Health Policy Issues and Health Programmes in ... - Amazon S3

Arogya Raksha: Health Insurance Scheme for Family Welfare Acceptors in Andhra Pradesh2. Individual districts will be supplied a requisite number of certificates. The District Medicaland Health Officers (DM&HOs) will maintain a register for monitoring the furtherdistribution of these of certificates. They will distribute certificates to all Family WelfareProgramme service centres and population policy units and will enter the serial number inthe distribution register. For continuous monitoring, a single register, with separate sections(two or three pages for each service centre), will be maintained.3. At the service centres, certificates will be issued and maintained and in a register, the detailsand number of the certificate would be entered. The certificates will be held in the safecustody of medical officers.4. Auxiliary nurse midwives (ANMs) will be responsible in preparing for the issue of certificates.At the time of the sterilization procedure, they will inform the couples about the healthinsurance scheme and make enquiries about whether they hold rice cards (below thepoverty line), or whether they have only two or fewer surviving children. If the couple iseligible under the health insurance scheme, the ANM will inform them, ensuring that theybring their white ration card (or if they are eligible but do not have a card, an incomecertificate from their mandal revenue officer), and the ANM will issue a certificate regardingthe number of children that the couple has (i.e., two or less).5. After the sterilization surgery is completed, couples eligible under the health insurancescheme would, on producing the two documents above, be issued a health insurancecertificate, but only after entering their particulars in the register. These particulars includetheir names, wife/husband and father/mother names, residential address, and identificationmarks (moles). Thumb impressions of the spouse undergoing sterilization and two childrenincluded on the insurance certificates would be in the register and on the certificate asadditional identity marks, as well as evidence of the issue of the certificate.6. The certificate would then be put in a polythene cover, sealed, and given to the couple, withan explanation of the benefits under the scheme and procedures for obtaining them. Thelist of hospitals in which these benefits can be availed will also be provided.7. The medical officer of each service centre or population policy unit will send a monthly reportto (1) the concerned insurance company branch, (2) the DM&HO, and (3) the Commissioner ofFamily Welfare regarding the number of certificates issued that month. This important reportindicates how the premium payment to the insurance company is adjusted.Availing the Benefits under the Scheme by Certificate HoldersIn the event that any other individual covered with an insurance certificate becomes sick or isinjured and feels that it is serious, he or she should go to any one of the hospitals enrolled inthat scheme, in that district or another district, taking the certificate and white ration card.Admission as In-patient1. After verifying the identity of the person to be admitted, the medical officer at the hospitalwould undertake a preliminary examination of the person to determine whether the personshould be admitted.2. Health insurance scheme beneficiaries can, upon each hospitalization, avail services,including bed charges, diagnostic charges, drugs, surgery charges, and any other medical orhealth items, up to Rs 2000 per hospitalization, and up to a total of Rs 4000 per year for two or121