According to people familiar with the matter, the government is considering allowing Central Government Health Scheme (CGHS) beneficiaries to seek treatment at hospitals affiliated with the flagship Ayushman Bharat-Pradhan Mantri Jan Arogya Yojna (AB-PMJAY).
It is being planned that the beneficiaries of the CGHS scheme can also seek treatment at any of the hospitals across the country empanelled under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojna. It will ensure patients have a larger ambit of hospitals to choose from, especially those patients who are looking for super speciality treatment,” said a senior government functionary aware of the matter, requesting anonymity.
The government runs two separate health insurance schemes, CGHS and AB-PMJAY.
The CGHS primarily serves Central Government employees, both active and retired. The scheme has nearly 4.1 million registered beneficiaries, and 2,000 hospitals and diagnostic centres have been empanelled across the country. The distribution of hospitals is somewhat uneven, with larger cities having more hospitals than tier 2-3 cities.
By offering the option of getting treated at AB-PMJAY hospitals, the ambit would increase for beneficiaries,” said the government functionary cited above.
AB-PMJAY has at least 107.4 million beneficiaries, and until last month, approximately 37.5 million hospital admissions totalling approximately 45,000 crores were authorised through a network of 25,000 empanelled health care providers.
Several changes are in the works for the current public health insurance schemes, including a unified card for AB-PMJAY and schemes run by individual states, according to Union Health Minister Mansukh Mandaviya at a select briefing last month.
“It will be a unified card called Ayushman Card.” We have essentially done co-branding, which allows beneficiaries to use treatment packages from both the Central and state-run health insurance schemes with a single card. Many states have their health insurance schemes, and beneficiaries were often perplexed about empanelled hospitals, implementation support agencies, insurance companies, and third-party administrators. “There will now be a common name,” Mandaviya predicted.
According to the Union Health Ministry, several states are currently running close to 20 schemes.
According to officials in the health ministry, the government is in the process of creating new cards with the Central and state government logos and the words ‘Ayushman Bharat Pradhan Mantri Jan Arogya Yojna-MukhyaMantri Yojna’ imprinted on them to represent the unification.
As part of the new arrangement, eligible beneficiaries of any government insurance scheme will be able to seek treatment at any of the central scheme’s 25,000 empanelled hospitals.
Even though it is not legally required for states to implement the changes, all states, except Delhi, Odisha, and West Bengal, have agreed to implement the proposed changes, according to an official.
The idea of expanding Ayuhsman Bharat empanelled hospitals to CGHS beneficiaries is good as these will be private hospitals offering multi-speciality care. The options will widen, which is a good thing.,” said Dr MC Misra, former director, All India Institute of Medical Sciences, Delhi.
“However, it will be better if the cashless benefit that Ayushman Bharat beneficiaries get is also be extended to CGHS beneficiaries,” he added.
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What is The Full Meaning of Health?
Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. Health may refer to the ability to adapt and manage physical, mental, spiritual, emotional, and social conditions through changes in lifestyle or self-care.
The word “health” is sometimes used as an abbreviation for “health care”, although health care is only one part of what is meant by health. For example, one might speak about the benefits of “going to the doctor” or “taking medicine”, or the costs of not getting enough sleep or exercise.
There are many other factors that impact on health each day: nutrition(the food we eat), childhood experiences (the way we were raised), quality of medical care (the drugs and surgery used), genetics (how strong our immune system is), stress levels (whether we feel anxious or depressed), environmental exposure to chemicals and toxins (pesticides on crops, exhaust from cars) and so on .
Health is a state of optimal physical, mental and social well-being, not merely the absence of disease or infirmity. An important way to promote health is to prevent disease, which can be accomplished through immunization programs and screening for early signs of disease. Promotion of good health often involves advice and education about healthy eating habits, exercise, hygiene, self-care, preventive measures against infectious diseases and other health practices. Health care systems are organizations established to meet the health needs of target populations.
Why do we need a healthy lifestyle?
A healthy lifestyle refers to the habits that help people live longer and healthier lives. A healthy lifestyle includes:
Eating a balanced diet that includes fruits and vegetables.
Not smoking cigarettes.
Kashmiri ASHA worker serves as inspiration by donating blood 28 times
A 32-year-old woman named Bilqees Ara, an ASHA worker, has donated blood 28 times since 2012. She has served as an inspiration to others across the nation.
