Medical Service

Kalaignar Insurance Scheme for life saving treatments

Aravind Eye Hospital Receives Award for Best Kalaignar Kapitu Thittam Implementation
Dr. R.Kim, Chief Medical Officer, Aravind - Madurai has received the Best Kalaignar Kapitu Thittam Implementation Award from Mr. C. Kamaraj, Madurai District Collector at Republic Day function held at Madurai (Reserve Police Line Ground) on January 26, 2011. Totally 6 hospitals in Madurai district have received the award and Aravind Eye Hospital is the only ophthalmic hospital in the list.

Mahathma Eye Hospital is a leading well known and reputed Hospital in the Rockfort City of Tiruchirappalli, Tamil Nadu (India). The Hospital is situated in the heart of the city and easily approachable to all public. The Hospital has its own three story modern building with all facilities and has provision for sixty beds with latest modern equipment for all necessary tests and surgery etc. Mahathma Eye Hospital joined the Tamil Nadu Chief Minister Kalaignar Insurance scheme on 1st October 2009 and successfully completed 350 surgeries till date under the scheme. Our Mahathma Eye Hospital had participated in various KKT camps under the leadership of special Ophthalmologist and a special technical team in many KKT speciality medical camps organized by district Government authorities screened Eye test and gave treatment to the poor people under the scheme. All the time the team was headed by Dr. R.Ramesh, M.S.D.O.FPOS., who is the Chief Medical Officer of Mahathma Eye Hospital, Trichy. 

Mahathma Eye Hospital has been honoured and awarded a Performance Certificate for the best performance under the KKT scheme. Honorable Minister for Health of Tamilnadu, Thiru M R K Panneerselvam has delivered the award during the one year KKT completion function held at Vestry School on 29th August 2010.

Ophthalmic Surgical Procedures under the Kalaingar Insurance Scheme

  • Surgery and other procedures for detachment of Retina)
  • Surgery for Glaucoma)
  • Vitrectomy
  • Laser treatment for Retinopathies
  • Intra vitreal anti veg F Injection)
  • Laser Treatment For Diabetic Retinopathy  

 

Kalaignar Insurance Scheme for Lifesaving Treatments

  • This insurance scheme provides cashless insurance protection against a host of identified high-cost medical contingencies that require surgical care and hospitalisation.

  • About 352 identified surgical procedures affecting more than 13 body-systems are covered and the medical treatment is available in the most modern hospitals that are tied up and networked exclusively for attending to the insured BPL population.

  • The Tamil Nadu State government introduced the ‘Kalaignar Insurance Scheme for Life Saving Treatments in July 2009.

  •  The Kalaignar Insurance Scheme has been implemented in collaboration with Star Health & Allied Insurance Company.

  • The entire premium will be borne by the Tamil Nadu State Government.

  • People who have an annual income of less than Rs.72,000 are eligible for the Kalaignar Insurance Scheme.

  • Under the Kalaignar Kapitu Thittam, the sum insured is Rs.1,00,000/- per family for 4 years. People are eligible to avail cashless medical facilities only in the empanelled hospitals.

Coverage

The scheme provides for the sum insured of Rs. 1,00,000/- for a period of 4 years, per family for surgical procedures and hospitalization for the following treatments:

  • E.N.T
  • Oncology
  • Thoracic
  • Gynecology
  • Haematology
  • Ophthamology
  • Plastic Surgery
  • Vascular surgery
  • Gastroenterology
  • Orthopaedic surgery
  • Cardiac & Cardiothoracic Vascular Surgery.
  • Nephrology / Urology / Neurology & Neuro surgery

The scheme also covers other specified surgeries. Under this scheme the policy undertakes to cover pre-existing diseases as on the day of the commencement of the insurance policy or earlier, which may warrant medical intervention whilst admitted as an in-patient.

Beneficiary

  • Families of members of 26 welfare boards
  • Any family having annual income less than 72,000/-

Benefit limit on Floater Basis

The treatment expenses for any hospitalisation is up to a maximum of Rs.1,00,000 per family for a period of four years, for treating any of the listed medical conditions/ailments in any of the networked hospitals. The benefit on family is on floater basis i.e. the total reimbursement of Rs.1 lakhs can be availed of individually or collectively by members of the family.

 

Enrollment Process

Guidelines:

Members of Agricultural Welfare Board

  • Welfare Board Card
  • Additions based on VAO authorization

Members of Other Welfare Board

  • Welfare Board Card
  • Copy of ration card/VAO authorization
  • Additions based on VAO authorization

Income based enrollment

Income Certificate


 

  • District Collector, overall in-charge of scheme

  • Assisted by Special Deputy Collector, Social Security Scheme and Labour Officer, SSS to deal with enrolment process
  • Deputy Directors (Health Services) would be the nodal officers for implementation of the programme

  • SDC, SSS coordinating with Municipal Commisioners and Executive Officers of Town Panchayats for arrangements

  • Prepare detailed disrict-wise plan (encompassing village-wise in rural areas and ward-wise in urban areas) for enrollment along with Star Insurance

  • Also ensure sufficient IEC
    • Door to door campaigning
    • Posters and bill boards
    • Tom-tom

  • Other IEC
    • Announcement over loudspeakers
    • Press release announcing date and time
  • VAO/District Collector desginated officer to be present at the time of enrollment
  • Designated Official/VAO to ensure no duplication of enrollment and appropriate certificates to be issued

Smart Card

  • Smart Card with biometric information to identify every family under this scheme
  • Photographs of every member along with fingerprints
  • Facility for additions/deletions of members throughout the policy period
  • Enrolment at every village/urban area in the State
  • 750 teams of 2-3 people in field for a period of 3 months
  • Dedicated taluk kiosks for spillovers for an extra period of 3 months
  • Permanent district kiosks for the entire period of the policy

Networking of Hospitals

  • Hospitals shall be empanelled
  • Treatment only at empanelled Hospitals (Government & Private)
  • Minimum of 6 hospitals in each district and a minimum of 15 hospitals in major cities
  • Beneficiary not required to pay any amount to the hospital for the treatment until the limit of Rs.1 lakh is exhausted.

Hospitalization Procedures

Registration

  • Identification
  • Through smart card
  • Through specified alternate identification approach

     

    • Welfare Board Card
    • Ration Card
    • Identity Card (if relative of member)
    • Income certificate for non-welfare board members

Referral slips in prescribed standard format from Government hospital or General practitioner (either government or Private)

Treatment under specified treatment protocols- general ward, post-operative care, etc.

Assistance

  • A key factor for the successful running of the Scheme is that there is guidance and assistance extended to beneficiaries at the time of a claim.

  • Each hospital network is staffed with a Help-Desk Executive who will help and guide the BPL member through the entire procedure so that no one is turned away from receiving the intended medical care.

Total Number of Patients treated under this Scheme: 2101 patients as on 03.02.2011 in Meenakshi Mission Hospital and Research Center, Madurai.

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