Amaravati: The Andhra Pradesh State government has enhanced the role of government hospitals in implementing the recently approved Health Insurance Scheme for All under the hybrid policy.
155 additional medical services at govt hospitals
As part of this, 155 additional medical services have been allocated to government hospitals. With the 169 services already reserved, these hospitals will now offer a total of 324 medical services under the new policy.
In addition, 197 rarely used services under the Dr NTR Medical Services Trust will continue to be provided free of charge through the Trust.
Streamlining of medical services
Health Minister Satya Kumar Yadav reviewed the current services available to beneficiaries under the Dr NTR Medical Scheme and explained how they have been rationalised under the hybrid model.
Earlier, the number of services was shown as 3,257, as many treatments with identical procedures and package values were listed separately.
After reclassification into broader categories, this list has been streamlined to 186 service groups.
Once the 324 services reserved for government hospitals and 197 rarely used services are excluded, the remaining 2,736 services have been reorganised into 2,550, which will now be covered through an insurance company.
The minister assured that all 3,257 services currently available will continue under the new insurance scheme.
How services were consolidated
Officials explained the previous government’s policy of artificially expanding the list of services. Under the new scheme, similar treatments have been merged for clarity and cost control.
1. Fever cases: Dengue, typhoid, and paratyphoid were earlier listed separately despite identical treatment plans. They are now grouped together.
2. Cardiac procedures: Right and left heart catheterisation, including stent placement, have been brought under a single category.
3. Ulcer treatments: Multiple types of ulcer procedures have been merged into a single category.
In this process, 319 similar services were consolidated into 133 categories based on recommendations from a panel of senior doctors.
Allocation to government hospitals
Taking into account available infrastructure and medical staff, the government has added 155 procedures to be exclusively performed in public hospitals. High-volume services such as hysterectomy, appendicectomy, and ENT surgeries are part of this list.
For 197 highly rare procedures—such as thymus gland removal or duodenum resection—payments will continue to be made through the Dr. NTR Medical Trust.
Premium costs and cost control
The government’s premium payments to the selected insurance company will depend on the number of services included in the insurance component.
More services mean higher costs due to pre-authorisation and administration. Officials pointed out that the previous government’s inflated service classification would have increased premiums. The new rationalised classification is aimed at keeping costs under control while maintaining service quality.
Rs 2.5 lakh per year to 1.63 crore families
The hybrid health insurance scheme will provide coverage of Rs 2.5 lakh per year to 1.63 crore families in the state. For the first time, 20 lakh Above Poverty Line (APL) families will also be brought under the insurance net.
Currently, 1.43 crore families receive free treatment under the Dr NTR Medical Services Trust. Under the new system, the government will continue to bear expenses ranging from Rs 2.5 lakh to Rs 25 lakh, depending on eligibility. Special health insurance schemes for employees and journalists will also continue.
Highlights
– 324 medical services reserved for government hospitals.
– 2,736 services streamlined to 2,550 under insurance coverage.
– 197 rare services funded by the NTR Trust.
– 3,257 services in total will continue under the hybrid scheme.
– Coverage extended to 20 lakh APL families for the first time.
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