Healthcare & PM-JAY

RASHTRIYA SWASTHYA BIMA YOJANA (RSBY): 2016-17

• Thuhmahruai:

Ministry of Health & Family Welfare hnuaia Scheme, chhungkaw ziaklutten kum khata damdawiin admit senso 30,000/- thleng hman theih na.

II.RSBY Huam Chin Category-te:

1.RSBY BPL. 

2.RSBY APL- MNREGA Job Card nei leh Street Vendor chhungkua te

III.Enrolment (Inziahluh) Dan Tur: 

Mahni bial Sub-Centre-ah Enrolment Fee Rs 30/- nen INZIAHLUH tur.

Chumi hnuah THLALAK leh FINGER PRINT (kut zung thla) lak tur. Thlalak hun hi Veng tin Information Center atanga inhriattir thin a ni.

RSBY hmang thei- SMART CARD a Thlalak leh Fingerprint pete chauh

IV.Damdawi In-a RSBY hmanga Inenkawl Dan Tur: 

Damdawiin ah Smart Card a Chhungkaw member finger print pe ve ngeiin kalpui tur, damloin fingerprint pek theih loh a kalpuitu pek ah.

Damdawiin RSBY counter-ah in admit hma ngeia in report a, kut zung nem (fingerprint) leh a tul dang tih zawhah in Admit theih chauh a ni.

Chhuah dawnah kut zung nem leh phawt a chhuah chauh tur. Chhuah hnuah ‘Smart Card’ hmangin a Bill theih loh.

• Damdawiin senso man hi rate pawmsa chin bak a hman theih loh. Damdawiin ah ni 7 aia tam awm chuan phalna dang lak a ngai.
• Kal man 100/- Hospital-in an pe ang.
• RSBY Smart Card hi 1.4.2016 - 31.3.2017 thleng a hman theih. A kum leh a hman theih tur chuan tih nun thar/thlalak thar leh a ngai.
• Harsatna nei ten a chinfelna tur thlen theihna phone nambar te chu:

V.Naupiang hlim- Scheme intan hnua naupiang, chhungkua-a ziahluh lo chu, naute nu hming chawiin enkawl nghal theih a ni.

VI. RSBY hnuaia Bill theih loh natna te (A bak zawng a bill theih vek): 

1.Admit ngai lova (OPD) enkawl theih natna

2.Natna bik vang ni lova Serh tan hrim hrim a Bill theih loh.

3.Accident/natna vang lova Plastic Surgery (LASIK below-8 vision telin).

4.Tarmit, Contact Lens, beng dar leh Vaccine lakna man.

5.Chauh satliah vanga damdawi ina inenkawlna/investigation tihna.

6.Congenital external diseases- nunna a khaihlak phah chuan a huam

7. Insiam, Fa neih theihloh leh hmeichhiat/mipat hmansualna natnate.

8. Mahni intihnatna, Zu & Drugs nghei duh vanga enkawlnate (Detox).

9. HIV leh AIDS (MSACS hnuaia a thlawna inenkawlna bak a huam).

10. Investigation tihduh vanga damdawiin a Admit.

11. Vitamin leh Tonics chauha in admit emaw Doctor-in a chawh loh.

12. Indo leh Nuclear Weapons vanga natna.

13. Hormone Replacement Therapy, Sex change.

14. Ayurvedic, Homeopathic leh Naturopathic enkawlnate.

Note: Private Damdawiin a Hepatitis B & C enkawl in RAL (Request authorization Letter- Pre authorization) a ngai. 

VII.RSBY hnuaia 2016-17 a bill theih tharte:

Fa neih tawh zat limit a awm lo. Psychiatric/Psychosomatic natnate, day care treatment ang pawh in a huam.

MIZORAM STATE HEALTH CARE SCHEME (MSHCS): 2016-17

I.Mizoram State Health Care Scheme-in a huam theihte:

RSBY BPL & RSBY APL Smart Card nei & Above Poverty Line (APL) pangngai

I.a.RSBY BPL Smart Card nei:

Enrolment Premium hranpa pek a ngailo. RSBY hnuaia bill theih chin 30,000/- hman zawh hnuah, MSHCS ah eng natna pawh (70,000/- thleng) leh critical illness (2,00,000/- thleng) reimbursement in a bill theih.