Bilqees, who is from the Handwara Tehsil in the Kupwara area of North Kashmir, stated that she understands the “importance of blood”.
She said that by donating a pint of blood, she not only saves a precious life but an entire family.
She began donating blood in 2012 and has since given 28 pints.
She expressed her gratitude and pride at being the saviour of so many patients in the Kashmir valley.
I’ve seen people cry helplessly as they try to get blood to save their loved ones, but I’m proud of myself because I’ve arranged blood for them as well. “I felt an inner joy after that,” she said.
In Kashmir, she is known as the “Blood Woman of Kashmir”.
She is a registered blood donor. Whenever a need arises, the officials at the Blood Bank at Handwara hospital call her and, within the shortest span of time, she makes herself available to donate blood.
Women should come forward and do this as there is nothing to be afraid of. This is to be done for society, she said. She also said that she wondered who else would do it if she refused.
If a person has blood and courage, why can’t he give it to someone else in a time of need? She asked.
Covid facilities to reduce in Delhi amid drop in cases
The Delhi government has closed 11 Covid care facilities because to a consistent reduction in cases. Two Covid Care Centers are operational at Ambedkar Nagar Hospital, which has 50 beds, and Balak Ram Hospital, which has 25 beds, according to a government report. Only five admissions were registered at Ambedkar Nagar Hospital over the past three months, while there were none at Balak Ram Hospital.
The number of patients has steadily decreased at the remaining CCCs as well, according to reports.
According to officials, the Delhi Disaster Management Authority on Thursday decided to scale back the medical staff and infrastructure that had been deployed for COVID management in a planned manner. The health department will now formulate an action plan in response to this decision.
“The deven CCCs were closed and dismantled by Delhi government and one by the Centre and three others with total 4000 bed capacity- Radha Saomi Satsang ,Chattarpur, Sawan Kirpal, Burari , and Sant Nirankari, Burari- were closed but not yet dismantled”, officials said.
India’s daily covid tally falls below 5k with 4,858 new cases
India reported 4,858 new Covid-19 cases in the last 24 hours, 806 fewer than yesterday, bringing the total to 4,45,39,046, according to data released by the Union health ministry on Monday. On the other hand, according to the health bulletin, the number of active cases rose to 48,027.
India has 0.11 percent of the infections that are still active, and the Covid recovery rate has risen to 98.71 percent. 2.76 percent was the daily positivity rate, while 1.78 percent was the weekly positivity rate.
Infections with the coronavirus are currently most common in Kerala, followed by Tamil Nadu, Maharashtra, Karnataka, Assam, and West Bengal.
The health ministry stated that as many as 18 fatalities were reported today, taking the death toll to 5,28,355. This included eight deaths reconciled by Kerala.
According to the data available, 2.16 billion doses of vaccines have been administered in the country so far under the nationwide Covid vaccination drive.
On December 19, India’s Covid-19 total had reached one billion. On May 4 and June 23, respectively, last year, it reached the depressing milestones of two and three crore. On January 25 of this year, the number of Covid cases in the nation surpassed four crore.
Over 100 people suffer food poisoning in Manipur
Since Tuesday, over 100 people, including children, have been admitted to hospitals in the Senapati district of Manipur due to a possible case of food poisoning linked to a birthday celebration in the hilly state.
According to medical officer Dr. Th Veidai Shuru of PHC Paomata on Thursday, the majority of the patients, who are from the villages of Tungjoy and Tunggam, were admitted at the Public Health Centre (PHC) Paomata while some were in the Public Health Sub-Centre (PHSC) at Tungjoy.
From Tuesday onward through Wednesday, patients with complaints of loose motion, fever, and bodily soreness were admitted to health centres.
“Now most of the patients are getting relatively better, “said Dr Veidai.
According to reports from medical facilities, about 83 people have been released, and the 31 others are anticipated to leave soon.
According to the specialists, food poisoning is a possibility. According to locals, the primary cause may be the drinking of fermented fish chutney during birthday festivities.
“However, it will take at least 7 to 14 days to get the results for the samples which we collected and sent for testing and we’ve also collected blood samples to check other diseases, Dr Veidai said.”
