Experiences of Beneficiaries, Enrollees, Providers and Stakeholders of Tamil Nadu Chief Minister's Comprehensive Health Insurance Scheme (CMCHISTN): A Case study of Gudalur and Pandalur taluk of Tamil Nadu

Abstract

In recent years many states have implemented their own health insurance schemes, Tamil Nadu Chief Minister's health insurance scheme is a similar attempt which was launched for the first time in 2009 and later has been reformed based on the ruling government. This paper is an attempt to study the experiences of both the provider and beneficiaries and other stakeholders through 8 in-depth interviews with the insurance in the Nilgiris district, Tamil Nadu. Thematic analysis provided with various insightful findings, mainly the problem faced by the enrolees was to get the smart card necessary to avail benefit. The startling facts were revealed when few respondents narrate that they were given the smart card at their homes or received it by the Village administrative officer of their village while others had to travel painstakingly several times to the district Ooty for getting the same. Also the providers were of the opinion that there is a need to include more commonly performed surgeries in the list of procedures entitled for reimbursement. Once the enrolees got their smart card they hardly faced any out of pocket expenditure or hindrance in undergoing the intended procedure, except one case where the patient was charged for the procedure but was reimbursed before discharge. As most of the enrolees work in unorganised sector and paid on per day basis, the enrolment method and smart card acquistion needs to be made transparent and hassle-free so that they don't suffer wage loss and other hardships.