Bajaj Allianz General
Insurance Company to provide part of the health insurance under the “Ayushman Bharat-Swasthya Sathi” scheme to over 10 million families in the state, ET has learnt.
The insurance firm has “in principle” agreed to do so at an average premium of Rs 590 per family, two of the persons told ET on condition of anonymity.
West Bengal was initially reluctant to join Ayushman Bharat, known informally as “Modicare”, as it runs its own health insurance scheme called “Swasthya Sathi”, launched in 2016.
Bajaj Allianz has an existing agreement with West Bengal for its state-run scheme, under which it provides Rs150,000 cover per family to around 6.3 million families that offers basic health coverage for secondary and tertiary care, according to three persons directly, aware of the development.
Now, discussions are on to expand the same agreement to cover additional beneficiaries added under the new scheme, which merges Swasthya Sathi with the Ayushman Bharat scheme announced by the centre earlier this year, they said. All pre-existing diseases are covered from the first day of the policy.
Apollo Munich has also secured a contract to provide the entire Rs500,000 coverage per family to as many as 280,000 families in Nagaland at Rs444 premium, confirmed a senior government official.
“The premium rates (for West Bengal) will vary slightly from district to district, based on the risk pool in each district,” said one of these persons. This is because West Bengal previously partnered with Bajaj Allianz to provide insurance for each district separately instead of partnering with the firm through one tender covering the entire state, the person said.
Under Ayushman Bharat-Swasthya Sathi, the state’s existing “Swasthya Sathi” scheme will be merged with the centre’s “Ayushman Bharat-National Health Protection Mission” to cater to a larger pool of beneficiaries.
West Bengal plans to implement the scheme through a mix of third party insurance and state-run trust and the government will pay the premium to the third party insurance company brought on board. It will provide the remaining Rs350,000 health cover through its trust, said the person.
Bajaj Allianz declined to comment on the development at this stage.
West Bengal last week officially came on board to implement Ayushman Bharat under the joint banner “Ayushman Bharat-Swasthya Sathi”, ending months of uncertainty over whether the Trinamool Congress-ruled state would back the initiative.
The centre wants every state to be prepared to roll out the scheme by August 15, Ayushman Bharat-National Health Protection Mission CEO Indu Bhushan told ET earlier.