All You Need to Know About the Atal Amrit Abhiyan Scheme in Health Insurance

The Atal Amrit Abhiyan Scheme is a health insurance scheme launched by the Government of Assam. It aims to provide critical care insurance to the underprivileged residents of the state. At present, families who come under the BPL (Below Poverty Line) and APL (Above Poverty Line) categories can claim compensation under the Atal Amrit Abhiyan Scheme. A unique feature of the Atal Amrit Abhiyan Scheme is that the insurance coverage will be available on a cashless basis. Let’s learn more about the Atal Amrit Abhiyan Scheme below.

What is Atal Amrit Abhiyan?

The below pointers give a fair overview of the features and coverage of the Atal Amrit Abhiyan Scheme:

1. The objective of the scheme is to help the vulnerable sections of the state receive critical care treatment and limit their out-of-pocket spending for the covered diseases.
2. An Implementation Support Agency (ISA) named Medi Assist Insurance TPA Pvt Ltd. has also been roped in. It will help make the cashless health insurance process easier for those involved. Claims are subject to terms and conditions set forth under health insurance policy.
3. The scheme will provide inpatient treatment facilities at empanelled hospitals (i.e., private and public hospitals under the network of the scheme). Hospitals outside the State have also been empanelled.
4. The coverage per member of a family is limited to Rs 2 lakhs per annum.
5. The scheme also covers the travelling expenses of the families if it falls within the daily allowance limit.
6. A total of 438 procedures for the following categories of diseases would be covered under the scheme:
7. Cardiovascular diseases
8. Neonatal diseases
9. Neurological diseases
10. Kidney or renal diseases
11. Cancer
12. Burns

Now, let’s look at who can opt for the Atal Amrit Abhiyan Scheme and the conditions involved.

Diseases Covered by Atal Amrit Abhiyan Card

The Atal Amrit Abhiyan Card provides coverage for a range of critical illnesses, offering much-needed support to individuals in need of costly medical treatments. This initiative aims to make healthcare more affordable and accessible, especially for those facing severe health conditions.

1. Cancer
2. Kidney Diseases
3. Cardiovascular Ailments
4. Neurological Disorders
5. Neonatal Conditions
6. Burns

Eligibility Criteria for Atal Amrit Abhiyan

To be eligible for the benefits of this health insurance scheme, applicants must keep the following criteria in mind:

1. All BPL families with an annual income of less than Rs 1.2 lakhs are eligible for the scheme, free of cost.
2. All APL families with an annual income between Rs 1.2 to Rs 5 lakhs are eligible for the scheme, with a nominal premium of Rs 100 per individual.
3. Individuals working or retired from the Central or State Government services are not eligible for the scheme.
4. The documents shall be thoroughly scrutinised to check whether the individual belongs to APL or BPL category.

Documents Required For Atal Amrit Abhiyan

The applicant must possess the following documents:

1. Voter ID
2. Pan card
3. Income certificate
4. NFSA card (applicable for BPL families)
5. A photograph of the patient (attested by a doctor).

In the case of minors, a birth certificate might be required.

What is the Enrolment Procedure for the Atal Amrit Abhiyan Scheme?

The enrolment process of the scheme is still underway. To enrol, you must follow the given steps:

1. Visit the National Health Mission (NHM) portal of the Government of Assam, where you can access the details of the scheme and the application format. You can also visit the enrolment centre in the district and obtain the form.
2. Fill out the application form, providing the required details.
3. Submit the application form with the required documents at the office of the Joint Director of Health Services of your district. You can even send the same via post.

Once the process is complete, you will receive an Atal Amrit card. You can use this card to avail of cashless treatments at empanelled hospitals. It is advisable to read in detail about the reach of the scheme before you enrol for it. You can do so by visiting the website/ portal for the scheme and by reaching out via available contact numbers.

Importance of Health Insurance Coverage 

Having health insurance can benefit a person in many ways. It can allow you to get access to quality treatment. This can help you and your loved ones recover faster from any health issues.Furthermore, in the absence of health insurance, the treatment expenses would have to be funded by your savings. By taking care of the expenses, health insurance coverage can also help you preserve your savings. * Lastly, it can provide peace of mind. With health insurance, you can be certain that you do not have to worry about hospital bills if you or your loved ones were to get hospitalised. * You can also buy affordable health insurance policies from a private health insurance provider for higher coverage. To get an idea of the premiums of such a plan, you can use a health insurance premium calculator. It is ideal to reach out to a knowledgeable professional before proceeding.

FAQs

Who is eligible for Atal Amrit Abhiyan?

The scheme is open to Below Poverty Line (BPL) and Above Poverty Line (APL) families in Assam with an annual income up to ?5 lakh. Families of government employees are not eligible.

What is 12 rupees health insurance?

This refers to the Atal Amrit Abhiyan, which offers health coverage for critical illnesses at a minimal cost, making healthcare more accessible.

Can I avail treatment in a private hospital under the Atal Amrit Abhiyan?

Yes, beneficiaries can avail treatment at empanelled private hospitals under the scheme. A list of 303 private hospitals and their specialities is available.

What is the income ceiling under the Atal Amrit Abhiyan?

The annual family income must be below ?5 lakh to qualify for the scheme.

Can a government employee enroll for Atal Amrit Abhiyan?

Families of government employees are not eligible to enrol in the Atal Amrit Abhiyan. * Standard T&C Apply. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.