Pune MC area’s urban poor to get Rs 2 lakh health cover for Covid-19 treatment

“This special health insurance scheme is only for treatment of Covid-19 patients registered under EBS category. The civic administration has approached insurance companies to submit proposals for implementing the scheme,” said Kalpana Baliwant, Assistant Medical Officer.

The Pune Municipal Corporation (PMC) has decided to start a special scheme, Covid Suraksha Kavach, for the urban poor in which each family member registered in the civic body’s Economically Backward Class scheme (EBS) will get Rs 2 lakh insurance cover for treatment of Covid-19.

“This special health insurance scheme is only for treatment of Covid-19 patients registered under EBS category. The civic administration has approached insurance companies to submit proposals for implementing the scheme,” said Kalpana Baliwant, Assistant Medical Officer.

According to the EBS, the PMC incurs 50 per cent of medical expenses up to Rs 2 lakh for treatment of various critical ailments of each person. The beneficiary has to register with the civic body every year by paying Rs 200 fee and an EBS card is issued by the PMC. The card is provided only to those families that are residents of area administered by the civic body and hold a yellow ration card or are certified as Below Poverty Line (BPL) category.

The EBS provides assistance of Rs 2 lakh to a member of the registered EBS family in a year, said Baliwant, adding, “The Covid Suraksha Kavach Insurance scheme will provide a health cover of Rs 2 lakh for each eligible member of the registered EBS family. It will specifically cover expenses for investigation and hospitalisation for treatment of Covid-19 of any EWS card holder.”

At least six members of a family of EBS card holders, including the primary card holder, spouse, first two dependent children up to 25 years of age and parents, can benefit under the scheme. In case of physically or mentally handicapped child with more than 50 per cent disability and divorcee daughter, there will be no age limit. This child would be considered a third child and in such case, the family size would be seven.

At present, the PMC has 20,000 families registered under EBS with the total number of beneficiaries being one lakh, Baliwant said, adding, “We expect another one lakh members to register under EBS till the end of the financial year. So, the plan is to cover two lakh citizens under the Covid Suraksha Kavach scheme.”

The Covid Suraksha Kavach scheme will be applicable only for those not availing benefits of any other health insurance scheme, sources said. The state government’s Mahatma Jyotiba Phule Jan Arogya Yojana also provides Rs 2 lakh cover but only if the beneficiary takes treatment in a designated hospital registered under the scheme.

The PMC will pay the yearly insurance premium for the Covid Suraksha Kavach scheme on behalf of the total number of EBS scheme card holders. The scheme will be implemented by insurance intermediary duly licensed by the insurance company as per the guidelines of Insurance Regulatory and Development Authority (IRDA).

The PMC will sign an agreement with the selected insurance company to implement the scheme for one year and failure to abide with the terms will attract penalties as per IRDA guidelines, sources said. The civic body will have the right to accord the contract to another insurer if it finds the insurer’s service track unsatisfactory, sources said.

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