Exclusive | West Bengal to join Modicare, sign MoU with Centre soon

New Delhi: Prime Minister Narendra Modi with Chief Minister of West Bengal, Mamata Banerjee in New Delhi on Thursday. PTI Photo / PIB (PTI5_25_2017_000200B)

Viswanath Pilla
Moneycontrol News
Mamata Banerjee-led West Bengal has finally decided to come on board Prime Minister Narendra Modi's pet project Ayushman Bharat - National Health Protection Mission (AB-NHPM), a top government official confirmed to Moneycontrol.

West Bengal will be the 26th state to join AB-NHPM popularly called as Modicare. The state will soon sign a memorandum of understanding (MoU) with the Centre marking its entry into the scheme.

The AB-NHPM aims at providing Rs 5 lakh health coverage to 10 crore poor families, covering 40 percent of India's population.

Unlike most other states that are following a trust-based model where claims are settled from a corpus created from central and state government contributions, West Bengal will run the scheme through insurance model. This means the state will buy cover from the insurance company that quotes the lowest premium.

West Bengal was initially reluctant to join Modicare as it runs its own health insurance scheme called “Swasthya Sathi” launched in 2016. The scheme offers basic health coverage for secondary and tertiary care up to Rs.1.5 lakh per annum per family through insurance mode and up to Rs.5 lakh for certain critical diseases such as cancer, neurosurgery, orthopedic and cardiological diseases, among others. All pre-existing diseases are covered from the first day of the policy.

The state was also worried about contributing funds towards AB-NHPM.

Several media reports in February reported West Bengal has decided to opt out of the scheme.

Times of India earlier reported Chief Minister Mamata Banerjee as saying the state will not “waste” its hard-earning resources in contributing to the programme

Barring a few large states like Karnataka, Tamil Nadu, Kerala, Odisha and Telangana, most of the states have decided to be part of NHPS.

"We are confident the rest others will also sign MoUs with us," said Indu Bhushan, Chief Executive Officer of Ayushman Bharat - the agency that's tasked to build and run the scheme.

Bhushan said 3-4 states are expected to join the scheme in a week's time.

To be sure states have started seeing the value and are signing up with NHPS as they are given freedom to operate the scheme and set prices over and above NHPS rates.

In addition, the states also get funding support from the Centre.

However, states have to follow guidelines laid out by Centre on enrollment of patients, empanelment of hospitals, IT systems, governance and calling tenders for insurance companies.