Atal Amrit Abhiyan Health Insurance Scheme 2024 : Assam State Peoples Avail Free Treatment upto Rs. 2 lakh

Atal Amrit Abhiyan Health Insurance Scheme:- Atal Amrit Abhiyan is a new health insurance scheme announced by the State Government of Assam. Under the scheme, the government is providing insurance coverage of up to Rs. 2 lakh per year to each family of the state. The scheme was originally launched on 25 December 2016 and is still running. Assam Atal Amrit Abhiyan Application form can be downloaded in PDF format from the official website of the scheme. Atal Amrit Abhiyan health insurance scheme was launched for BPL and APL families besieged with chronic, sudden, or acute health issues.

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Various diseases like cancer, Cardiovascular diseases, Cancer, Kidney diseases, Neonatal diseases, brain and heart-related ailments and burn injuries have been included in the scheme. The beneficiary can go for the treatment only in government-aided and CGHS empaneled hospitals in the state. There have been 245,491 APL Enrollments, 15,889,339 BPL Enrollments, and 85,717 treatment Under AAA till 23rd March 2020.

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All the beneficiaries can avail cashless treatment (not reimbursement) at govt. and empaneled private hospitals inside and outside the state. The enrollments for the scheme are open and one can reach out to the enrollment center to get themselves registered under the scheme.

Atal Amrit Abhiyan Health Insurance Scheme : Highlights

What is Atal Amrit Abhiyan Health Insurance Scheme

The scheme “Atal Amrit Abhiyan Scheme” is a flagship scheme of the Government of Assam to provide cashless treatment and coverage of critical care targeted at the Below Poverty Line (BPL) population and Low-Income households. To address this key vulnerability faced by the BPL population and Low-Income households in the State, the Government of Assam has launched the health assurance scheme “Atal Amrit Abhiyan Scheme” which aims at making treatment more affordable and also to limit the disastrous financial impact that households often experience due to out of pocket spending.

Under this scheme, treatment benefits up to ₹2.00 lakhs per individual annually towards approved procedures on a complete cashless basis is given. Beneficiaries can avail of cashless treatment under the scheme in the empanelled Government/Private Hospitals in six critical care specialities.

Application Form Download for Abhiyan Health Insurance Scheme

Six Disease of Atal Amrit Abhiyan Health Insurance Scheme

• Cancer
• Heart disease
• Kidney disease
• Neurological disorder
• Neonatal diseases
• Burns

Vistarita Atal Amrit Abhiyan specialities

• ICU Packages
• Trauma
• Critical Care Paediatrics
• Paediatric Surgery
• Japanese Encephalitis and Acute Encephalitis Syndrome
• Supplementary Procedure (Bone Marrow Transplantation is also covered under AAA).

Objective of Atal Amrit Abhiyan

To address this key vulnerability faced by the BPL population and Low Income households in the State, the Government of Assam has launched the health assurance scheme“Atal Amrit Abhiyan” providing cashless treatment and coverage of critical care targeted at the BPL population and Low Income households. The Health Assurance Scheme, Atal Amrit Abhiyan aims at making treatment more affordable and also to limit the disastrous financial impact that households often experience due to out of pocket spending.

Hospitals Comes Under Atal Amrit Abhiyan Health Insurance Scheme

Hospitals, public, trust, and private-within and outside the state, have been empanelled under the Scheme. Empanelled hospitals are the only hospitals where the beneficiary is entitled to free cashless treatment (up to the eligible amount) under the Scheme.

Note 01: The Scheme is being implemented through one Implementation Support Agency (ISA) named Medi Assist Insurance TPA Pvt. Ltd., selected and engaged for the purpose.

Note 02: Each individual adult member of the eligible families will be enrolled for the purpose through the ISA and will be issued a laminated ID card having a unique identification number to facilitate a cashless treatment facility at the empanelled hospitals. Children below 18 years of age will be enrolled with the head of the family.

Benefits of Atal Amrit Abhiyan Insurance Scheme

1. The scheme will provide inpatient treatment facilities at the empanelled hospitals (Private and Public) up to a maximum limit of ₹2.00 lakh per individual member per annum within and outside the State of Assam covering 438 procedures.
2. The six diseases such as cardiovascular diseases, Cancer, Renal (Kidney) diseases, Neo-natal diseases, Neurological conditions & Burns will be covered under the scheme.
3. Cashless treatment and coverage of critical care targeted at the Below Poverty Line (BPL) population and Low-Income households.
4. The enrolled beneficiary is to be treated or can be admitted without making any payment to the hospital.
5. There will be no pre-existing condition exclusions. Pre-existing diseases are also covered from day one which means that any illness existing prior to the inception of the scheme shall also be covered.
6. The travel expenses of visiting people, treatment, and the daily allowance are also covered in this scheme.
7. For out of State treatment in empanelled hospitals in selected cities, patients and one attendant will be provided economy cheapest airfare on that route.

