Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY), the State’s insurance scheme for the poor, is set to empanel nearly 500 more hospitals in the next few months. The scheme, which is now implemented along with Centre’s Pradhan Mantri Jan Arogya Yojana (PMJAY), has applications from 1,200 hospitals that are now being scrutinised by the authorities.
“At present, we have 492 hospitals empanelled with us. For better reach, we are in the process of increasing this number to 1,000,” said MJPJAY’s chief operating officer Sudhakar Shinde. The focus is to empanel hospitals on the taluka level. “Urban areas have most of the hospitals. In Maharashtra, there are at least 200 talukas that still don’t have a single hospital under the scheme. We are aiming to get at least two hospitals in each taluka,” said Dr. Shinde.
The MJPJAY covers 2.2 crore families for 971 ailments at a cost of ₹1.5 lakh per year. The beneficiaries are yellow-and-orange ration-card holders. In the 14 farmer suicide-affected districts, the scheme also covers white ration-card holders. While the MJPJAY is based on ration cards, the PMJAY, unveiled in Maharashtra in September 2018, has beneficiaries identified on the basis of Socio-Economic Caste Census, 2011.
While the schemes have empanelled all public hospitals and smaller private hospitals, top corporate hospitals have stayed away from being a part of it due to low package rates. According to Mr. Shinde, they are in the process of revising a few rates and also increasing the umbrella of ailments covered under the scheme. “For example, the package rate of dialysis treatment will go up to ₹1,100 from ₹800. The ‘open reduction internal fixation procedure’ for fractures may go up to ₹20,000 from ₹15,000,” he said. He also said they were on the verge of closing a new tender for the expanded scheme. At present, the National Insurance Company is providing insurance for MJPJAY.