I.b.RSBY APL Smart Card nei & APL pangngai:

RSBY APL tan RSBY hnuaia 30,000/- hman zawh hnuah MSHCS ah reimbursement in Critical illness a bill theih. APL pangngai (Sorkar a bill theilo tan) Critical illness chauh a bill theih. Enrollment fee pek dan chu:

II.2015-16 tan a Natna Bill Theih (Critical Illness) Thlanchhuahte:- 

MSHCS hnuaiah heng natna thlanchhuahte chauh hi APL & RSBY APL tan a Bill theih (RSBY BPL tan 1.a a tarlan ang a ni) [Heng critical illness natna vei si, natna dang critical list lo in a belhchhahna a Bill theih loh]:-

a.Cardiology and Cardio Thoracic Surgery (Lung lampang)

1.Coronary By-pass Surgery (CABG).

2.Valve Replacement / Repair or Valvuloplasty (Valve thlak/repair).

3.Correction of Congenital Heart Diseases eg. VSD, ASD, TOF, etc. (Pianpui lung pawp/thawl)

4.Angioplasty and PTCA Stent (Thisen dawt zim/ping siamthat)

5.Permanent/Temporary Pacemaker Implantation (Lungphu diklo tihdikna khawl vuah)

6.Surgeries for Repair of Aneurysm (Thisen zam puar zai)

7.Electrophysiologic Study and Radiofrequency Ablation.

8.Pericardial Surgery & Pericardial Effusion requiring Drainage (Lung tuamtu zai & Lung tuamtu a tui tling siak)

9. Acute Coronary Syndrome (Unstable Angina, Myocardial Infarction) (Heart attack leh a kaihnawih).

10. Heart Failure / Cardiogenic Shock (Lung hnathawh chawl/fail).

b.Oncology (Cancer)

1.Surgical treatment of all Malignant Tumours (Cancer zaina).

2.Radiation Treatment of Malignancies (Cancer hemna).

3.Chemotherapy/Targeted Therapy for Treatment of Malignancies

4.Complications and Toxicities of Treatment of Malignancies (Cancer enkawl avanga taksa in a tawrh enkawlna).

Note : Supportive Cancer Treatment liau liau chu a huam lo.

c.MEDICINES

i.Nephrology (Kal / Zun kawng)

1.Kidney Failure requiring Replacement Therapy (Kal function fail).

ii. Endocrinology : 

1. Diabetic Coma/Hyperosmolar Coma (Zunthlum vanga nikhawhrelova awm)

2. Other Metabolic Emergencies (eg. Thyrotoxic Crisis, Hyponatremia, Pheochromocytoma Myxoedemic Coma, Dyselectrolytemic Crisis, Cushing’s Disease) (Thalbe leh a kaihhnawih hormone natna nasa)

iii.Respiratory System (Chuap) 

1. Respiratory Failure (Chuap Function fail)

2. Pulmonary Thromboembolism (Chuap thisen petu inhnawh)

3.Empyema Thoracis (Awmchhung hnai tlingkhawm)

4.Pneumothorax (Chuap pawp)

5. Pleural Effusion requiring Intervention other than simple Drainage (Chuap tuamtu a tui tling siak bak a enkawlngai)

6.Lung disease requiring Pneumonectomy (Chuap zai)

Note : COPD leh Asthma pangngai a huam lovang.

iv.GI Tract (Pum leh Kawchhung)

• Non-alcoholic acute Pancreatitis with/without complications (Zu vang nilo Pancreas natna)
• Chronic Diarrhoea (in-hospital Investigation) (Khawthalo benvawn admit ngai khawp)
• Non-alcoholic GI bleed where upper GI Endoscopy is normal (Zu vang ni lo chaw dawt thi put/internal bleeding)

v.CNS (Tha/Nerve leh thluak)

1. CVA (Stroke)

2. Intra Cranial Space Occupying Lesions (ICSOL) (Thluak a bawk)

3. Myelopathies (non-traumatic) (Inhliam vang ni lo Spinal Cordnatna)

4. Hydrocephalus (Pathological) (Thluak a tuitling)

5. Myasthenia Graves (Tihrawl chau natna)

6. Severe CNS Infections (thluak/hamda a natna hrik lut/septic.).

vi.  Hematology (Thisen leh a kaihhnawih natnate)

1.Complicated Cytopenias (eg: Aplastic/Hypoplastic Anaemia,Neutropenias, Thrombocytopenias).

2.Hemoglobinopathies for Splenectomy (Thalassemia/Sickle Cell Anemia)

3.Thromboembolic Disease (eg: DVT, Mesenteric Artery Thromboembolism, Pulmonary Thromboembolism, etc).

