Nagpur: Offering a major ray of hope to thousands of poor and needy patients battling life-threatening conditions, the Maharashtra Cabinet, chaired by Chief Minister Devendra Fadnavis, on Tuesday approved a landmark proposal to extend financial aid for medical procedures costing above Rs 5 lakh. The decision directly addresses a long-standing gap in health coverage for critical diseases requiring highly expensive treatments.
Until now, patients in Maharashtra could avail health insurance up to Rs 5 lakh per family per year under the Mahatma Jyotirao Phule Jan Arogya Yojana and the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. While this provided relief for routine surgeries and many major illnesses, it fell short for procedures such as organ transplants, where costs run into tens of lakhs, leaving patients and their families in despair.
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To bridge this gap, the Cabinet has empowered the Maharashtra State Health Assurance Society to use its reserve funds generated from existing scheme claims. These reserves will now be strategically deployed, not only to cover super-expensive treatments but also to strengthen government hospitals across the state.
As per the revised funding model, 20% of the society’s total funds will be placed in a dedicated reserve corpus, while the remaining 80% will continue to support hospitals. Of this, hospitals may utilise the funds in a structured manner, 19% for upgrading infrastructure, 40% for medicines and consumables, 20% for staff incentives, and 1% for awareness campaigns.
The decision is expected to be a game-changer for patients requiring high-cost interventions such as:
• Heart transplant – Rs 15 lakh
• Lung transplant – Rs 20 lakh
• Heart and lung transplant – Rs 20 lakh
• Liver transplant – Rs 22 lakh
• Bone marrow transplant (allogenic) – Rs 9.5 lakh
• Bone marrow transplant (unrelated) – Rs 17 lakh
• Bone marrow transplant (haplo) – Rs 17 lakh
• Transcatheter Aortic Valve Implantation (TAVI) – Rs 10 lakh
• Transcatheter Mitral Valve Replacement (TMVR) – Rs 10 lakh
In addition to patient benefits, the Cabinet also revised incentive allowances for doctors and paramedical staff working in government hospitals under the scheme. This move is aimed at boosting morale and retaining talent in the public healthcare system.
A special treatment assistance and empowerment committee, headed by the Secretary of the Public Health Department, will oversee the implementation. The committee will regularly review treatment costs, monitor utilisation of reserve funds, and ensure transparency in financial deployment.
Officials said the decision represents a paradigm shift in the State’s healthcare strategy, moving from basic coverage towards comprehensive financial protection for even the most complex medical procedures. For families grappling with the impossible choice between debt and treatment, this Cabinet approval could well be the difference between despair and survival.
