Govt-provided insurance coverage set to double to ₹10L

Delhi residents may soon see their government-provided health insurance coverage double from ₹5 lakh to ₹10 lakh, with the newly elected Bharatiya Janata Party (BJP) government set to implement the Centre’s Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in the Capital.

For a decade, the Aam Aadmi Party (AAP) government relied on mohalla clinics and the Delhi Arogya Kosh scheme for free healthcare, refusing to adopt AB-PMJAY. Now, in a major policy shift, chief minister Rekha Gupta has announced that Delhi will integrate with the central scheme, with the state adding a ₹5 lakh top-up, bringing total coverage to ₹10 lakh per family.

A memorandum of understanding (MoU) between the Delhi government and the National Health Authority (NHA) is expected soon, paving the way for implementation.

In a media briefing on Friday, V Kiran Gopal, joint secretary, NHA, said the modalities were currently being worked out between the state government and NHA to see the scheme launched in Delhi soon, and while the centre will fund the original ₹5 lakh, the state is free to expand the coverage using their funds.

“We have to strengthen the back-end to ensure the scheme works seamlessly. The MoU modalities are being currently worked out and we should soon be able to sign the MoU, may be in a week or so. Then the state government will create a beneficiary database, following which hospital empanellment and card creation will also begin,” said Gopal.

Delhi is likely to have about 650,000 beneficiaries, if the government manages to sign on the bottom 40% segment of its population, said officials. Currently, 66 Delhi hospitals— both government and private— are empanelled under the scheme. “These hospitals were to treat patients under the scheme portability benefit; but now more hospitals will join to provide treatment to Delhi residents. Delhi Hospitals will find on-boarding attractive as there are additional incentives for most hospitals that are NABH accredited and there’s extra incentive for hospitals in tier-one cities,” said Gopal.

According to people familiar with the matter, is a possibility Delhi government may merge the existing health insurance scheme — Delhi Arogya Kosh — with AB-PMJAY. Plans are also underfoot to rename mohalla clinics as aarogya mandirs.

“The preparatory note is ready and is to be sent to the cabinet. It’s likely that there will be some modifications that may likely include merging existing health schemes with AB-PMJAY,” he said.

On February 17, a meeting to discuss implementation of Ayushman Bharat scheme was held at Delhi Secretariat. HT has accessed minutes of the meeting that said the discussion happened on implementation of ABPM-JAY, Ayushman Arogya Mandirs, Ayushman Bharat Infrastructure Mission Scheme, Ayushman Bharat Digital Mission, and Pradhan Mantri Bhartiya Janaushadhi Pariyojana in Delhi.