OBJECTIVE: To improve access of Below Poverty Line (BPL) and Above Poverty Line (APL) families (excluding White Card Holders as defined by Civil Supplies Department) to quality medical care for identified speciality services requiring hospitalization for surgeries and therapies or consultations through an identified Network of health care providers SCHEME: Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) would be implemented throughout the state of Maharashtra in phased manner for a period of 3 years.The insurance policy/coverage under the RGJAY for the eligible beneficiary families in 8 districts: Gadchiroli, Amravati, Nanded, Sholapur, Dhule, Raigad, Mumbai and Suburbs BENEFITS: scheme would provide 972 surgeries/therapies/procedures along with121 follow up packages in following 30 identified specialized categories: 1 GENERAL SURGERY 2 ENT SURGERY 3 OPHTHALMOLOGY SURGERY 4 GYNAECOLOGY AND OBSTETRICS SURGERY 5 ORTHOPEDIC SURGERY AND PROCEDURES 6 SURGICAL GASTRO ENTEROLOGY 7 CARDIAC AND CARDIOTHORACIC SURGERY 8 PEDIATRIC SURGERY 9 GENITOURINARY SYSTEM 10 NEUROSURGERY 11 SURGICAL ONCOLOGY 12 MEDICAL ONCOLOGY 13 RADIATION ONCOLOGY 14 PLASTIC SURGERY 15 BURNS 16 POLY TRAUMA 17 PROSTHESES 18 CRITICAL CARE 19 GENERAL MEDICINE 20 INFECTIOUS DISEASES 21 PEDIATRICS MEDICAL MANAGEMENT 22 CARDIOLOGY 23 NEPHROLOGY 24 NEUROLOGY 25 PULMONOLOGY 26 DERMATOLOGY 27 RHEUMATOLOGY 28 ENDOCRINOLOGY 29 GASTROENTEROLOGY 30 INTERVENTIONAL RADIOLOGY BENEFICIARY FAMILIES: holding yellow ration card, Antyodaya Anna Yojana card (AAY), Annapurna card and orange ration card from eight districts viz. Gadchiroli, Amravati, Nanded, Sholapur, Dhule, Raigad, Mumbai city and Suburban Mumbai. The families with white ration card holding would not be covered under the scheme. The beneficiary families would be identified through the “ Rajiv Gandhi Jeevandayee Health Card ” issued by the Government of Maharashtra or based on the Yellow and Orange ration card issued by Civil Supplies Department. HEALTH CARDS: eligible families in these districts shall be provided with Rajiv Gandhi Jeevandayee Arogya Yojana Health Cards in due course of time. This Health Cards will be used for identification of Beneficiary families in the family under the Scheme. Family Health Cards will be prepared by using data from valid Yellow or orange ration cards coupled with Aadhaar numbers issued by UID authorities. As an interim measure till the issuance of health cards, the valid Orange/Yellow Ration Card with Aadhaar number or in case Aadhaar number not available, any Photo ID card of beneficiary issued by Govt. agencies (Driving License, Election ID,) to correlate the patient name and photograph would be accepted in lieu of health card. FAMILY: Family means members as listed on the Rajiv Gandhi Jeevandayee Arogya Yojana Health Cards or holding valid Orange/Yellow Ration Card. IDENTIFICATION: Health card issued by Govt. of Maharashtra/Rajiv Gandhi Jeevandayee Arogya Yojana Society or valid Orange/Yellow Ration Card with Aadhaar number if Health card is not issued would act as a tool for beneficiary identification for availing the health insurance facility. The following actions would be undertaken by Network hospitals in case of the possible exceptional situations:
Posted on: Fri, 23 Aug 2013 11:36:32 +0000
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