Chennai: The Chief Minister’s Comprehensive Health Insurance scheme (CMCHIS) that provides free treatment to families whose annual income is less than Rs 72,000, has found more takers but the overall awareness remains low as per the recent process evaluation report of the scheme.
The overall claims (by both men and women beneficiaries) under the CMCHIS surged by 38.2 per cent in the last four years. However, overall awareness among the newly enrolled households regarding eligibility for the scheme is low, because 61 per cent of households had reported that they were not aware of the eligibility conditions.
The report said that government spent Rs 9 crore on awareness generation programmes, but the field report has a different tale to convey.
Out of the total 771 hospitals empanelled under the scheme, 616 are private hospitals, but only 12 per cent the eligible population is aware that they could get treatment under the scheme in both empanelled public and private hospitals. Awareness about post-hospitalisation benefits for selected procedures was as low as 7 per cent.
The state has around 56 per cent of the total state population covered under the scheme, where almost three-fourths were continuing from the earlier health insurance scheme sponsored by the Tamil Nadu government, 26 per cent were newly enrolled.
Only 34 per cent of the cardholders (both the newly enrolled in CMCHIS and the earlier ones continuing from the pre-CMCHI scheme) were aware of the eligibility criteria for family members who could be covered under the scheme.
While 60 per cent of the eligible people were unaware that only selected disease conditions were covered under the scheme, 70 per cent did not know that they could get treatment under the scheme in only empanelled public and private hospitals.
However, the total claims that have increased from 255,673 in 2012-13 to 353,525 in 2015-16, rate of increase in claims by males is greater than that by females.
As a result, the share of female beneficiaries to the total has fallen to 34.6 per cent. The share of government hospitals in the claims under this insurance scheme had increased from 35.7 per cent in 2012-13 to 41.9 per cent in 2015-16, with the rest going to private hospitals.
“Government spends Rs 750 crore annually towards the premium for insurance, which is nearly 9 per cent of the total health sector budget,” said Dr Umakant Dash, Head, Department of Humanities and Social Sciences, IIT Madras.
