Aarogyasree

Aarogyasri Scheme is a unique Community Health Insurance Scheme being implemented in State. The scheme provides financial protection to families living below poverty line upto Rs. 2 lakhs in a year for the treatment of serious ailments requiring hospitalization and surgery. 949 treatments are covered under the scheme. The objective of the scheme is to improve access of BPL families to quality medical care for treatment of identified diseases involving hospitalization, surgeries and therapies through an identified network of health care providers. The scheme provides coverage for the systems like Heart, Lung, Liver, Pancreas, Kidney, Neuro-Surgery, Pediatric Congenital Malformations, Burns, Post -Burn Contracture Surgeries for Functional Improvement, Prostheses (Artificial limbs), Cancer treatment (Surgery, Chemo Therapy, Radio Therapy ), Polytrauma ( including cases covered under MV Act) and Cochlear Implant Surgery with Auditory-Verbal Therapy for Children below 2 years. All the pre-existing cases of the above mentioned diseases are covered under the scheme.

The beneficiaries of the scheme are the members of Below Poverty Line (BPL) families as enumerated and photographed in BPL Ration Card and available in Civil Supplies Department database. The benefit on family is on floater basis i.e. the total reimbursement of Rs.1.50 lakhs can be availed of individually or collectively by members of the family. An additional sum of Rs 50,000 is provided as buffer to take care of expenses if it exceeds the original sum i.e. Rs 1.50 lakhs per family. Cost for cochlear Implant Surgery with Auditory Verbal Therapy is paid by the Trust up to a maximum of Rs.6.50 lakhs per case.

All transactions are cashless for covered procedures. A BPL beneficiary can go to any hospital and come out without making any payment to the hospital for the procedures covered under the scheme. The same is the case for diagnostics if eventually the patient does not end up in undergoing the surgery or therapy. Hospitals have to conduct free health camp, there by taking advanced evaluation to the doorstep of patient. All the Primary Health Centers (PHCs) which are the first contact point, Area/District Hospitals and Network Hospitals, are provided with Help Desks manned by AAROGYA MITHRAs to facilitate the illiterate patients. The field staff including Network Aarogyamithras were recruited through the district collectors on outsourcing basis.

