SHILLONG: While the convergence of the Megha Health Insurance Scheme (MHIS) and Pradhan Mantri Jan Arogya Yojana (PMJAY) has helped many in the state, the scheme still faces a lot of problems concerning its portability which in turn leads to the harassment of patients who seek treatment outside the state.
In a recent case, an MHIS beneficiary who went to Bangalore for an operation ended up in a situation where the private hospital simply refused to acknowledge the MHIS card.
It was only after the intervention of MHIS officials from Meghalaya that the hospital then offered a discount to the patient.
As the hospital was reluctant to acknowledge the scheme, the officials from the Health and Family Welfare Department took up the matter with the Ministry of Health and Family Welfare in New Delhi after which the hospital finally agreed to give a discount to the patient.
When contacted, officials from the Health and Family Welfare admitted that portability is a major issue when it comes to the PMJAY scheme as other states give more preference to their own patients.
The officials also said that the trend is more common at multi specialty centres.
Stating that the department usually lodges a complaint with the ministry if it receives word that a hospital fails to adhere to the guidelines of the scheme, officials said that the state government would definitely take up the portability issue with the Centre.
According to a cancer patient from Meghalaya who was admitted at a multi speciality hospital in Assam, the hospital plainly told him that it wanted to give priority to its own patients.
The MHIS-IV offers over 2,300 medical and surgical packages and up to Rs 5 lakh coverage per family.
The Central scheme will benefit 3.47 lakh families and the MHIS-IV (converged with the PMJAY) will benefit all households except for government employees.
The benefits of the convergence can be availed at the empanelled health facilities in the state and outside of Meghalaya.
