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(A Joint Venture between Govt. of Maharashtra and TCS) Rajiv Gandhi Jeevandayee Arogya Yojana.

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Presentation on theme: "(A Joint Venture between Govt. of Maharashtra and TCS) Rajiv Gandhi Jeevandayee Arogya Yojana."— Presentation transcript:

1 (A Joint Venture between Govt. of Maharashtra and TCS) Rajiv Gandhi Jeevandayee Arogya Yojana

2 (A Joint Venture between Govt. of Maharashtra and TCS) 1.Objective of the scheme 2.Beneficiaries. 3.Benefits 4.Health card 5.Family and Sum insured 6.Package Details 7.Cashless Transaction 8.Process at Health Cards by VLE 9.Aarogyamitra and its Process Flow (Arogyamitra) 10.Pre-Printed Stationary 11.Role of SCAs VLE. 12.Role of Directorate of Health Services 13.Commercials for Health Cards Service 14.Business Potential for SCAs 15.Contact us for Beneficiary Agenda

3 (A Joint Venture between Govt. of Maharashtra and TCS) To improve access of Below Poverty Line (BPL) and Above Poverty Line (APL) families. To provide Quality health care for identified specialty services requiring hospitalization for surgeries through Network hospitals. 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 Objective of the Scheme

4 (A Joint Venture between Govt. of Maharashtra and TCS) Beneficiaries Families holding - Yellow Ration cards (BPL Families) - Orange Ration cards (APL Families) - Antyodaya Anna Yojana card and - Annapurna card 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.

5 (A Joint Venture between Govt. of Maharashtra and TCS) Scheme would provide 971 surgeries/therapies/procedures along with121 follow up packages in following 30 identified specialized categories Benefits Sr. No.Specialized CategoriesSr.No.Specialized Categories 1GENERAL SURGERY16POLY TRAUMA 2ENT SURGERY17PROSTHESES 3OPHTHALMOLOGY SURGERY18CRITICAL CARE 4GYNAECOLOGY AND OBSTETRICS SURGERY19GENERAL MEDICINE 5ORTHOPEDIC SURGERY AND PROCEDURES20INFECTIOUS DISEASES 6SURGICAL GASTRO ENTEROLOGY21PEDIATRICS MEDICAL MANAGEMENT 7CARDIAC AND CARDIOTHORACIC SURGERY22CARDIOLOGY 8PEDIATRIC SURGERY23NEPHROLOGY 9GENITOURINARY SYSTEM24NEUROLOGY 10NEUROSURGERY25PULMONOLOGY 11SURGICAL ONCOLOGY26DERMATOLOGY 12MEDICAL ONCOLOGY27RHEUMATOLOGY 13RADIATION ONCOLOGY28ENDOCRINOLOGY 14PLASTIC SURGERY29GASTROENTEROLOGY 15BURNS30INTERVENTIONAL RADIOLOGY

6 (A Joint Venture between Govt. of Maharashtra and TCS) Health Cards Rajiv Gandhi Jeevandayee Health Cards will be issued to families based on Yellow, Orange Ration cards, Antyodaya Anna Yojana, Annapurna cards. Health Cards will be used for identification of Beneficiary 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

7 (A Joint Venture between Govt. of Maharashtra and TCS) Family and Sum Insured Family means members as listed on the Rajiv Gandhi Jeevandayee Arogya Yojana Health Cards or holding valid Orange/Yellow Ration Card The Scheme shall provide coverage for meeting all expenses relating to hospitalization of beneficiary up to Rs.1,50,000/- per family per year in any of the Empanelled Hospital subject to Package Rates on cashless basis through Health cards or valid Orange/Yellow Ration Card. The benefit shall be available to each and every member of the family on floater basis i.e. the total annual coverage of Rs.1.5 lakh can be availed by one individual or collectively by all members of the family. Coverage up to INR 2, 50,000/- (for renal transplants).

8 (A Joint Venture between Govt. of Maharashtra and TCS) Package details The package rates will include Bed charges in General ward, Nursing and boarding charges, Surgeons, Anesthetists, Medical Practitioner, Consultants fees, Anesthesia, Blood, Oxygen, O.T. Charges, Cost of Surgical Appliances, Medicines and Drugs, Cost of Prosthetic Devices, Implants, X- Ray and Diagnostic Tests, Food to inpatient, One time transport cost by State Transport or second class rail fare (from Hospital to residence of patient only)

9 (A Joint Venture between Govt. of Maharashtra and TCS) Cashless Transaction Transaction shall be cashless for covered procedures at Network hospitals. Beneficiary will go to hospital and come out without making payment to the hospital. When the beneficiary visits the selected Empanelled hospital and services of selected Empanelled hospital should be made available The facility of cross referral to nearest another Empanelled hospital is to be made available Aarogyamitra will also provide the beneficiary with the list of nearby Empanelled hospitals.

