The National Health Protection Scheme is likely to have an annual premium of less than ₹1,100, with the Centre and States saying it should be closer to ₹1,050 for every family.
The scheme, which is likely to be launched on August 15 with Prime Minister Narendra Modi’s Independence Day address, is expected to provide complete health insurance cover to a family of five.
Industry sources said that insurers were keen on keeping the premium a bit higher at about ₹1,500-2,000 per year for the scheme to be feasible.
However, the government is banking on the scale of the scheme as well as previous schemes such as the Rashtriya Swasthya Bima Yojana while fixing the premium.
Niti Aayog, which is finalising the contours of the Ayushman Bharat National Health Protection Scheme, is in the last rounds of discussions with insurers and States.
It is expected to finalise the full details of the health insurance scheme, and also finalise a tender for calling bids from insurers by early next month with an upper limit for the premium.
At present, the ceiling is likely to be set for only one year and could be revised from the second year, based on the response.
“The idea is to keep the annual premium as close to ₹1,000 per family as possible as it will make it more affordable. People often have to reassess costs at even marginally higher prices of even ₹1,100 or ₹1,500,” noted a source, adding that it would ensure that insurers also do not face losses.
Officials also point out that the very low rates for the annual premium for other government insurance schemes, such as the Pradhan Mantri Jeevan Jyoti Bima Yojana and the Pradhan Mantri Suraksha Bima Yojana of ₹330 and ₹12, respectively, have made them tremendously popular with crores of subscribers.
“Insurers under Ayushman Bharat will not have to worry about losses, given the huge market that will be available to them,” noted a senior government official.
Announced as part of the Union Budget 2018-19, the government had said the National Health Protection Scheme would cover over 10 crore poor and vulnerable families or about 50 crore beneficiaries. It would provide coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalisation.