Tripura Health Assurance Scheme for Poor (THASP)

The Tripura Health Assurance Scheme for Poor (THASP) is a government-backed health scheme introduced to the residents of Tripura state to provide access to healthcare for families and individuals living below the poverty line within the state.

The scheme aims to extend support to those facing financial constraints in accessing healthcare services. Beneficiaries under the THASP are entitled to health coverage of up to ₹1.15 lakh per annum, along with coverage of ₹10,000 for the journey from Agartala to the hospital and back.

This coverage extends to various medical expenses, including hospitalisation costs, surgeries, therapies, and treatments for critical illnesses.

The scheme operates cashless, facilitating seamless access to healthcare services at designated hospitals. Beneficiaries can avail themselves of treatment without the burden of upfront payment, as expenses are directly settled through the scheme's provisions.

Participating hospitals enlisted under the THASP health scheme in Tripura are mandated to adhere to pricing guidelines established by the Central Government Health Scheme (CGHS).

This ensures uniformity and transparency in healthcare costs, safeguarding beneficiaries against exploitation or excessive charges.

By leveraging a network of accredited healthcare providers, THASP endeavours to broaden access to essential medical services while mitigating financial barriers for economically disadvantaged individuals and families across Tripura.

To qualify for enrollment in the THASP, families must adhere to the following eligibility criteria:

• The total yearly income of the family seeking THASP should not exceed ₹1.5 lakh.

• THASP provides coverage for a maximum of 5 family members – the policyholder's parents, legal spouse, and unmarried children up to 25 years.

• To be eligible for coverage under THASP, all eligible family members' names must be included on the family ration card issued by the Tripura State Government.

To enrol in the THASP, applicants need to provide several essential documents, each serving as a crucial component of the enrollment process:

• Proof of Residence

• Proof of Age/Date of Birth

• Bank Account Details

• Documentation Related to the Patient's Health Condition

• Income Certificate

• The primary goal of the 'Tripura Health Assurance Scheme for the Poor' is to extend financial aid to individuals residing below the poverty line within the state.

• This initiative, featuring a sum assured of ₹1.15 lakh, is designed to alleviate healthcare expenses for families and individuals undergoing treatment at any accredited hospital within Tripura.

• The THASP covers the individual's medical expenses, including hospitalisation, treatments, and critical care, up to the specified sum assured.

• The THASP health scheme in Tripura aims to provide financial assistance to economically disadvantaged individuals by addressing the escalating costs associated with medical treatments and hospital stays.

• With a sum assured of ₹1.15 lakh, the scheme endeavours to mitigate out-of-pocket expenses for families and individuals seeking treatment at designated hospitals within the state.

• THASP ensures coverage for essential medical services such as treatments, hospitalisation, critical care, and surgeries up to the predetermined ceiling limit

Inclusions of Tripura Health Assurance Scheme for Poor (THASP)

• Below are the inclusions of the THASP, encompassing various treatments, surgeries, and diseases:

• Renal and neo-natal diseases

• Eye surgery expenses

• Cancer treatment

• Neurosurgeries medical coverage

• Cardiovascular surgeries

• Polytrauma treatment

Exclusions of Tripura Health Assurance Scheme for Poor (THASP)

• The following are exclusions from the Tripura Health Assurance Scheme for Poor (THASP):

• Ineligibility of government employees to apply for the THASP health scheme in Tripura.

• Students benefiting from the scheme are prohibited from accessing benefits offered by any other scheme with analogous objectives.

Outlined below are several prominent features and advantages of the THASP:

• The THASP health scheme in Tripura offers a maximum sum of ₹1.15 lakh. However, if the treatment expenses at the designated hospital surpass this limit, the patient will be responsible for covering the additional costs.

• Treatment expenses up to ₹1.15 lakh will be directly settled with the listed hospital.

• Transportation expenses from Agartala to the designated hospital and vice versa are included in the scheme. The maximum coverage for transportation expenses is capped at ₹10,000.

• THASP health scheme in Tripura operates on a family floater basis, ensuring coverage for all members of the enrolled family.

• For financial aid related to transportation, the scheme disburses funds either through a bank draft or directly into the beneficiary's account.

Below is the process ensuring eligible individuals receive cashless benefits under the THASP from impanelled hospitals:

• Step 1: Upon receiving the application for medical coverage, the impanelled hospital will be notified via email or fax by health department officials of Tripura, referring the patient for medical treatment. The patient will be provided with a copy of the referral letter.

• Step 2: After receiving the referral letter, the hospital will assess whether the treatment is eligible for coverage based on the scheme's terms and conditions.

• Step 3: Treatment facilities will be covered if they fall within the scope of services listed under the State Illness Fund.

• Step 4: If the treatment is deemed eligible, the State Government will provide coverage up to ₹1.15 lakh. The impanelled hospital will notify the Tripura health department of the incurred expenses and generate a bill for coverage.

• Step 5: Alongside the medical expense coverage bill, the impanelled hospital will forward details of the healthcare services provided to the patient to the Director of the THASP.

• Step 6: The Director will review the bill, and upon approval, the Tripura health department will reimburse the amount to cover medical expenses up to the scheme's ceiling limit of ₹1.15 lakh.

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Our medical insurance for senior citizens often comes with additional benefits such as coverage for pre-existing conditions, daycare procedures, in-patient treatment and more.

In Tripura, where access to advanced medical facilities may be limited in certain areas, our health insurance plan ensures that individuals can avail themselves of necessary treatments without financial strain.

Tripura's journey towards strengthening its healthcare system is underscored by initiatives like THASP, which prioritise the well-being of the marginalised sections of society.

By prioritising the healthcare needs of the poor and vulnerable, the THASP health scheme in Tripura plays a pivotal role in advancing the state's healthcare sector towards greater inclusivity and equity.

Through improved healthcare facilities and comprehensive coverage schemes, Tripura strives to ensure that every individual, regardless of their socio-economic background, can lead a healthy and fulfilling life.

1. How many government hospitals are there in Tripura?

• Tripura boasts six State Hospitals, namely:

• Agartala Govt. Medical College & G. B. Pant Hospital

• Atal Bihari Vajpayee Regional Cancer Centre

• I.G.M. Hospital

• Netaji Subhash State Homoeopathic Hospital

• State Ayurvedic Hospital at the State Headquarters in Agartala

• Modern Psychiatric Hospital in Narsinghpur.

2. What is the health care delivery system in Tripura?

Tripura's healthcare infrastructure is organised into three tiers: a primary healthcare network, a secondary system that includes district and sub-divisional hospitals, and tertiary hospitals offering specialised and super-specialised medical care.