospital procedures provided under the scheme.

Pre-Existing Diseases:

All diseases proposed under the scheme shall be covered under the scheme from one. A person suffering from any of the identified diseases prior to the inception of policy shall also be covered.

Procedure for Enrolment of Hospitals:

All the Public Hospitals (District Hospitals, Government/ Private Medical Colleges) identified Private Hospitals/ Nursing Homes shall individually be empanelled. Priv Hospitals/ Nursing Homes meaning, any institution in Karnataka established for in-pat surgical care and the Networked Hospital should comply with minimum qualifying crit for empanelment. For the empanelment of Super Specialty treatment of Neurol Heart, Cancer treatment (Surgery, Chemotherapy and Radiotherapy), Renal, Burns Poly-Trauma cases (not covered by the Motor Vehicles Act) and Neo-natal care, Hospital should have super specialty infrastructure of the same along with service specialists. The concerned agency will provide supporting services of Health Insurance, like crea awareness among the community by conducting Health awareness/ check up cam through Arogyamitras in the concerned areas. Role of Arogyamitras in the hospital

To create publicity and awareness Maintain Help Desk at Hospital

Receive the beneficiary Verify the beneficiary Criteria (eligibility criteria) Facilitate consultation with doctors Fill up the referral cards Guide the patient to the next centre To counsel the patients who may require one of the listed treatments To guide the patients either to a Government Hospital or to a network hosp for further tests. Follow up the referred cases To act as a guide and friend to the beneficiary.

Memorandum of Understanding (MoU) with Network Hospitals:

The trust shall sign the MoU with all the Hospitals to be empanelled under the sche The Empanelled Medical Institutions will extend Medical Aids to the beneficiary under scheme.

Claims Settlement:

Vajpayee Arogyashree shall settle the claim within 21 days of receving the claims f the network hospital.

Camps:

Health Camps will be conducted in all Gram Panchayats and Municipalities. A minim number of one free medical camp will be conducted by each Network Hospital per w at a place suggested by the Trust. They will carry necessary screening equipment a with specialist and other Para-medical staff as suggested by the Trust and will also w in close liaison with District Coordinator, District Health Officer in consultation Deputy Commissioner.

Hospitalization Period:

The minimum period for which the insured person is admitted in the hospital as in-pat and stays there for the sole purpose of receiving the necessary and reasonable treatm for the disease/ ailment contracted/ injuries sustained during the period of policy, s be 24 hours.

State Level Coordination:

24 hour Call center with toll free help line MIS to collect and report data on a real-time basis. Collect hourly round the clock information from Arogya Mitra, regional coordinators, district coordinatorsetc. MIS

follow up the cases at all levels. They shall also generate reports as desired by the Directorate of Health and Family Welfare Services. 24 X 7 online computer control room to ensure that the website with e-preauthoriza claims settlements, and real-time follow-up is to be maintained and updated. Pre-Authorization Section with specialist doctors for each category of diseases sha work along with the Directorate of Health and Family Welfare Services doctors to pro the claims.

District Level Committee:

A committee chaired by Deputy Commissioner will form the Grievance Redressal Ce the District level.

Expected Outcomes:

1. To Cover Catastrophic Illnesses which are not covered by other Health Insu Schemes. 2. Universal Coverage of BPL (Rural + Urban) 78 lakh families in a Phased man 3. Super Specialty Surgical care to be made available to vulnerable sections o society

Latest Answers(5)

Sort by Latest | Oldest | Top-rated well venkatesh With a view to obviate the problem of lack of Gynaecologists, it is proposed to take up the scheme titled Vande Mataram" for providing free safe motherhood services including immediate post natal care on a fixed date of every month by all Gynaecologist both in public arid private facilities including NGOs..