4.Bleeding Disorders (eg : Hemophilia).

vii. Hepatology (Thin): Liver Abscess, Hepatic Encephalopathy & Hep B & C - Interferon/Antiviral Therapy (neutropenia treatment a huam lo).

viii.Connective Tissue Disease -SLE, Mixed Connective Tissue Disease etc.

ix.Organ Transplant:Renal/Bone Marrow/Liver/Heart/Stem Cell etc., and Procedures/Treatment Cost of the Donor (Taksa bung hrang hrang thlak ngai, a petu pawh a huam ang)

x.Infective Diseases (Inkaichhawntheih natnate)

1. Complicated Malaria (identified according to WHO criteria).

2. Multi Drug Resistant Tuberculosis

3. Septic Shock requiring Inotropic Support (Septicemia)

d. SURGERY

i.Urology/Nephrology:

1.Nephrectomy and Surgery for Perinephric Abscess (Kal paih ngai)

2.Surgery for Urinary Stone (Zun kawng a lungte awm zai ngai)

3.BPH cases requiring Surgery (Phingbe lian zai ngai)

ii.Plastic Surgery- 

• Treatment of Major Burns with complication (Kang nasa)
• Post Infective raw area requiring extensive skin grafting (Hliam nasa avanga vun thlak ngai)
• Congenital Cleft Lip/Palate (Hmui/dang kak zai)

iii.Head & Neck: Pleomorphic Adenoma, Warthin’s Tumor

iv.Gastroenterology (Pum leh Kawchhung)

• Acute Abdomen requiring Major/Emergency Surgery: eg. Gut Perforation, Acute Appendicitis, Volvulus, Intussusception, Peritonitis, Intra-Abdominal Abscess, Acute Cholecystitis with Cholelithiasis, Blunt Trauma requiring organ removal/repair (Pum lam emergency-a zai ngai hrang hrang eg. Ril phir, Rilpawp, Mita lungte zai, Ril hnawh leh accident vanga taksa bung hrang hrang repair/paih ngai)
• Non alcoholic GI Bleed needing Surgery (Zu vang nilo thi a luak/ek thi zaipui)

3.Chronic Cholecystitis/Cholelithiasis (Mita lungte awm zai)

Note : Recurrent Appendicitis a huam lovang.

v.Neurology & Neurosurgery (Tha/nerve/thluak): 

1.Life saving Surgeries on Brain & Spinal Cord. (eg : Intracranial Hematomas/Abscess) (Thluak & Spinal Cord zai ngei ngei ngai)

e. Ophthalmology (Mit)

1.Surgery/other procedures for detachment of Retina (Mit parda zai)

2.Surgery/ other procedures for Glaucoma (Mit BP sang zai)

2.Vitreous Heamorrhage, Vitrectomy (Mit chhung thi put zai)

3.Laser Treatment of Retinopathies (SSN, Gauhati & Sushrut Eye Foundation, Kolkata-a zai chauh).

4.Orbital Fracture and Penetrating Eye Ball Injury (Hmai/mitmu hliam zai)

5.Intraocular Blood Disorders & Intraocular Foreign body (Mit chhunga pawnlam thil lut)

6.High Myopia with impending Retinal damage.

7.Hemifacial Spasm/Blepherospasm/Cervical Dystonia requiring Therapeutic Botox Injection (in Aizawl Civil Hospital only) (Mit kaih leh nghawng zawi Botox mamawh)

f.ENT (Beng, Hnar leh hrawk )

1.Complicated CSOM requiring surgery (Bengdar hnai benvawn zai)

2.Complicated Otosclerosis requiring surgery (Beng chhung ruh belhbawm zai)

2. Complicated Sinus’ requiring Surgery (Govt. Hospital only) (Sinus zai)

3.Ludwig’s Angina (Awrbawr hnai la nasa)

4.Upper airway Obstruction requiring Trachaestomy (Thawkna dawt chunglam diklo, hrawk dawt pawh zai ngai)

5.Sensorineural hearing lost requiring Cochlear Implant (up to 14 years) (Kum 14 hnuailam bengchhet zai/Cochlear implant)

g.Orthopaedic Surgery (Ruh)

1.Joint Replacement (Hip/Knee, etc) (Ruhchuktuah thlak)

2.Surgery for correction of Fractures of Bones and Joints (Ruh tliak zai)

