Aarogyasri Scheme - Telangana

Aarogyasri Scheme is a unique Government-sponsored Community Health Insurance Scheme being implemented by the Government of Telangana. The scheme is the flagship of all health initiatives of the State Government with a mission to provide quality healthcare to the BPL population. The aim of the Government is to achieve “Health for All. 

Objectives of Aarogyasri Scheme in Telangana

To provide Free quality hospital care and equity of access to BPL families to protect against Catastrophic health expenditures through Strengthened public institutions and by the purchase of quality private medical services from an identified network of health care providers through a self-funded reimbursement mechanism (serviced by Trust) to assist BPL families for their catastrophic health needs.

Financial Coverage under Aarogyasri Scheme in Telangana

The scheme shall provide coverage for the services to the beneficiaries up to Rs.1.50 lakh per family per annum on a floater basis and 0.50 lakh through the buffer, thus total coverage is for Rs.2.0 lakhs. There shall be no co-payment under this scheme. The following are the categories under which High-end procedures beyond the financial coverage of 2.00 Lakh are included in the Aarogyasri Scheme.

• Cochlear Implantation Surgery.

• Medical Oncology

• Organ Transplantation Surgeries

• Maintenance Haemodialysis

• Thalassemia

Benefits Coverage under Aarogyasri Scheme in Telangana

The scheme shall provide coverage for the following “Listed Therapies” for identified diseases in Secondary and Tertiary care.

• 949 Secondary and Tertiary Care procedures.

• 126 Follow-up packages.

• 9 Organ Transplantation packages with Lifelong 28 Immunosuppressive Follow-up packages for Organ Transplantation.

• Package includes the following services:

• End-to-end cashless service offered through an NWH from the time of reporting of a patient till ten days post-discharge medication, including complications if any up to thirty (30) days post-discharge, for those patients who undergo a “listed therapy(ies);

• Free evaluation of patients for listed therapies who may not undergo treatment for “listed therapies

• Pre-existing diseases
  All the pre-existing cases of the above-mentioned diseases are covered under the scheme.

• Follow-up Services
  One-year Follow-up package for 126 listed Secondary and Tertiary Care procedures. Follow-up services are provided through fixed packages to the patients who require long-term follow-up therapy including consultation, investigations, drugs in order to get optimum benefit from the procedure and avoid complications.

• Dialysis services are provided under Aarogyasri scheme in Area Hospital Kamareddy and Banswada.

• Free bus pass facility for dialysis patients undergoing treatment under Aarogyasri scheme. Varicose veins treatment has been included among the treatments listed under the Aarogyasri scheme

• Considering the age limit for cochlear implantation surgery is 3 years to 5 years

• Use of bare metal and drug eluting coronary artery stents under Aarogyasri scheme

Eligibility Criteria under Aarogyasri Scheme in Telangana

Following are the eligibility criteria under Aarogyasri Scheme in Telangana.

• Any BPL family can get free cashless treatment up to 2.00 lakh per annum in any of the 322 private/government hospitals across the state

• Patients who are natives of the state of Telangana and not having a White Ration Card, suffering from identified diseases are eligible to obtain the CMCO referral card. The CMCO center will generate the referral card with the digital photograph which will enable the patient to avail cashless treatment under the Aarogyasri scheme.

References

While crafting this guide, we have consulted reliable and authoritative sources, including official government directives, user manuals, and pertinent content sourced from government websites.

• Aarogyasri Nizamabad

• Aarogyasri Kamareddy

• Aarogyasri Karimnagar