Claims under PMJAY received for 42% Covid deaths in Karnataka

Suvarna Arogya Suraksha Trust (SAST), the independent agency that implements the Ayushman Bharat-Arogya Karnataka (AB-ArK) scheme has so far received 15,780 claims under the Pradhan Mantri Jan Arogya Yojana (PMJAY), which accounts for 41.48% of Covid patients who died in the state.

In all, 38,037 Covid deaths have been reported so far in the state's official daily bulletins.

While 4,682 claims were of people who succumbed to the virus in a government set-up, 11,098 claims were by people who died in private hospitals.

PMJAY primarily covers BPL (below poverty line) patients (up to Rs 5 lakh per year).

If an individual is uninsured, it covers 30% of the package rates (up to Rs. 1.5 lakh per family per year) for APL (above poverty line) families.

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So far, 2,75,707 Covid patients have taken treatment under PMJAY, out of the 29,86,835 who got sick due to Covid in the state.

Many of these were home-isolated or isolated at Covid care centres. Only those who were hospitalised can raise claims under PMJAY.

"The number of beneficiaries who got AB-ArK benefits for Covid treatment are far fewer than those who are eligible and in need, because many people find availing the scheme difficult in rural hospitals. Secondly, there is limited systemic support to help BPL patients to benefit from AB-ArK," Dr Prashant N S, assistant director (research) and faculty, Institute of Public Health, Bengaluru, said.

Prashant has been working with the adivasi community in Chamarajnagar district since 2014, after his first stint as a doctor from 2003 to 2008 in the same district.

"For instance, tribal patients who travel by bus from BR Hills to the Chamarajanagar district hospital, a distance of 44 km, are asked for BPL/ration cards which they don't carry or a referral letter from the taluk hospital. The process is long drawn and the poor are not educated enough to approach the officials concerned. If the ration card doesn't mention the name of the son (beneficiary), for example, they are asked to approach the panchayat development officer. There are many such instances," he said.

SAST executive director N T Abroo told DH, "The question of producing a BPL card doesn't arise, as once tested Covid positive, a bed is offered to a patient. The scheme was open for Covid patients from BPL, APL, migrant families and other state returnees who do not have any card or documentation. Quite a large number of beds were reserved for walk-in patients who do not have mobile phones, in government hospitals. Triaging was done well, especially in the second Covid wave."

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