Page 15 - Insurance Times August 2023

Maharashtra ready to cobranded card.
SMS hosp incurs huge
implement health cover- The number of ailments covered will
losses due to ‘abscond- increase from 996 to 1,949 ailments
age for all citizens
ing’ patients and the number of hospitals covered
Maharashtra is set to roll out a health will increase from 1,000 institutions to
Patients are knowingly or unknow-
cover for all its citizens, a first of its about 1,200, he said.
ingly causing revenue loss to Sawai
kind, top health authorities said.
Man Singh (SMS) Hospital and also Maharashtra will be a first in covering
even to the state government. As the Centre's Ayushman Bharat all its citizens, he said, adding that
Many patients getting admitted to Pradhan Mantri Jan Arogya Yojana other States have either the Centre's
SMS Hospital for treatment ab- (ABPMJAY) and the State's own Ma- Ayushman Bharat cover, or a local
sconded without informing the doc- hatma Jyotirao Phule Jan Arogya cover running along with the Central
tors and hospital administration. Yojana (MJPJAY) come together, the scheme, but this was only for people
expanded cover will see an increase in with lower economic means.
The patients undergo treatment at
the number of beneficiaries, hospitals
the SMS Hospital and without com-
and procedures covered, MJPJAY act-
pleting the formalities of getting dis- Medical insurance premi-
ing Chief Executive Officer, Vinod
charged from the hospital in a proper
Bondre, said. ums surge 10-25% due to
way, they abscond from the hospital.
A new health insurance company will rising costs, demand
“If a patient has left the hospital or
be appointed for this expanded Premiums of medical insurance policies
absconded, the hospital does not
scheme, Bondre told, adding that the have risen 1025 per cent over the last
get the claim of amount spent on
entire due diligence process will be year, led by medical inflation, techno-
his treatment by the insurance com-
completed shortly. logical innovation, and increased
pany roped in by the state govern-
awareness of healthcare facilities.
ment under Chiranjeevi Health In- The universal health plan was an-
surance Scheme. It is a major con- nounced last week when Union Health The increase by standalone health in-
cern for us,” said Dr Achal Sharma, Minister Mansukh Mandaviya was in surers has been much higher at 1520
medical superintendent, Sawai Man the State. per cent, whereas for general insur-
Singh Hospital. ance companies it has been slightly
Currently, the State scheme provides a
The hospital has come to know that health insurance cover of Rs. 1.5 lakh lower at 1015 per cent due to their
there are cases of patients getting for 2.2 crore citizens. But with the relatively diversified portfolios, said in-
dustry players.
surgeries done here but go to pri- expanded scheme, all citizens in the
vate hospital for post-operative care State will be eligible for a Rs. 5lakh "The cost of healthcare services has
after absconding from SMS Hospital. cover, irrespective of their ration card increased yearonyear, driven by tech-
In some cases, they abscond with- colour, he said, indicating about 12.5 nology enhancements and other costs
out completing the treatment. crore people would be covered on a such as medicines, medical treat-

12 August 2023 The Insurance Times