Karnataka Government has introduced unique scheme called Arogya Bhagya Yojane to its Police Personnel and their families, which was launched during June 2002. This scheme is a self-financing scheme managed through monthly contribution from the Police Personnel themselves & through medical reimbursement from the Government. The scheme is administered by a Nodal Agency having expertise in Medical administration.
The Nodal Agency identifies high-tech hospitals among Government recognized Hospitals for the purpose of medical reimbursement with excellent infrastructural facilities in districts and cities in the State. An amount of Rs.26.39 Crores up to 15-10-2005 have been spent towards medical treatment for Police personnel and their families. At present the scheme is running successfully.
Evolution of ABY
Announced on April 2nd ‘2002
Launched on 1st Aug ‘2002
Over 60000 Police personnel enrolled under the scheme
Over 69 quality care hospital providers (including Govt. hospitals) are empanelled across the state
Scheme operated under Karnataka Police Health Welfare Trust
Contribution under ABY
Gazetted employees shall contribute Rs.50/-
Non Gazetted employees shall contribute Rs.40/-
Most Revolutionary Features of the Scheme
Most revolutionary fact pre-existing diseases no bar to avail the benefit.
Cashless transaction across Karnataka State and complete transaction from time of admission till discharge of the member is cashless.
All ailments are covered as per Karnataka Govt. Medical Attendance Rules 1963.
Implants, prosthesis and materials are excluded under Karnataka Govt. medical Attendance Rules 1963 BUT are covered under ABY.
Over view of the utilization
Specialty wise Disease Profile
Entities involved
Implementation of the Scheme
Trust
The DG & IGP is the Chairman
The Addl. DGP is the Vice-Chairman
The IGP, G&HR is the Secretary
Governing Body
Fund maintenance & Disbursement
Dept of Police
Periodic Review
Member identification
Membership protocol - collection of contribution
Monitoring Reimbursement
Feed Back
Accident Relief Care
Administration
Network management
Claim processing
Services to member
Reporting – MIS
Periodic review
Dedicated Manpower
ARC (I) PL has dedicated team consisting of Medical Doctors, Administrators, Field Co-ordinators, Network Executives
Assist the members in getting admission in network hospitals
Periodic meeting with unit officials for speedy reimbursement
Random record verification
Customer feedback / analysis
Over all co-ordination & recording of incident
Success factor
Public private participation with missionary zeal
Defined and extensive network of hospitals
Effective administration by ARC
Good cooperation and commitment for the scheme by the officers of Police department
What Can Hamper The Scheme?
Irregular / delayed / No contribution from individuals
Delayed reimbursement
Delayed payment to network hospitals
Non Existence of network hospitals in each district
Non acceptance of Karnataka Govt. tariff by the network hospitals
Spin off Benefits
Better health…
productivity contributing
to better public service
