Programmes & Schemes
Health is a precursor to happiness and prosperity. Without good health, life is difficult, happiness elusive, and prosperity cannot be enjoyed. Access to affordable healthcare is a vital component of good health. Most medical conditions are curable or can be managed if caught early. However, access to affordable healthcare, including early diagnosis, is a distant dream for so many people who live below the poverty line, as well as to many living above it. The hilly north-eastern state of Meghalaya is home to around 30, 00,000 residents. Many of them are poor tribals with inadequate access to quality healthcare. They suffer from several endemic and lifestyle-related illnesses that can be treated effectively with early diagnosis and treatment. Therefore, MHIS was envisaged to build on the existing RSBY coverage with an aim to reduce the out of expenditure (OOP) of the people of Meghalaya Megha Health Insurance Scheme(MHIS) is a universal health insurance scheme (UHIS) in the State of Meghalaya, utilizing the existing RSBY framework to provide health insurance to all persons that are resident in the State excluding state and central government employees. The Megha Health Insurance Scheme (RSBY + UHIS) was launched on 15th December, 2012 at Polo Grounds by the Hon’ble Chief Minister Dr Mukul Sangma with an objective to provide financial aid to all the citizens of the state at the time hospitalisation and reduce the out-of-pocket expenses of the residents of the State.
When the scheme first started the cover available to enrolled beneficiaries was Rs 1,60,000 for an enrolment fee of Rs 31/-. But improvements and amendments have been made to the scheme in the years that followed. Now, MHIS Phase III has an enhanced insurance cover of Rs 2,80,000 for up to 5 members of a family on a floater basis. Additionally, a Senior Citizen cover has been introduced whereby each enrolled senior citizen per smart card belonging to BPL and NREGA category will receive an additional insurance cover of Rs 30,000. The enrolment fee for MHIS Phase III is Rs 50/- and the scheme does not have any age limit. In addition, pre-existing diseases are also covered under this insurance scheme. The insurance policy is valid for a period of one year, and beneficiaries are expected to renew their smart cards on a yearly basis by paying a nominal amount. The smart cards provided in this scheme can only be used in MHIS empanelled hospitals across the state and other secondary and tertiary care hospitals which have been empanelled outside the state of Meghalaya. New India Assurance Company Ltd is the Insurance Company identified for implementing the scheme and they have been selected through a rigorous and competitive bidding process
The main Objectives of MHIS are:
- To create a sustainable and practical universal health insurance scheme for the residents of the State of Meghalaya. To enhance the hospital network, implementation, administration, enrolment and utilization of the benefits under the Scheme.
- To adhere to quality database maintenance of the population of the State.
- Ensuring costing packages are monitored rigorously which is aimed at minimizing out-of-pocket expenditure.
- To provide adequate cover after considering the incidence rate of regional diseases and diseases or illnesses requiring tertiary care procedures.
- To improve the overall service quality, including patient care facilities
- To provide strong quality control, monitoring and fraud control mechanisms.
- To strengthen citizen voice and empower patients by influencing their health seeking behaviors.