Andhra Pradesh to Provide Universal Health Insurance – Free Coverage for Poor and Rich Alike

Andhra Pradesh has announced a new universal health insurance scheme that removes the divide between poor and rich, ensuring free medical services for all sections of society. The scheme, implemented in a hybrid mode through insurance companies and government support, will cover 1.63 crore families, benefiting nearly 5.02 crore people across the state.

Key Features of the Scheme

• Cashless Medical Services: Treatment will be available in 2,493 hospitals across the state.

• Specialties Covered: 3,257 treatments under 31 super-specialty departments will be included.

• Insurance Mode: Hybrid system with 2,550 medical packages.

  • 324 packages reserved for government hospitals (government bears full cost).

  • 197 packages available in both government and private hospitals (government bears full cost).

  • Remaining packages covered by insurance companies.

Coverage for Families

• BPL Families (1.43 crore families)

  • Annual coverage up to ₹25 lakh.

  • Initial cashless treatment up to ₹2.5 lakh through insurance.

  • Expenses beyond ₹2.5 lakh reimbursed via Dr. NTR Vaidya Seva Trust.

• APL Families (20 lakh families)

  • Annual coverage up to ₹2.5 lakh through insurance companies.

• Working Journalists: Special inclusion under this scheme.

Monitoring and Accountability

• District Grievance Redressal Committees (DGRCs) at district level for supervision.

• State-level Claim Review Committee (CRC) to finalize compensation.

• Strict Action: Penalties for fraud, delays, and violations; suspension or de-recognition of hospitals if rules are broken.

• Confidentiality: Beneficiary data protected under a Non-Disclosure Agreement (NDA).

• Regular Reviews: Fortnightly and monthly evaluations of implementation.

Financial Burden on the Government

The scheme is expected to cost the state government around ₹641.07 crore annually.

• ₹301.58 crore – General treatments

• ₹239.49 crore – High-cost treatments (521 services)

• ₹100 crore – Administrative expenses

In 2024–25, data shows that 99.34% of beneficiary families availed treatment costing below ₹2.5 lakh, while only 8,042 families required higher coverage.

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 This initiative positions Andhra Pradesh as one of the leading states in India providing comprehensive health security for all citizens, regardless of income level.