3.Arthroscopic Repair of Ligaments (Ruh/Ruhchuktuah duar zai)

4.Major limbs amputations due to any diseases excluding single terminal/digits Phalanged Amputations (with prosthesis) (Kut/ke tan/lem vuah)

5.Correction of Locomotor disabilities- Congenital/Acquired Contractures (kut leh ke diklo zai)

6.PIVD with Severe Cord Compression requiring Surgery (Saitika zai)

7.Osteomyelitis requiring Surgery, Severe Crush Injury & Necrotizing Fascitis (Ruh nget zai)

8.Removal of ‘in-situ` Implant under GA/SA (Thir phum hnimhlum hmanga lakchhuah)

h. OBS & Gynaecology (Chhul/chibawm etc)

1.Ruptured Ectopic Pregnancies, DUB, Twisted Ovarian Cyst, Bleeding Fibroid, Post Partum Haemorrhage (Hmeichhe thihawrh, naupai fual, chibawm bawk tingtawm, chhul bawk thi nasa- zai ngai vek)

2.LSCS complicated by Rupture Uterus, Re-opening of Abdomen (Nau ziachhuah khawbaw, chhul keh leh pum zai hawn leh ngai)

3. Genital Fistulae requiring Surgery (Serh piangsual zai ngai)

4. Tubal Block requiring Surgery (Government Hospital only) (Chikawng ping zai hawn ngai, Sawrkar damdawiin ah chauh)

i.Paediatrics (Naupang natna)

1.Meningitis/Encephalitis (thluak/hamda septic)

2.Severe Pneumonia & a kaihnawih complications

3.Nephrotic Syndrome & ARF (kal natnabenvawn)

4. Birth Asphyxia & related complications (Pianphung fuhlo vanga thaw diklo)

5.Preterm/VLBW requiring NICU (hun hma a piang/zang lutuk ICU awm ngai)

6.Congenital Malformations requiring Major Surgery (Pianpui piansualna zai pui ngai)

j.Dental Surgeries (Ha/khabe/hmai ruh natna):

1.Ameloblastoma (Khabe ruh cancer)

2.Post Traumatic Maxilofacial Fractures requiring Surgery (Hmai bawr ruh tliak/hliam zai)

3.Dento-facial deformity requiring Therapeutic Corrective Surgery (Ha leh hmai piangsual siam that ngai)

k.Psychiatry (Rilru natna): Schizophrenia, Major Depressive Disorder, Generalised Anxiety Disorder, Bipolar Disorder & Dementia.

l.Dermatology:  Steven Johnson’s Syndrome–drug induced, Deep Fungal Infection, Erythroderma (any cause), Pemphigus (all variants).

m.ICU Care: ICU admit ngai khawp natna (routine post-operative & uncomplicated surgeries tellovin)

n.Others: Seizure Disorder requiring hospitalization (Kaih nasa/phungzawl lampang Admit ngai)

III.Hriattur dang pawimawhte:

a.Damlo leh a kalpuite kalman senso –Mizoram chhungah 1,000/-, phai kal tan 10,000/- thleng vawikhatah a bill theih.

b.Damdawi in awm hma/chhuah hnu-a Bill theih chin:

Damdawiin awm hma/chhuah hnu ni 1 & 10 leh Organ Transplant tan ni 30 thleng damdawi a Bill theih. Doctor certify in Admit hma (Pre-admission) Investigation (thisen, X-ray etc. tests nate) a huam tel.

c.Enrolment kalpui dan tur- Bial Sub-Centre-theuh ah in enroll tur.

d.Phai-a Refer chungchang: Civil Hospital, Aizawl & Lunglei-a Medical Referral Board refer hnuah Health Care Office ah lehkha pawimawh pek anni. Refer-na Damdawiin ah kal ngei tur tihna a ni lo, MSHCS-in a tul chuan a thlak thei.

e.Health Care hnuaia Bill thehluh huna thil tel tur Documents te:

Enrolment Form Xerox Copy, Original Discharge Card, Doctor Prescriptions, Cash Memo, Investigation reports, Death/Birth Certificate (thi leh nau piang bikah), Medical Board Refer lehkha (phaia refer te tan), Original Ticket (Thlawhna hmangten boarding pass thil tel tur)

 Issued by:
 Mizoram State Health Care Society,
Dinthar, Aizawl - 796001
 Contact No - 2321484/2310842/2300218

Email : snamizoram@gmail.com, mshcsdinthar@gmail.com