Center for Health Market Innovations (CHMI)

Programs

Raigarh Ambikapur Health

last updated Jun 14, 2012

Overview

Legal Status: 
Private (not-for-profit)
Year Launched: 
1980
Stage: 
Existing/expansion stage

Funding

Primary Source of Funding: 
Membership/subscription fees
Additional Source(s) of Funding: 
In-kind contributions

Scale

Number of Clients Served: 
53,598 as of 2002
Summary: 

Raigarh Ambikapur Health Association is a voluntary community based health insurance scheme providing coverage to individual families and students. The scheme targets rural, tribal populations and allows for cash or in-kind premium payments.

Key program components: 

The scheme is open for new membership between October and January (harvest season). Students can also enroll in June – July each year. 45% of clients men and 55% women. The annual premium is paid at the time of enrollment. Members can either pay US$0.44 (Rs. 20) or the in-kind equivalent to two kilos of rice per person per year for primary level care (as of 2005).

At village level members can receive free basic healthservices. Members receive outpatient care including free consultation and medication up to US$2.22 (Rs. 100) per year, and inpatient care including free consultation, a 50 % rebate on the total bill. The maximum rebate for hospitalization is US$27.77 (Rs. 1250) on total treatment per year. For maternal care and delivery, the client pays only US$1.11 (Rs. 50). Hospital level: Rebate to the extent of US$27.77 (Rs. 1250) given on total treatment per year.

Depending on the travel distance to the hospital, patients’ contribution towards hospital services are: US$5.55 (Rs. 250) for an adult for distances up to 25 Km, US$4.44 (Rs. 200) for an adult for distances up to 50 Km, US3.33 (Rs. 150) for an adult for distances up to 75 Km, and US1.90 (Rs. 100) for an adult for distances greater than 75 Km. A co-payment of US$1.11 (Rs. 50) is applied to students for regardless of the distance to the hospital (as of 2005).

Program history: 

Raigarh Ambikapur Health Association was formed in 1969 by the Catholic Church in aneffort to encourage local tribal populations to seek health care. The health insurance scheme was started in 1980.

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