Aarogyasri Scheme is a unique Community Health Insurance Scheme being implemented in State. The scheme provides financial protection to families living below poverty line upto Rs. 2 lakhs in a year for the treatment of serious ailments requiring hospitalization and surgery. 949 treatments are covered under the scheme. The objective of the scheme is to improve access of BPL families to quality medical care for treatment of identified diseases involving hospitalization, surgeries and therapies through an identified network of health care providers. The scheme provides coverage for the systems like Heart, Lung, Liver, Pancreas, Kidney, Neuro-Surgery, Pediatric Congenital Malformations, Burns, Post -Burn Contracture Surgeries for Functional Improvement, Prostheses (Artificial limbs), Cancer treatment (Surgery, Chemo Therapy, Radio Therapy ), Polytrauma ( including cases covered under MV Act) and Cochlear Implant Surgery with Auditory-Verbal Therapy for Children below 2 years. All the pre-existing cases of the above mentioned diseases are covered under the scheme.
The beneficiaries of the scheme are the members of Below Poverty Line (BPL) families as enumerated and photographed in BPL Ration Card and available in Civil Supplies Department database. The benefit on family is on floater basis i.e. the total reimbursement of Rs.1.50 lakhs can be availed of individually or collectively by members of the family. An additional sum of Rs 50,000 is provided as buffer to take care of expenses if it exceeds the original sum i.e. Rs 1.50 lakhs per family. Cost for cochlear Implant Surgery with Auditory Verbal Therapy is paid by the Trust up to a maximum of Rs.6.50 lakhs per case.
All transactions are cashless for covered procedures. A BPL beneficiary can go to any hospital and come out without making any payment to the hospital for the procedures covered under the scheme. The same is the case for diagnostics if eventually the patient does not end up in undergoing the surgery or therapy. Hospitals have to conduct free health camp, there by taking advanced evaluation to the doorstep of patient. All the Primary Health Centers (PHCs) which are the first contact point, Area/District Hospitals and Network Hospitals, are provided with Help Desks manned by AAROGYA MITHRAs to facilitate the illiterate patients. The field staff including Network Aarogyamithras were recruited through the district collectors on outsourcing basis.
S.No. | Procedures | S.No. | Procedures |
---|---|---|---|
01. | Open Partial Nephrectomy | 45. | Open Cystolithotomy |
02. | Nephroureterectomy For Transitional Cell Carcinoma Of Renal Pelvis in malignant conditions | 46. | Laparoscopic Pyelolithotomy |
03. | Radical Nephrectomy | 47. | Cystolithotripsy |
04. | Emasculation in malignant conditions | 48. | PCNL |
05. | Open radical cystectomy with Ilealconduit diversion | 49. | Extracorporeal shockwave lithotripsy (ESWL) |
06. | Other Cystectomies in malignant conditions | 50. | ursl |
07. | Total Penectomy | 51. | Nephrostomy - Lithotropsy |
08. | Partial Penectomy | 52. | Dj Stent (One Side) |
09. | Inguinal Block Dissection One Side in malignant conditions | 53. | Single Stage Urethroplasty for stricture Urethra |
10. | Radical Prostatectomy in malignant conditions | 54. | Stage 1 Urethroplasty for stricture Double Stage |
11. | High Orchidectomy | 55. | Stage 2 Urethroplasty for stricture Double Stage |
12. | Bilateral Orchidectomy | 56. | Reconstruction procedure Urethroplasty for stricture |
13. | Retro Peritoneal Lymph Node Dissection(Rplnd) (For Residual Disease) in malignant conditions | 57. | Single Stage HYPOSPADIASIS (ADULT) |
14. | Unilateral Adrenalectomy in malignant conditions | 58. | Stage-1 HYPOSPADIASIS (ADULT) |
15. | Urinary Diversion in malignant conditions(56.6/56.7) | 59. | Stage-2 HYPOSPADIASIS (ADULT) |
16. | Retro Peritoneal Lymph Node Dissection Rplnd As Part Of Staging in malignant conditions | 60. | Transurethral resection of bladder tumour (TURBT) |
17. | Anterior Exenteration (CA. URINARY BLADDER) | 61. | Post Renal Transplant Immunosuppressive Treatment From 7th To 12 Th Month. |
