All You Need to Know About the Atal Amrit Abhiyan Scheme in Health Insurance

The Atal Amrit Abhiyan Scheme is a healthcare initiative launched by the Government of Assam with the objective of providing critical care insurance to economically vulnerable citizens of the state. This scheme primarily targets families falling under the Below Poverty Line (BPL) and Above Poverty Line (APL) categories. A key feature of this program is the provision of cashless insurance coverage, enabling beneficiaries to access treatment without the burden of upfront payments.

The scheme is designed to alleviate out-of-pocket medical expenses and improve access to critical treatments. Medi Assist Insurance TPA Pvt. Ltd. serves as the Implementation Support Agency (ISA) for this scheme, managing the claim processes in accordance with the policy’s terms and conditions. Beneficiaries can receive inpatient care at empaneled hospitals, including both public and private hospitals within Assam and select facilities outside the state.

Each enrolled family member is entitled to an annual coverage of up to ₹2 lakh. Additionally, the scheme provides travel cost reimbursements, provided these remain within the daily allowance limits. The scheme covers a total of 438 medical procedures across six major disease categories, namely: cancer, cardiovascular diseases, kidney (renal) disorders, neurological diseases, neonatal conditions, and burn injuries.

Diseases Covered by the Atal Amrit Abhiyan Card

The card issued under the Atal Amrit Abhiyan Scheme offers coverage for various critical illnesses that typically require expensive and prolonged treatments. These include:

• Cancer
• Kidney/Renal Diseases
• Cardiovascular Conditions
• Neurological Disorders
• Neonatal Illnesses
• Burns

Eligibility Criteria

To avail the benefits of the scheme, the following eligibility criteria must be met:

• BPL families with an annual income less than ₹1.2 lakh are eligible for free enrollment.
• APL families with an income ranging between ₹1.2 lakh and ₹5 lakh per year can join the scheme by paying a nominal premium of ₹100 per person.
• Central and State government employees (current or retired) and their families are not eligible for the scheme.
• Applicants must present the necessary documents to verify their income category (BPL or APL).

Documents Required

Applicants must furnish the following documents at the time of enrollment:

• Voter ID
• PAN Card
• Income Certificate
• NFSA Card (for BPL families)
• Recent passport-sized photograph (attested by a doctor)
• Birth certificate (for minors, if applicable)

Enrollment Process

To enroll in the Atal Amrit Abhiyan Scheme, applicants can follow these steps:

1. Visit the National Health Mission (NHM) portal of the Government of Assam to find detailed information and download the application form. Alternatively, forms are available at the enrollment center in each district.
2. Fill out the application form with accurate details.
3. Submit the completed form along with the required documents to the Office of the Joint Director of Health Services in your respective district or mail it to the same office.
4. Once processed, the applicant will be issued an Atal Amrit Card, which can be used to avail cashless treatment at empaneled hospitals.

It is highly advisable to read the scope and coverage of the scheme thoroughly before enrollment. Additional guidance can be obtained through the scheme’s portal or helpline numbers.

Importance of Health Insurance Coverage

Health insurance plays a vital role in ensuring access to timely and quality medical care. It helps safeguard an individual’s savings by covering substantial medical expenses, especially in critical or emergency cases. With insurance coverage, individuals and families can focus on recovery instead of worrying about treatment costs. Moreover, a good health insurance policy offers peace of mind, knowing that hospital expenses will be taken care of without financial strain. For broader protection, one can also consider buying affordable private health insurance plans. To get an idea of the costs involved, a health insurance premium calculator can be used. It is recommended to seek professional advice before purchasing a policy.

FAQs

Who qualifies for Atal Amrit Abhiyan?
The scheme is available to BPL and APL families in Assam with annual incomes up to ₹5 lakh. Families of government employees are not eligible.

What is the ₹12 health insurance?
This refers to Atal Amrit Abhiyan, which offers health insurance coverage for critical illnesses at a nominal premium, making quality healthcare accessible to low-income families.

Can I receive treatment in a private hospital under Atal Amrit Abhiyan?
Yes, treatment is available at empaneled private hospitals, and a list of over 300 hospitals along with their specialties is accessible through the scheme.

What is the income limit for Atal Amrit Abhiyan?
Families with an annual income under ₹5 lakh are eligible for the scheme.

Can a government employee enroll in the scheme?
No, families of government employees—whether currently serving or retired—are not eligible for the Atal Amrit Abhiyan Scheme.

In summary, the Atal Amrit Abhiyan Scheme is a significant step towards making critical healthcare services more accessible and affordable for the economically weaker sections of Assam.