Bypass for Rs 1.10L, stent for Rs 50K: ‘Modicare’ may roll out from I-Day

Union health ministry fixes charges for 1,352 diagnostic tests and surgical procedures under the proposed National Insurance Scheme

New Delhi: The government has fixed the charges for 1,352 diagnostic tests and surgical procedures under the Modicare National Health Insurance Scheme. The Scheme would provide a health insurance cover of up to Rs 5 lakh and may be launched from August 15 this year, covering around 55 crore individuals, including socially and economically backward and BPL citizens.

Under the scheme, the insured persons can get knee implant for Rs 90,000, stent implant for Rs 40,000 and go through cardiac bypass surgery for Rs 1,10,000.

Delhi govt willing to join

The Delhi government has agreed to join the scheme. Dr. Indu Bhushan, CEO of the National Health Protection Mission said that under the scheme, the costs of procedures, surgeries and investigations will be lower than the Central Government Health Scheme (CGSHS). A complete list of the charges will be published soon.

Charges for some common procedures:

  • Knee implant:                         Rs 90,000
  • Stent:                                     Rs 40,000
  • Cardiac bypass surgery:        Rs 1.10 lakh
  • Cardiac valve replacement:   Rs 1.20 lakh
  • Arthroscopy:                         Rs. 20,000
  • Hip joint replacement:          Rs 90,000
  • Knee surgery:                       Rs 25,000
  • Cervical surgery:                  Rs 20,000
  • Hysterectomy:                     Rs 50,000

Punjab, WB say no

Punjab and West Bengal have refused to join the scheme. The two states said that they have already implemented similar schemes and did not need a new one.

According to Brahm Mohindra, Punjab’s health minister, the state government is not against the National Health Insurance Scheme. “We have some questions, which remain unanswered to date. Punjab already has a number of similar schemes. However, we are still discussing the issue”, he added.

15,000 hospitals to join; will receive up to 30% incentive

The government is preparing to link 15,000 hospitals to the scheme. The Ministry of Health has decided to give 30 per cent incentive to the private hospitals which join the scheme. NABH-approved hospitals will be paid an amount 10 per cent higher than the one fixed for various procedures.

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