Eligibility of Atal Amrit Abhiyan Health Insurance Scheme

1. All the BPL families in the state with income of less than Rs. 1.2 lakhs per annum will get free health care under the scheme.
2. Moreover, those who belong to the APL category with income between Rs. 1.2 lakhs and 5 lakhs per annum have to pay a nominal premium of Rs. 100/- per year per member to avail of the scheme.
3. All the employees who are working or retired in the service of the Central and State Government will not be eligible for this scheme.
4. All documents of each enrollment will be checked properly whether they belong to BPL or APL category.

Documents Required for Atal Amrit Abhiyan

1. Attested copy of the Voter ID card
2. Aadhaar Card
3. Pan Card
4. Photograph of the Patient (Attested by Doctor)
5. For every BPL family member, National Food Security Act (NFSA) card
6. For every other family member, an income certificate from the Circle officer signifying annual family income as less than ₹5.00 Lakhs.
7. Birth certificate for a minor member of the family.

Application Fees for Atal Amrit Abhiyan

Members of other families having an annual family income of ₹5 lakhs or less are required to pay a nominal amount of ₹ 100/- per individual at the time of enrolment. Every year at the time of the yearly renewal ₹100 will be charged from such family members. AND Enrollment under the scheme is totally free for members of the BPL families.

How to Apply Online for Atal Amrit Abhiyan Health Insurance Scheme?

There is Only Offline application process for Atal Amrit Abhiyan Health Insurance Scheme. and this process are given below step by step:-

Step 01: Applicant can visit the official website and download the application form: https://nhm.assam.gov.in/schemes/detail/atal-amrit-abhiyan-0

Step 02: Fill out the application form completely and visit the nearest enrolment center. (All beneficiaries must be physically present at the enrollment center)

Step 03: The Verifying Officer scrutinizes all documents and verifies eligibility.

Step 04: Other than BPL family members receive a uniquely numbered challan for depositing the premium into the designated bank account.

Step 05: After verification (and payment of challan when applicable), the Operator takes a photograph of and also captures the fingerprints of each beneficiary.

Step 06: The operator issues the unique Atal Amrit Abhiyan Card (AAA ID card) along with the scheme hand-out to beneficiaries.

Note 01: Enrollment under the scheme is totally free for members of the BPL families.

Note 02: Members of other families having an annual family income of ₹5 lakhs or less are required to pay a nominal amount of ₹ 100/- per individual at the time of enrolment. Every year at the time of the yearly renewal ₹100 will be charged from such family members.

Steps to be followed for availing treatment by beneficiaries In the empaneled Hospitals

Step 1: Beneficiaries approach nearby Sub Divisional Civil Hospital/District Hospital/Medical College & Hospital/empaneled Hospital. Arogya Mitras would facilitate the beneficiary. If the beneficiary visits any other Government hospital other than the empaneled Hospital, the doctors will give him/her a referral card to the empaneled Hospital after the preliminary diagnosis.

Step 2: The Arogya Mitra engaged by the Implementation Support Agency examines the referral card and barcoded laminated card and facilitates the beneficiary to undergo preliminary diagnosis and basic tests.

Step 3: The empaneled Hospital, based on the diagnosis, admits the patient and sends a preauthorization request to the Implementation Support Agency.

Step 4: Doctors/Specialists of the Implementation Support Agency examine the preauthorization request and approve preauthorization within 24 hours of receiving the preauthorization request from the empaneled hospitals, if all the conditions are satisfied.

Step 5: The empaneled Hospital extends cashless treatment and surgery to the beneficiary subject to the limits prescribed under the scheme.

Step 6: Ernpaneled Hospital after discharge forwards the original bill, discharge summary with the signature of the patient, and other relevant documents to the Implementation Support Agency for processing and settlement of the claim within one week (7 days) from the date of discharge of the patient.

Step 7: Implementation Support Agency scrutinizes the bills and forwards the payment request of the bi to the State Nodal Cell (SNC) within fifteen days (15 days) of the receipt of bills from the empaneled Hospital.

Step 8: The State Nodal Cell (SNC) after verification of the bills in lieu of the services provided will directly make the payment by way of electronic transfer to the empaneled Hospital(s) within 30 days of receiving the bills from the Implementation Support Agency.

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