As per the World Health Organization reports on health financing,out-of-pocket payments for health can cause households to incur catastrophic expenditures, which in turn can push them into poverty. The need to pay out-of-pocket can also mean that households do not seek care when they need it. National health accounts of India show that 72% of all health expenditure is made by individual households, which is one of the highest proportions in the world, and it is most regressive form of health care financing.
After taking into account the need, status of health financing and existing health insurance schemes in India, the Government of Tamil Nadu took a decision to roll out the Chief Minister’s Comprehensive Health Insurance Scheme.
Key program components
Every member of a family whose annual family income is less than Rs.72,000/- as certified by Village Administrative Officer will be declared eligible for coverage. This scheme will cover approximately 1.34 crore (13,400,000) people.
“Family” includes the eligible member, and the members of his or her family as detailed below: i. Legal spouse of the eligible person; ii. Children of the eligible person till they get employed or married or attain the age of 25 years, whichever is earlier, and who are dependent on the eligible person; iii. Dependent parents of the eligible person.
Every single family can get Rs.1 Lakh per year and a total sum of Rs 4 Lakhs in four years. Certain treatments can get up to Rs 1.5 lakhs. Those who qualify for the program will receive a biometric smart card with the medical details of the family encrypted in it. Patients are able to attend Government and private hospitals who are contracted with the program and use completely cashless transactions up to their insurance limit.