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HEALTH

Arogya Raksha Yojana Health Micro Insurance

Overview

Health shocks are often the primary cause of impoverishment in India. Almost 80% of health expenditure in India is out-of-pocket. As per WHO report, 32 million Indians go from above poverty to below poverty line due to a health event in the family.

A lady with her ARY Micro Insurance Card


About the Program

Biocon Foundation aims at ensuring access to affordable and quality health services to low income households. The Foundation launched The Arogya Raksha Yojana, Health Micro Insurance in 2005 and since then it serves the economically lower segments of the society. 80% of the members are enrolled with this scheme for more than 7 years. This is a self-paid program where members who enroll for a sum of Rs 275, are covered for surgeries up to Rs 1,00,000 (One Lakh) through a network of approved hospitals.

The Government of Karnataka runs a number of health insurance schemes for people below the poverty line. The number of lives covered under the Arogya Raksha Yojana, Health Micro Insurance scheme till date is more than one lac.

Inorder to scale up the enrollment process, the manual membership is now upgraded to mobile phone based enrollment solution. This has considerably reduced errors while transmitting and relative loss of data. In this process, data captured on the mobile phone is transmitted directly to a centralized server.

Arogya Raksha Yojana Micro Insurance handed over to the beneficiary, Chikballapura


Claims Analysis

Category 2006 2007 2008 2009 2010 2011 2012 2013 2014
No. Lives 56411 62532 69324 72489 74754 79529 58864 36700 34500
Premium 69.09 76.58 84.9 88.77 93.85 116.43 96.4 95.42 81.57
Premium per life 122.47 122.47 122.47 122.47 125.55 146.4 163.76 260.00 236.00
No. of Hospitals 20 20 20 20 30 35 35 38 34
Claims 320 324 410 483 527 452 565 367 354
Value of claims 29.95 68.92 90.84 97.65 112.62 186.28 134.95 78.17 69.15
Av. Claim cost 8414 21273 22157 13471 21370 23183 239000 21300 19533
Claim Ratio(%) 43 90 107 110 122 160 140 81.9 117


Claims by Illness 2013-14

Illness Procedures (2013-14) % of total
Cardiac Procedures 8 2.2
OB/GYN 18 5
Normal Delivery 16 4.5
C-Section 31 8.7
Hysterectomy 6 1.6
Ophthalmology 78 22
All others 197 55.6
TOTAL 354 100


For more details visit
Arogya Raksha Yojana

 
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