The Health Ministry is contemplating a proposal that will make it mandatory for the insurance companies to refund excess premium if the claim ratio under the National Health Protection Mission (NHPM) turns out to be less than 85%. The Ministry also called upon representatives from general and standalone health companies to discuss the matter with them.
This meeting with the representatives of the insurance companies was chaired by Indu Bhushan, CEO of Ayushman Bharat National Health Protection Mission (AB-NHPM). He also sought the feedback of the insurers regarding the proposal. NHPM is a huge initiative by the Health Ministry, and is expected to provide coverage of ₹5 lakh to 10 crore of the poorest families of the country.
The programme will focus on urban worker’s families that amount to 8.03 crore in rural and 2.33 crore in urban areas. In total, the scheme will cover 50 crore people. The rolling out of the scheme is expected after July with the Centre allocating ₹10,000 crore for the project. The proposal intends to ensure that the insurance companies do not make windfall gains from the scheme.
The representative of the insurers were all praise for the initiative and went over critical aspects such as package details and rates, empanelment criterion, operational guidelines and model tender document. The initiative will be rolled out with the aim of expanding quality health services into rural areas and Tier-2 and Tier-3 cities.
*Source: Money Control
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