The Ultimate Glossary of Terms About Arogya Karnataka :health
to extend ‘Universal Health Coverage’ to all residents in Karnataka State. Under this new scheme, primary health care, specified secondary and tertiary health care benefits will be provided. The current ongoing health schemes like Vajpayee Arogyashree, Yeshaswini Scheme, Rajiv Arogya Bhagya Scheme, RashtriyaSwasthayaBimaYojana (RSBY) including RSBY for senior citizens, RashtriyaBalaSwasthayaKaryakram (RBSK), MukhyamantriSantwana Harish Scheme, Indira Suraksha Yojana, Cochlear Implant Scheme, etc. will all be converged under this new Arogya Karnataka Scheme.
About AROGYA KARNATAKA Scheme
The United Nations, people-oriented ‘Millennium Development Goals’ concluded in the year 2015, which triggered new initiatives in the form of ‘Sustainable Development Goals (SDG)’ with a continuing mandate to “Ensure healthy lives and promoting well-being for all, at all ages”. The focus towards achieving Universal Health Coverage for ensuring the wellbeing of all was expressly underpinned in this goal.
Karnataka has been at the forefront of successfully implementing various health care schemes through Suvarna Arogya Suraksha Trust on an Assurance Mode, for the benefit of a large section of BPL and APL populace in the State including Road Accident Victims within the borders of Karnataka. The success of implementation through Assurance Mode was reinforced by the fact that there was a 64 % reduction in Out of Pocket Expenditure (OOE), mortality was reduced by 64 % among BPL families and 12.3 % of households are more likely to access hospital care –as per a World Bank Study. Thus continuing the mandate of SDGs, the government decided to extend Universal Health Care in all the three sectors of primary, secondary, and tertiary care to all residents of Karnataka by pooling resources from various ongoing schemes.
Hence the launch of the pioneering “Arogya Karnataka” dedicated to the people of Karnataka. With this Karnataka is proud to be the FIRST STATE in the Country to declare and implement Universal Health Coverage to insulate Karnataka people from impoverishment as well as to ensure the overall health and well-being of the people of Karnataka.
Arogya Karnataka Scheme Objective
The objective of the Arogya Karnataka scheme is to extend ‘Universal Health Coverage’ to all residents in Karnataka State. Under this new scheme, primary health care, specified secondary and tertiary health care benefits will be provided. The current ongoing health schemes like Vajpayee Arogyashree, Yeshaswini Scheme, Rajiv Arogya Bhagya Scheme, Rashtriya Swasthaya BimaYojana (RSBY) including RSBY for senior citizens, Rashtriya Bala Swasthaya Karyakram (RBSK), Mukhya Mantri Santwana Harish Scheme, Indira Suraksha Yojana, Cochlear Implant Scheme, etc. will all be converged under this new Arogya Karnataka Scheme.
The scheme will be rolled out in Karnataka in phases. In the first phase, 10 major hospitals have been chosen, They are KC General Hospital, Jaya Sri Jayadeva Institute of cardiology and research PMSSY, Victoria Campus, Mandya Institute of Medical Sciences, Mcgann Institute of Medical Sciences, Shimoga, Wenlock District Hospital, Bengaluru, Karnataka Institute of Medical Sciences, Hubli, Gulbarga Institute of Medical Sciences, GulbargaVijayanagara Institute of Medical Sciences, Bellari. In the next phase, it shall be rolled out in other 33 major and district level hospitals within 30.6.2018.
Thereafter, the rollout of the scheme to taluka level hospitals, CHC, and PHCs shall be completed by 30.9.2018, 31.10.2018, and 31.12.2018 respectively.
For accessing the scheme benefits, the beneficiaries have to be enrolled in the “Arogya Karnataka” system. A patient needs to be enrolled at a PHI only once. When a patient approaches a PHI for the treatment, the enrollment staff of the PHI will be enrolling the patient on the enrollment portal developed for “Arogya Karnataka” and generate a unique ID called “ArKID”. The enrollment is based on a person’s Aadhar Card number. The patient’s biometric impression is captured on a biometric device and authenticated with CIDR Aadhar Server. The E-KYC details will be auto-populated.
In case there is a failure in reading the biometric impression of the beneficiary wishing to enroll, other options such as “OTP”, capturing data from the QR code, and getting data from the Food Department’s database are provided.
While benefits of the scheme can be availed in PHIs by the alternate methods provided for enrolment, producing Adhaar card/ number and authentication with the Adhaar database is mandatory for referral to private hospitals.
A mandatory consent will be obtained using a pre-printed self-declaration form from the enrolling beneficiary to use his details only for the purpose of enrollment. The self–declaration form will also contain a section wherein the beneficiary desiring to be enrolled under the “Arogya Karnataka” scheme gives a declaration that he/she does not have insurance in any other scheme.
Patient Entitlement under the Scheme
The PDS card decides the entitlement of the patient and is authenticated via a web service, with the stored PDS details in the Food and Civil Service Database to determine whether the beneficiary belongs to “Eligible Category” or not, as per the norms defined under the National Food Security Act 2013. Accordingly, He will be categorized as an ‘Eligible Patient”. If a beneficiary is not from the “Eligible category” as per the FSA or if the beneficiary does not have a PDS card, he or she will be automatically enrolled as a “General Patient”.
Once the E-KYC form is filled and the beneficiary categorization is completed, the beneficiary will become registered under the Scheme and will be given a unique scheme ID “ArKID” number. The generated unique ID number printed on a card will be provided on payment of Rs.10/- only for the first time to the successfully enrolled beneficiary. For reprinting the card on request of the enrolled beneficiary in case he has lost the card he will be given another card at a cost of Rs.20/- only.
The UHC Card provided will contain a Photo, Name, Unique Scheme ID, and Basic Details of the Beneficiary. An SMS alert will also be sent to the Enrolled Patient to his mobile number wherever the mobile number has been shared with the registration personnel.
Once the Scheme card is generated the patient can access the treatment under the “Arogya Karnataka” scheme.
The beneficiary will not be required to carry his Adhaar card or Food card the next time he visits the hospital for treatment. He will be serviced based on the Arogya Karnataka card.
Eligible Patient: A patient who is a resident of Karnataka State and belongs to “Eligible Household” as defined under the National Food Security Act, 2013;
General Patient: A patient who is a resident of Karnataka State but does not come under the definition of “Eligible Household” as defined under the National Food Security Act, 2013, or does not produce the eligible household card. The treatment cost will be on a co-payment basis.