Mukhyamantri Amrutum Yojana

Increasing medical costs in India are a major concern especially for poor people. Economically challenged people often get trapped in a debt cycle when there is a medical emergency in their families. Mukhyamantri Amrutum Yojana is a health care plan developed by the Government of Gujarat to help poor families in their major adversities. This scheme provides financial support to below poverty line and lower income families living in Gujarat. Though originally intended for below poverty line families, this plan was later modified to include lower middle class families in the state. Mukhyamantri Amrutum Vatsalya Yojana is the modified cover that includes more families in its ambit.

Eligibility for Mukhyamantri Amrutum Yojana

The following eligibility criteria must be met in order to get benefits under Mukhyamantri Amrutum Yojana:

• The total annual income of the beneficiary must be less than Rs.2.5 lakh.
• It is a must to have an income certificate before subscribing to this scheme.
• This cover can be taken for self, spouse, and three dependent children.

List of other beneficiaries included in the scheme:

Apart from families below the poverty line and low income families, a few more beneficiaries were included in the scheme. Here are the new additions to the scheme:

• In 2016, U-win card holders were also permitted to avail the benefits under the scheme.
• In the FY 2017-18, fixed pay state government employees of Class 3 and Class 4, reporters, and rural as well as urban Accredited Social Health Activists (ASHAs) were added as beneficiaries.
• Senior citizens whose families’ income is within Rs.6 lakh are also included.

 

Features of Mukhyamantri Amrutum Yojana

Some of the notable features of Mukhyamantri Amrutum Yojana can be given as follows:

• This scheme offers a sum insured amount of Rs.3 lakh on a floater basis
• Five members of a family can avail the benefits under the scheme.
• There is no cost incurred by beneficiaries as this is a 100% government funded scheme.
• A quick response coded card (QR coded card) is issued to families that avail coverage under this scheme.
• Since this is not an insurance policy, there are no intermediaries involved in the coverage process.The state government transfers the benefit amount through RTGS.
• Complete cashless coverage can be obtained under this scheme as the government bears all costs including treatment expenses, follow-up consultation, medicines, and transportation etc.
• The claim is settled on a paperless basis to make the claim settlement faster.
• The network hospitals empanelled under this scheme include private hospitals, government hospitals, and standalone dialysis centers.
• There is no specific time frame for beneficiary enrollment, and people can sign up for this cover anytime of the year.
• Civic Centre kiosks and Taluka kiosks have been set up for the beneficiaries so that they can enrol themselves or make any additions or deletions under the scheme.
• Mega health camps and General Health camps are set up by public and private empanelled hospitals.

Benefits of Mukhyamantri Amrutum Yojana

Exclusions of Mukhyamantri Amrutum Yojana

There are no specific exclusions listed out under Mukhyamantri Amrutum Yojana. This scheme covers all reasonable medical expenses incurred by the beneficiary and his/her family. However, certain things like cosmetic treatments or non-emergency procedures may not be covered under this scheme.

Claim Procedure

Mukhyamantri Amrutum Yojana comes with a completely cashless process for all expenses involved in hospitalisation. Once a diagnosis is made, the network hospital will seek pre authorisation for the treatment. The beneficiary must provide the identity card issued at the time of subscribing to this cover. The hospital will proceed with the treatment after the approval is obtained.

Once the treatment is over, the hospital will forward all the documents including medical bills, discharge summary, physician certificate, etc. to the company. For smooth and transparent transaction, the claim amount is settled by transferring the amount through RTGS.

Awards won by the Mukhyamantri Amrutum Yojana

The awards won by the Mukhyamantri Amrutum Yojana designed by the government of Gujarat are:

• SKOCH Awards for Smart Governance 2014
• CSI-Nihilent e-Governance Awards 2013-14
• Best Affordable Healthcare Initiative in the Healthcare summit 2016 at Jaipur
• “Gems of Digital” India Award
• “Best Accessible Healthcare Initiative” by ELETS

Health Insurance Related Pages

Mukhyamantri Amrutum Yojana network hospital list

A number of hospitals and dialysis centres, both public and private, are empanelled under the scheme. Here is a list of all such hospitals from where beneficiaries can enjoy coverage under the scheme.

This unique health insurance scheme will provide financial aid to all those individuals who could not afford to get treatments. Such people need not let their illnesses get worse thanks to the Mukhyamantri Amrutam Yojana by the government of Gujarat.

FAQs on Mukhyamantri Amrutam Yojana

1. How can one find out if he/she is eligible under the scheme?

The rural development department, as well as the urban development department, of the state government prepare lists of people below the poverty line (BPL). Only such individuals are eligible to avail benefits under the scheme. One will have to check if his/her name is in the BPL list to know whether he/she is covered under the scheme.

2. Can insured members get coverage for treatment of any cardiovascular or renal disease?

Yes, treatment of cardiovascular and renal diseases are covered under the plan along with coverage for neurological diseases, cancer, burns, poly-trauma, and neonatal diseases.

3. How many family members can be covered under the scheme?

A family of 5 can avail benefits under the scheme up to Rs.2 lakh.

4. What documents need to be submitted at the time of enrolment?

At the time of enrolment to the scheme, an individual has to submit the following documents:

• Proof of residence
• Proof of identity
• Income certificate
• BPL certificate
5. Will the beneficiary have to pay a fee to enroll himself/herself?

No, the beneficiary need not pay any fee to enroll himself/herself under the scheme.