18. | Total Exenteration (CA. URINARY BLADDER) | 62. | Nephrostomy - Renal |
19. | Bilateral Pelvic Lymph Node Dissection(Bplnd) (CA. URINARY BLADDER) | 63. | Nephrectomy for Pyonephrosis/Xgp |
20. | Surgical Management of Congenital Hydronephrosis in Paediatric Patients | 64. | Simple Nephrectomy |
21. | Surgical Management of Ureteric Reimplantations | 65. | Laproscopic Simple Nephrectomy |
22. | Stage 1 procedure for Exstrophy Bladder in Paediatric Patients | 66. | Laproscopic Radical Nephrectomy |
23. | Stage 2 procedure for Exstrophy Bladder in Paediatric Patients | 67. | Lap. Partial Nephrectomy |
24. | Surgical Management of Posterior Urethral Valves in Paediatric Patients | 68. | Bilateral Nephroureterectomy |
25. | Single Stage procedure for Hypospadiasis | 69. | Renal Cyst Excision |
26. | Stage 1 procedure for Hypospadiasis | 70. | Anatrophic Peylolithotomy For Staghorn Caliculus |
27. | Stage 2 procedure for Hypospadiasis | 71. | Endoscope Removal Of Stone In Bladder |
28. | Undescended testis | 72. | Anderson Hynes Pyeloplasty |
29. | Simple Nephrectomy in pediatric patients | 73. | Surgical correction of Vesicovaginal Fistula |
30. | Surgical Correction of Epispadiasis | 74. | Epispadiasis - Correction |
31. | Surgical Correction of Scrotal Transposition In Paediatric Patients | 75. | Closure Of Urethral Fistula |
32. | Surgical Management for Torsion of Testis | 76. | Optical Urethrotomy |
33. | Laparoscopic Orchidopexy In Paediatric Patients | 77. | Perineal Urethrostomy |
34. | Laparoscopic Varicocele Ligation | 78. | Ureteric Reimplantations |
35. | A.V. Fistula surgery (creation) [Pre-Transplant Procedure Only] | 79. | Surgical Procedure for Ileal Conduit Formation |
36. | Renal Transplantation Surgery | 80. | Surgical corrrection of Ureterocele |
37. | Post Renal Transplant Immunosuppressive Treatment From 1st To 6th Months | 81. | Transurethral Resection of Prostate (TURP) |
38. | Orchidopexy Bilateral | 82. | Transurethral Resection of Prostate (TURP) Cyst Lithotripsy |
39. | Surgical management of Torsion of Testis | 83. | Open Prostatectomy |
40. | Surgical correction of Chordee | 84. | Caecocystoplasty |
41. | Partial Amputation Of Penis(Non-Malignant) | 85. | Total Cystectomy |
42. | Total Penectomy | 86. | Bladder Diverticulectomy |
43. | Open Pyelolithotomy | 87. | Surgical Management of Incontinence Urine (Female) |
44. | Open Nephrolithotomy | 88. | Surgical Management of Incontinence Urine (Male) |
S.No. | Procedures | S.No. | Procedures |
---|---|---|---|
01. | Medical Management of Acute Mi (Conservative Management Without Angiogram) | 16. | Patent Ductus Arterious - Single Coil Closure |
02. | Management Of Acute MI With Angiogram | 17. | Patent Ductus Arterious - Multiple Coils Closrue |
03. | Medical Management of Acute MI With Cardiogenic Shock | 18. | Coaractation of Aorta Repair With Stent + Aortoplasty(35.11) |
04. | Medical Management of Acute MI Requiring IABP Pump | 19. | Coaractation of Aorta Repair Without Stent+ Aortoplasty(35.11) |
05. | Medical Management of Refractory Cardiac Failure | 20. | Renal Angioplasty |
06. | Medical Management of Infective Endocarditis | 21. | Peripheral Angioplasty |
07. | Medical Management of Pulmonary Embolism | 22. | PTCA 1 Additional Stent (00.46) |
08. | Medical Management of Complex Arrhythmias | 23. | Perpheral Angioplasty - Additional Stent(00.46) |
09. | Ablation Therapy for Simple Arrythmias | 24. | Coronary Balloon Angioplasty with Drug eluting stent(00.45) |
10. | Medical Management of Pericardial Effusion, Tamponade with Aspiration | 25. | PTCA 1 Additional Drug eluting Stent (00.46) |
11. | Coronary Balloon Angioplasty with stent(00.45) | 26. | Vertebral Angioplasty |
12. | Temporary Pacemaker Implantation | 27. | Balloon Valvotomy |
13. | Permanent Pacemaker Implantation | 28. | Balloon Atrial Septostomy |
14. | Patent Ductus Arterious - Stenting | 29. | ASD Device Closure |
15. | Patent Ductus Arterious - Device Closure | 30. | VSD Device Closure |