Meanwhile, representatives from the food safety agency visited a village in the Senapati district to determine what was causing the widespread illness.
Does Medicaid Pay for Air Purifiers?
Medicaid services, as convenient as it sounds, might not be fulfilling enough to live a comfortable life for low-income families. Air purifiers are no more a luxury and have become a requirement to stay healthy. When we come to this, the real question is: does Medicaid pay for air purifiers?
The answer to this simple question is no. Medicaid does not cover air purifiers until and unless it is prescribed by a doctor if you are medically ill. This is not just enough to know; read on to have a better idea of how medicare works and what are your other options.
Does Medicaid Pay for Air Purifiers?
Medicaid is an insuranse plan which does not cover equipment lik air purifier, room heater, humidifier, dehumidifier, and air conditioner. The plan is only entitled to cover only those devices, which are Durable Medical Equipment.
For instance, Medicare is shown to provide Positive Airway Pressure machines if you are medically proven to have obstructive sleep apnea. However, in some cases, Medicaid may reimburse you with an air purifier and humidifier if you are medically proven for its need.
To do so, you must provide a proof showing authentication of your medical need, like a prescription or a letter of medical necessity. The plan only covers medical grade air purifiers and Air Purifier Mag has shared some of the best options that may help you get your air purifier cost covered under Medicaid easily.
Why Original Medicaid does not Include Air Purifier in their Part B?
Original Medicaid part B only covers the equipments under the DME category and since the plan does not categorize air purifiers as a DME, it’s not in the list. They rather believe it to be an environmental control equipment and not primarily medical in nature.
Same is the case with the other such appliances like humidifiers and room heaters that are designed to improve or manage health conditions.
Can you Ask a Doctor to Prescribe you An Air Purifier?
You can request your doctor to prescribe you an air purifier only if you really think it could bring a difference in your health status. Medical grade air purifiers, which use HEPA filters are usually prescribed by the doctors to look after health condiitons like asthma. In some cases, doctors can refuse to sign you a prescription considering its short term benefits.
Does Medicaid Advantage Plus Pay for Air Purifiers?
Medicaid Advantage Plus is a long-term health management solution for people with chronic condition who need health devices and tools in their homes and have access to both Medicare and Medicaid plans.
The MAP plan is offered by the companies associated with Medicaid to cover all the services laid down by the original Medicaid plan.
Unlike the original plan, as allowed by the fall enrollment of 2020, the Advantage plan is more likely to be helpful in covering the cost of health equipment like air conditioners and air purifiers. Coverage plans and type of health devices covered in the Advantage plan vary from one provider to another.
Which Durable Medical Equipment does Original Medicaid Part B Cover?
Medicaid, in general, covers the major chunk i.e. 80% of the Medicaid approved health equipment also called, durable medical equipment, to be used at home. To consider it a DME, Medicaid believes the equipment should be able to be repeatedly used, must only be useful for the sick, and restricted to home usage.
The equipment the plan will cover is based on the plan you choose and your health condition. Here’s a list of equipment Medicaid plan covers:
● Hospital beds
● Seat lifts
● Pacemaker monitors
● Blood glucose monitors
● Wheelchair lifts
● Heating pads
● Oxygen regulators
● Face masks
● Alternating pressure pads, mattresses
● Motorized wheelchair
● Heat lamps
● Sitz baths
Other Ways To Get Inssurance or Pay for an Air Purifier
Either when time is running out or there is no way out to get your prescription approved by Medicaid, you can opt for other ways to cover the expenses for your DME.
Private insurance: Even though FSA or HSA debit card isn’t allowed to be used on purchase of equipments, you can reimburse the amount by FSA after buying it from your own money. Most of the insurance providers cover air purifier as long as a proof is provided in terms of prescription or letter of medical necessaity.
Second Hand: You can always pay for the the equipment from your pocket. However, one needs to understand the cost difference if one opts for an insurance plan. You can directly pay and get second hand DME at half price from Facebook Market place, eBay, or any good thrift store.
Veterans Health Care: With the help of Department of Veterans Affairs, veterans and their spouses have the benefit of getting Medicaid copayment or the complete cost of DME.
Nonprofit Assistance: There are a number of nonprofit foundations and state programs, which help elderly with DME through low or interest-free loans and different programs. Visit your state’s site to have a better idea on the available programs.
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