Universal Health Insurance Scheme (UHIS)

9 months ago Sarkari user 0
Universal Health Insurance Scheme (UHIS):
Three important points of UHIS:
  • The Universal Health scheme policy will be available for both Individuals as well as in Group.
  • Each Insured should cover all eligible members (insured persons) under one group policy only. In other words different categories of eligible members shall not be allowed to be covered under different group policies. It is not permissible to issue any unnamed group policy.
  • The Individual Policy will be issued in the name of the earning head of family with details of insured family members. The Group policy will be issued in the name of the Group/Association/Institution (called insured) with a schedule of names of the members including his/her eligible family members(called Insured persons) forming part of the policy.

HOSPITALIZATION EXPENSES:

The four public sector general insurance companies have been implementing Universal Health Insurance Scheme for improving the access of health care to poor families. The scheme provides for reimbursement of Hospitalization expenses for illness / diseases suffered or injury sustained by the Insured Person up to Rs.30,000/- towards hospitalization floated amongest the entire family, death cover due to an accident @ Rs.25,000/- to the earning head of the family and compensation due to loss of earning of the earning member @ Rs.50/- per day up to maximum of 15 days. The Universal Health Insurance Scheme (UHIS) has been redesigned targeting only the BPL families. The premium subsidy has been enhanced from Rs.100 to Rs.200 for an individual, Rs.300 for a family of five and Rs.400 for a family of seven, without any reduction in benefits.

The Policy is extended to include one Maternity Benefit with liability under the Section being restricted to Rs.2,500/- for normal delivery and Rs.5,000/- for caesarean delivery. A waiting period of 12 months from inception of the policy is applicable. The above amount would also cover the medical expenses incurred in respect of new born child upto 3 months. However, this benefit is within the overall limit of Sum Insured of Rs.30,000/- This benefit is available only once to an insured person during the currency of the policy or its subsequent renewals. ie. only once during the life time of insured person.

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