Objectives 1. To bring about the change in health seeking behaviour of and for expectant and new mothers and to create awareness in the family and community the need for safe motherhood. 2. To involve and utilize the vast resources and specialist l trained workforce available in the private sector and the private sector infrastructure for providing obstetric care on the 9'" of every month. 3. To improve the acceptance and access to family planning methods through improved family planning counseling during both ante natal and post natal period. 4. To detect for management of RTI/STI cases in pregnant women. 5. To improve institutional delivery. 6. To reduce the incidence and prevalence of nutritional anaemia in pregnant women. 7. To strengthen Public, private and civil society partnership. Strategy 1. The scheme, which is a step towards public-private and civil society partnership, will be a voluntary scheme under the auspicious of the FOGSI, eventually such gynaecologists / Lady doctors who are not members of FOGSI will also be able to participate. 2. It proposes to involve practicing Obstetricians and Gynecologists from the Government sector, the private sector including NGOs for providing the free OPD Services and ante natal check up to all pregnant women on a: fixed date, that is on the 9th of every month at their clinics or by visiting the nearest CHC/ Public hospital. Activities At Private facility 1. Gynecologists /Lady doctors will provide free antenatal /post natal services for pregnant women/new mothers and family planning services on the 9th Of every month. 2. Refer such women requiring treatment for complications if necessary, to pre identified and designated centres. At public facilities 1. In case some gynaecologists l lady doctors' in private sector volunteer, they could be permitted to visit nearby CHC/FRU/Sub-district hospital for this purpose. for more inf check http://www.whiteribbonalliance-indi a.org/vandem.htm Answered by sanjay , an ibibo Guru, at 1:58 PM on July 28, 2008 Report Abuse | Rate this : 00

sanjay Profile | Q&A well venkatesh,Vande mataram" scheme envisages provision of free OPD services including ante natal check up to all pregnant women and family planning counseling to new mothers regularly by the public and

private facilities on a fixed date each month would improve the access of pregnant women to ante natal check up and thus, reduce maternal and neonatal deaths significantly. With a view to obviate the problem of lack of Gynaecologists, it is proposed to take up the scheme titled Vande Mataram" for providing free safe motherhood services including immediate post natal care on a fixed date of every month by all Gynaecologist both in public arid private facilities including NGOs.. Objectives 1. To bring about the change in health seeking behaviour of and for expectant and new mothers and to create awareness in the family and community the need for safe motherhood. 2. To involve and utilize the vast resources and specialist l trained workforce available in the private sector and the private sector infrastructure for providing obstetric care on the 9'" of every month. 3. To improve the acceptance and access to family planning methods through improved family planning counseling during both ante natal and post natal period. 4. To detect for management of RTI/STI cases in pregnant women. 5. To improve institutional delivery. 6. To reduce the incidence and prevalence of nutritional anaemia in pregnant women. 7. To strengthen Public, private and civil society partnership. Strategy 1. The scheme, which is a step towards public-private and civil society partnership, will be a voluntary scheme under the auspicious of the FOGSI, eventually such gynaecologists / Lady doctors who are not members of FOGSI will also be able to participate. 2. It proposes to involve practicing Obstetricians and Gynecologists from the Government sector, the private sector including NGOs for providing the free OPD Services and ante natal check up to all pregnant women on a: fixed date, that is on the 9th of every month at their clinics or by visiting the nearest CHC/ Public hospital. Activities At Private facility 1. Gynecologists /Lady doctors will provide free antenatal /post natal services for pregnant women/new mothers and family planning services on the 9th Of every month. 2. Refer such women requiring treatment for complications if necessary, to pre identified and designated centres. At public facilities 1. In case some gynaecologists l lady doctors' in private sector volunteer, they could be permitted to visit nearby CHC/FRU/Sub-district hospital for this purpose Answered by Debashis , an ibibo Master, at 3:00 PM on July 27, 2008 Report Abuse | Rate this : 00

