Challenges Faced By Beneficiaries Of NHA'S Health Insurance Scheme: Insights And Solutions

livemint.com:

health insurance scheme, designed to provide health coverage of up to Rs. 5 lakh per family per year for secondary and tertiary care hospitalization.

The scheme targets economically vulnerable families identified through the Socio-Economic Caste Census (SECC) data.Despite its ambitious goals, several challenges affect the effective implementation and utilization of the scheme by beneficiary NHA.Many potential beneficiaries are unaware of their eligibility or the benefits provided under the scheme. This lack of awareness can be attributed to inadequate information dissemination and outreach efforts.Solution: Enhancing awareness campaigns through grassroots-level initiatives, community health workers, and local government bodies can improve knowledge about the scheme.

Leveraging digital platforms and local media can also play a crucial role in spreading information.Enrollment in the PM-JAY scheme requires a beneficiary NHA to have a valid identification, such as an Aadhaar card. However, many eligible individuals lack the necessary documents, making the enrollment process challenging.Solution: Simplifying the enrollment process and providing assistance for obtaining necessary documents can help.

Mobile enrollment units and camps in remote areas can facilitate easier access to enrollment services.Beneficiaries often face difficulties accessing empaneled hospitals, particularly in rural and remote areas. The limited number of empaneled hospitals in certain regions restricts beneficiaries' ability to utilize the scheme effectively.Solution: Increasing the number of empaneled hospitals, especially in underserved regions, is essential.