1. UROLOGY PROCEDURES

S.No. Procedures S.No. Procedures
01. Open Partial Nephrectomy 45. Open Cystolithotomy
02. Nephroureterectomy For Transitional Cell Carcinoma Of Renal Pelvis in malignant conditions 46. Laparoscopic Pyelolithotomy
03. Radical Nephrectomy 47. Cystolithotripsy
04. Emasculation in malignant conditions 48. PCNL
05. Open radical cystectomy with Ilealconduit diversion 49. Extracorporeal shockwave lithotripsy (ESWL)
06. Other Cystectomies in malignant conditions 50. ursl
07. Total Penectomy 51. Nephrostomy - Lithotropsy
08. Partial Penectomy 52. Dj Stent (One Side)
09. Inguinal Block Dissection One Side in malignant conditions 53. Single Stage Urethroplasty for stricture Urethra
10. Radical Prostatectomy in malignant conditions 54. Stage 1 Urethroplasty for stricture Double Stage
11. High Orchidectomy 55. Stage 2 Urethroplasty for stricture Double Stage
12. Bilateral Orchidectomy 56. Reconstruction procedure Urethroplasty for stricture
13. Retro Peritoneal Lymph Node Dissection(Rplnd) (For Residual Disease) in malignant conditions 57. Single Stage HYPOSPADIASIS (ADULT)
14. Unilateral Adrenalectomy in malignant conditions 58. Stage-1 HYPOSPADIASIS (ADULT)
15. Urinary Diversion in malignant conditions(56.6/56.7) 59. Stage-2 HYPOSPADIASIS (ADULT)
16. Retro Peritoneal Lymph Node Dissection Rplnd As Part Of Staging in malignant conditions 60. Transurethral resection of bladder tumour (TURBT)
17. Anterior Exenteration (CA. URINARY BLADDER) 61. Post Renal Transplant Immunosuppressive Treatment From 7th To 12 Th Month.
18. Total Exenteration (CA. URINARY BLADDER) 62. Nephrostomy - Renal
19. Bilateral Pelvic Lymph Node Dissection(Bplnd) (CA. URINARY BLADDER) 63. Nephrectomy for Pyonephrosis/Xgp
20. Surgical Management of Congenital Hydronephrosis in Paediatric Patients 64. Simple Nephrectomy
21. Surgical Management of Ureteric Reimplantations 65. Laproscopic Simple Nephrectomy
22. Stage 1 procedure for Exstrophy Bladder in Paediatric Patients 66. Laproscopic Radical Nephrectomy
23. Stage 2 procedure for Exstrophy Bladder in Paediatric Patients 67. Lap. Partial Nephrectomy
24. Surgical Management of Posterior Urethral Valves in Paediatric Patients 68. Bilateral Nephroureterectomy
25. Single Stage procedure for Hypospadiasis 69. Renal Cyst Excision
26. Stage 1 procedure for Hypospadiasis 70. Anatrophic Peylolithotomy For Staghorn Caliculus
27. Stage 2 procedure for Hypospadiasis 71. Endoscope Removal Of Stone In Bladder
28. Undescended testis 72. Anderson Hynes Pyeloplasty
29. Simple Nephrectomy in pediatric patients 73. Surgical correction of Vesicovaginal Fistula
30. Surgical Correction of Epispadiasis 74. Epispadiasis - Correction
31. Surgical Correction of Scrotal Transposition In Paediatric Patients 75. Closure Of Urethral Fistula
32. Surgical Management for Torsion of Testis 76. Optical Urethrotomy
33. Laparoscopic Orchidopexy In Paediatric Patients 77. Perineal Urethrostomy
34. Laparoscopic Varicocele Ligation 78. Ureteric Reimplantations
35. A.V. Fistula surgery (creation) [Pre-Transplant Procedure Only] 79. Surgical Procedure for Ileal Conduit Formation
36. Renal Transplantation Surgery 80. Surgical corrrection of Ureterocele
37. Post Renal Transplant Immunosuppressive Treatment From 1st To 6th Months 81. Transurethral Resection of Prostate (TURP)
38. Orchidopexy Bilateral 82. Transurethral Resection of Prostate (TURP) Cyst Lithotripsy
39. Surgical management of Torsion of Testis 83. Open Prostatectomy
40. Surgical correction of Chordee 84. Caecocystoplasty
41. Partial Amputation Of Penis(Non-Malignant) 85. Total Cystectomy
42. Total Penectomy 86. Bladder Diverticulectomy
43. Open Pyelolithotomy 87. Surgical Management of Incontinence Urine (Female)
44. Open Nephrolithotomy 88. Surgical Management of Incontinence Urine (Male)

2. CARDIOLOGY PROCEDURES

S.No. Procedures S.No. Procedures
01. Medical Management of Acute Mi (Conservative Management Without Angiogram) 16. Patent Ductus Arterious - Single Coil Closure
02. Management Of Acute MI With Angiogram 17. Patent Ductus Arterious - Multiple Coils Closrue
03. Medical Management of Acute MI With Cardiogenic Shock 18. Coaractation of Aorta Repair With Stent + Aortoplasty(35.11)
04. Medical Management of Acute MI Requiring IABP Pump 19. Coaractation of Aorta Repair Without Stent+ Aortoplasty(35.11)
05. Medical Management of Refractory Cardiac Failure 20. Renal Angioplasty
06. Medical Management of Infective Endocarditis 21. Peripheral Angioplasty
07. Medical Management of Pulmonary Embolism 22. PTCA 1 Additional Stent (00.46)
08. Medical Management of Complex Arrhythmias 23. Perpheral Angioplasty - Additional Stent(00.46)
09. Ablation Therapy for Simple Arrythmias 24. Coronary Balloon Angioplasty with Drug eluting stent(00.45)
10. Medical Management of Pericardial Effusion, Tamponade with Aspiration 25. PTCA 1 Additional Drug eluting Stent (00.46)
11. Coronary Balloon Angioplasty with stent(00.45) 26. Vertebral Angioplasty
12. Temporary Pacemaker Implantation 27. Balloon Valvotomy
13. Permanent Pacemaker Implantation 28. Balloon Atrial Septostomy
14. Patent Ductus Arterious - Stenting 29. ASD Device Closure
15. Patent Ductus Arterious - Device Closure 30. VSD Device Closure