Under the Ayushman Bharat scheme, currently serving regular employees, pensioners, and their dependents can avail medical facilities at any private hospitals empanelled with the Haryana government. According to the National Health Authority guidelines, treatment is provided to beneficiaries as per the Health Benefit Package Master, which includes 22,000 procedures. In a bid to ensure better health facilities and the benefits of the aforementioned scheme, the Haryana government recently increased the scope of the Ayushman Bharat scheme, providing free treatment up to Rs 5 lakh, as the number of empaneled hospitals with the state government has increased to 1145. Free treatment is being provided under the scheme in the listed 1145 hospitals of three categories: health institutions of the Government of India, private, and public sector.
Under the scheme, the package master includes 3 days pre-operation and 15 days post-operation, including stay, doctor fees, medicines, investigations, procedure cost, etc. Beneficiaries are provided cashless treatment by the hospitals. After providing treatment, the hospital claims the said treatment on the Transaction Management System Portal. Payment is made to the hospitals by the State Health Authority Haryana in FIFO (First In First Out) mode. In case the procedure is not available in the package master, the hospital can request special approval under unspecified procedures. During the financial year 2022-2023 until the first week of December, 36 cases have been approved, while as many as 67 cases have been approved under unspecified procedures.
Among the listed health institutions under the scheme, 11 hospitals come under the Central Government, while 635 hospitals are private. Apart from these, the remaining 499 hospitals are under the public sector, and with their listing, the needy people in rural areas are also benefiting from the scheme. Now, people with an annual income of Rs 3 lakh have also been included in the scheme. People are taking advantage of the scheme by paying Rs 1500. It is worth mentioning that the maximum number of hospitals listed with the scheme is in Hisar district, where out of a total of 109 hospitals, 76 and 32 hospitals are private and public, respectively, while 1 comes under the Government of India (GOI). In this series, Sirsa and Panipat occupy the second and third positions with 79 and 71 hospitals, respectively, in the aforementioned categories, followed by Karnal, Sonipat, Ambala, Bhiwani, Gurugram, Rohtak, and Mahendergarh with 68, 63, 62, 62, 58, 56, and 54 hospitals empanelled with the government.
A total of 11 hospitals of the Government of India are listed under the scheme, with 4 in Panchkula alone and 3 in Gurugram. Similarly, as many as 4 empanelled hospitals are in Sonipat, Rewari, Hisar, and Ambala, one each. Among the private hospitals listed, the maximum number of hospitals includes 76 in Hisar, followed by 54 in Panipat, 48 in Sirsa, 43 in Karnal, 42 in Ambala, 35 in Rohtak, 64 in Kurukshetra and Yamunanagar, 32 each, and 30 in Sonipat. While in terms of public hospitals, there are 37 hospitals in Bhiwani, 64 in Sonipat and Hisar districts, 32 each, followed by 31 in Sirsa, 30 in Mahendergarh, 29 in Gurugram, and 24 in Palwal. Apart from these, there are a total of 69 hospitals in this category in Jind, Ambala, and Mewat, 23 in each district.
It is worth noting that the benefits of INR 5,00,000 per annum are on a family floater basis, which means the same can be used by one or all members of the family. The scheme has been designed in such a way that there is no cap on family size or age of members. In addition, pre-existing diseases are covered from the very first day. The cover under the scheme includes all expenses incurred on the following components of the treatment: Medical examination, Inpatient treatment and consultation, Daycare procedures, Pre-hospitalization up to 3 days, Medicine and medical consumables, Non-intensive and intensive care services, Diagnostic and laboratory investigations, Medical implantation services (where necessary), Food services, Complications arising during treatment, and Post-hospitalization follow-up care up to 15 days. A cover of Rs 5 lakh per family per year is fixed, and the benefits will be portable across the country.
Apart from the aforementioned, for hospitalization expenses, package rates shall include all the costs associated with the treatment like Registration charges, Bed charges, Nursing and boarding charges, Surgeons, Anesthetists, Medical Practitioner, Consultant fees, etc. Anesthesia, Blood Transfusion, Oxygen, O.T. Charges, Cost of Surgical Appliances, etc., Medicines and drugs, Cost of prosthetic devices, implants, etc., Pathology and radiology tests: Medical procedures include basic Radiological imaging and diagnostic tests such as X-ray, USG, Hematology, pathology, etc. However, high-end radiological diagnostic and high-end histopathology (Biopsies) and advanced serology investigations packages can be booked as a separate add-on procedure if required. Surgical packages are all-inclusive and do not permit the addition of other diagnostic packages.
