In its bid to ensure free health services to 93 per cent of the country’s workforce, Centre on Monday launched a cashless health insurance scheme for the unorganised sector.

The scheme, which will be implemented from the next financial year, would cover all the BPL (Below Poverty Line) families without charging anything from them.

Assuming the cost of premium for each household per year would be Rs 600, it would be around Rs one lakh for each district and the total financial implications for the entire scheme for the first year would be about Rs 180 crore.

Releasing the guidelines for the states on the scheme,  Finance Minister P Chidambaram said the total cost would be shared by the Centre and the states at 75:25 ratio.

As part of the scheme, the workers would get a smart card per family with the help of which they could get medical treatment in government hospitals and in selected networked private hospitals with the cost not exceeding Rs 30,000 per family of five members in a year.

Elaborating about the scheme of cashless facility, Oscar Fernandes, minister for Labour and Employment, said there would be a Third Party Administrator, who would be licensed by the Insurance Regulatory and Development Authority.

Third Party Administrator would directly settle all eligible amounts with the network hospitals without the beneficiary paying any money, said Mr Fernandes.

Add on cover

As most of the BPL families are in rural areas, a provision of add on cover has been included in the scheme including out-of-pocket expenses of Rs 50 per day to a patient during hospitalisation maximum upto 5 days.

There is also provision for transport facility upto Rs 50 in case the patient had to be shifted from residence to hospital or from one hospital to another one.

All pre-existing diseases would be covered and there would be no age limit for the beneficiaries.

Maternity benefit upto Rs 5,700 per year would be given to one woman of the family who should be above 18 years of age.

However, limits of maternity benefit should be part of basic sum insured ie Rs 30,000.