10 (A Joint Venture between Govt. of Maharashtra and TCS) Beneficiaries will visit CSC along with their valid and eligible Ration cards CSC VLE will verify the details as per the ration card and asking the beneficiaries accordingly. CSC VLE will search Health Card through MahaOnline Portal by any one method from four options. VLE will print valid info on pre-printed stationary provided to VLE at free.

11 (A Joint Venture between Govt. of Maharashtra and TCS) Aarogyamitra A friend and guide for patient Registration & Enrollment Counseling the patient Creating Awareness Assuring patients interest Help patient to avail the benefit of the scheme

12 (A Joint Venture between Govt. of Maharashtra and TCS) Process Flow (Arogyamitra)

13 (A Joint Venture between Govt. of Maharashtra and TCS) Pre-Printed Stationary VLE will receive Pre-Printed stationary from RGJAY society absolutely free, in bunch of 500 Blank Health Cards. These Pre-Printed stationary will be available to VLE at Taluka Health Officer(THO) at taluka level. VLE will have to visit them with their VLE identity proof, and collect Pre-Printed stationary.

14 (A Joint Venture between Govt. of Maharashtra and TCS) Role of SCAs VLE SCAs VLE will receive Pre-Printed stationary from RGJAY society absolutely free. SCAs VLE will search the health cards through given 4 search option (Personal Details/Ration Card No/UID No/Village Data). SCAs VLE will have confirm the details with the beneficiary, along with the name of family manbers. SCAs VLE then print it on Pre-Printed stationary and handover it to beneficiary. SCAs VLE should provide this services absolutely free and should not charge any to beneficiary. SCA VLE will be paid by Government of Maharashtra RGJAY for each card printing, hence should not charge to beneficiary. SCAs will generate INVOICE on No. of card printed and forward it to Maha-Online, and received amount in 10 working days.

15 (A Joint Venture between Govt. of Maharashtra and TCS) Role of Directorate of Health Services DHS- Directorate of Health Services will also ensuing printing of cards where connectivity is low or No-Connectivity through EXE file. DHS- Directorate of Health Services will delivery the Pre-Printed Stationary via Taluka Health Officer to VLE. DHS- Directorate of Health Services will distribute Health cards at the location where internet connectivity is low or no existence of any VLE.

16 (A Joint Venture between Govt. of Maharashtra and TCS) Commercials for Health Cards Service

17 (A Joint Venture between Govt. of Maharashtra and TCS) Business Potential for SCAs Name of SCA's SCA's Division Name Sum of Imported Head of the Family Count Total Count Business Potential () CMS Amravati 14,96,712 46,11,10423,05,552 Aurangabad 31,14,392 SPANCO Konkan 13,78,319 51,66,86725,83,,433 Pune 37,88,548 MOL Nagpur 19,42,325 Basix Nashik 23,09,434 11,54,717 Grand Total 1,40,29,730

18 (A Joint Venture between Govt. of Maharashtra and TCS) Business Potential for SCAs Sr.DivisionDistrict Imported Head of the Family Count Sr.DivisionDistrict Imported Head of the Family Count 1 Amravati Yavatmal (510) 4,87, Konkan Thane (517) 7,43,974 2Buldhana (500) 4,67,176 16Ratnagari (528) 4,08,465 3Washim (502) 2,76,842 17Sindudurge (529) 2,25,880 4Akola (501) 2,65, Pune Pune (521) 16,88,508 5 Aurangabad Aurangabad (515) 7,24,247 19Kolhapur (530) 8,16,200 6Beed (523) 6,46,092 20Satara (527) 6,50,951 7Latur (524) 4,37,039 21Sangli (531) 6,32,889 8Osmanabad (525) 3,80, Nagpur Nagpur (505) 9,93,104 9Parbhani (513) 3,40,628 23Chandrapur (509) 4,52,391 10Jalna (514) 3,37,492 24Wardha (504) 2,59,260 11Hingoli (512) 2,48,852 25Gondia (507) 2,37, Nashik Nashik (516) 11,07,229 13Jalgaon (499) 8,83,144 14Nandurbar (497) 3,19,061

19 (A Joint Venture between Govt. of Maharashtra and TCS) Contact us for Beneficiary For any assistance VLE should guide the beneficiary and its family members with below contact details. Help-Line No: website :

20 (A Joint Venture between Govt. of Maharashtra and TCS)


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