Debashis Profile | Q&A

Hi "Vande mataram" scheme envisages provision of free OPD services including ante natal check up to all pregnant women and family planning counseling to new mothers regularly by the public and private facilities on a fixed date each month would improve the access of pregnant women to ante natal check up and thus, reduce maternal and neonatal deaths significantly. With a view to obviate the problem of lack of Gynaecologists, it is proposed to take up the scheme titled Vande Mataram" for providing free safe motherhood services including immediate post natal care on a fixed date of every month by all Gynaecologist both in public arid private facilities including NGOs.. Objectives 1. To bring about the change in health seeking behaviour of and for expectant and new mothers and to create awareness in the family and community the need for safe motherhood. 2. To involve and utilize the vast resources and specialist l trained workforce available in the private sector and the private sector infrastructure for providing obstetric care on the 9'" of every month. 3. To improve the acceptance and access to family planning methods through improved family planning counseling during both ante natal and post natal period. 4. To detect for management of RTI/STI cases in pregnant women. 5. To improve institutional delivery. 6. To reduce the incidence and prevalence of nutritional anaemia in pregnant women. 7. To strengthen Public, private and civil society partnership. Strategy 1. The scheme, which is a step towards public-private and civil society partnership, will be a voluntary scheme under the auspicious of the FOGSI, eventually such gynaecologists / Lady doctors who are not members of FOGSI will also be able to participate. 2. It proposes to involve practicing Obstetricians and Gynecologists from the Government sector, the private sector including NGOs for providing the free OPD Services and ante natal check up to all pregnant women on a: fixed date, that is on the 9th of every month at their clinics or by visiting the nearest CHC/ Public hospital. Activities At Private facility 1. Gynecologists /Lady doctors will provide free antenatal /post natal services for pregnant women/new mothers and family planning services on the 9th Of every month. 2. Refer such women requiring treatment for complications if necessary, to pre identified and designated centres. At public facilities 1. In case some gynaecologists l lady doctors' in private sector volunteer, they could be permitted to visit nearby CHC/FRU/Sub-district hospital for this purpose. Answered by KHURSHEED , an ibibo Master, at 10:54 PM on July 26, 2008 Report Abuse | Rate this : 00

KHURSHEED Profile | Q&A vandamatharam scheme is an programme which is implemented by government. it is a purely a voluntary scheme.any doctor/gynecologist/any nursing home or hospital can enroll for this programme! when enrolled they would be given a VANDEMATARAM logo that is displayed at their clinic! in this scheme the benefeciaries would get free IFA tablets, VACCINES FOR MEASLES,POLIO,TB,TT injections . Answered by surendra , an ibibo Advisor, at 6:49 PM on July 26, 2008 Report Abuse | Rate this : 00

surendra Profile | Q&A It is worthy and desirable scheme in this particular time Answered by PittaGroups , an ibibo Citizen, at 6:36 PM on July 26, 2008 Report Abuse | Rate this : 00

PittaGroups Profile | Q&A Related Search what do you mean about the vandemataram scheme? purely a voluntary scheme.any doctor/gynecologist/any nursing home or hospital can enroll for this programme! when enrolled they would be given a VANDEMATARAM logo that is displayed at their clinicwell venkatesh With a view to obviate the problem of lack of Gynaecologists, it is proposed to take up the scheme titled Vande Mataram" for providing free safe motherhood services including Posted in Personal Health by venkatesh at 11:37 PM on July 26, 2008 Tags mean, vandemataram, scheme More such questions Categories View All Health

Alternative Medicine Baby Care Children's Health Dental Health Diseases

Emergency Services Fitness Health Care Products & Shopping Hopsitals & Medical Centres Losing Weight Mental Health Nutrition Occupational Health & Safety Personal Health Pharmacy Pregnancy Public Health & Safety Senior Health Sexual Health

Advice Arts & Humanities Business & Economy Computers & Internet Education Entertainment Fashion Government ibibo Products Interview Questions Local Business News & Media Others Recreation Science Shopping Society & Culture Your Home Your Office

Ads Samsung galaxy 3 with 8 gb memory card 37 minutes ago concept computronics 37 minutes ago COMMERCIAL SPACE @ GROUND FLOOR AVAILIBLE FOR LEAS... 37 minutes ago
Ads

Advertise on ibibo Earn Revenues Classifieds Shopping New Cars Free SMS Mobile Jobs Travel 2006 - 2011 ibibo Web Pvt Ltd. All rights reserved. About ibibo Contact Terms Privacy Policy Careers Disclaimer Sitemap