Better healthcare for Government sector with NITF’s Agrahara-Lanka Hospitals collaboration

In a ground-breaking development in national healthcare, The National Insurance Trust Fund (NITF) has entered into an affiliation with Lanka Hospitals, offering Government employees access to high quality private healthcare services at affordable costs. 

All public sector employees; eligible for pension, are automatically entitled to NITF’s health insurance scheme titled Agrahara. The affiliation between the NITF and Lanka Hospitals will eventually make high expenditure private medical treatment like Heart bypass (CABG) and kidney surgery, hip and knee replacement surgeries more affordable to all public sector employees covered under this scheme. 

“The scheme empowers public sector employees by providing them financial protection against unforeseen health problems,” NITF CEO Sanath C. De Silva said. 

While the Agrahara Insurance scheme has stipulated sums for major surgeries, the cost of undergoing these surgeries in private medical institutions are often much higher. If a public sector employee has to undergo surgery in private hospital, patients have to bear a considerable additional cost, running into approximately Rs. 200,000-300,000 more than the sum assured for such surgery by Agrahara, making the surgery way beyond the means of the employee. 

Since it is a pre-arranged cost for major surgeries agreed upon in the affiliation, a wider scope and options at affordable rates are available to the public sector employee for major surgery. 

“The affiliation also paves the way for more transparent costs, with patients kept aware of exactly how much they will incur, thus letting them prepare their finances accordingly,” explained Lanka Hospitals PLC Head of Sales and Marketing Nilantha Ratnayake. 

He added that the collaboration between the NITF and Lanka Hospitals was particularly encouraging as both entities come under the auspices of the same Government entity, and are therefore able to better understand and efficiently serve the particular health insurance needs of public sector employees.

Lanka Hospitals has set up a dedicated counter for Agrahara recipients, which assists patients in securing the funds before the procedure, offering convenience and peace of mind for Agrahara patients at Lanka Hospitals. 

LH also offers discounts for procedures, including 10% inpatient and outpatient discount on laboratory investigations, and 5% discount on radiology for inpatient and outpatients, as well as 10% discount on room tariffs. 

In addition, Rs. 25,000 discount on all heart surgeries, including CABG, PTCA, etc., up to three post consultations after surgery with the hospital fee waived, and special surgery packages for general surgeries such as hernia, appendectomy, etc., ENT, gynaecology, vascular and ophthalmology surgeries, ensure Agrahara recipients receive the best possible financial assistance.

Among the many firsts and bests recorded by Lanka Hospitals, are the renowned Heart Center, with more than 5,500 paediatric and adult cardiac surgeries up to date, Fertility Center with almost 1,000 IVF births, Renal Care Center with more than 750 kidney transplants and ENT unit with more than 100 cochlear implant surgeries up to date.

LH has been awarded several prestigious awards, including the world class Joint Commission International Accreditation (USA) and Global Performance Excellence Award 2013 2013 (GPEA), said Ratnayake.

The Agrahara Insurance scheme currently services over one million public sector employees, as well as an additional one million dependents. All Government employees contribute a nominal amount of Rs. 125 monthly, which is automatically deducted from their salaries. For the nominal amount of Rs. 1,500 annually, employees are entitled to health insurance cover for a host of illnesses, surgeries, childbirth, hospitalisation, etc.

“The rates we offer are unmatched by the private sector. A policy covering all that we offer will cost 90% more from a private sector insurer,” said de Silva.

Operating as a non-profit fund, under the Ministry of Policy Planning, Economic Affairs, Child Youth and Cultural Affairs, the size of the fund annually is Rs. 1.2 billion. De Silva points out that claims paid out almost equal the size of the fund, and stresses that claims are settled expediently with minimum red-tape, adding that NITF is consistently the largest claim payer in health insurance.

Among the covers issued by the policy include settlements of Rs. 600,000 in the case of accidental death and Rs. 100,000 in the case of death due to natural causes and a hospital cover of Rs. 100,000 per event. For serious surgeries such as heart bypass (CABG) surgery, kidney transplants, hip replacements, etc. the cover offered is Rs. 400,000. The majority of contributors to the fund are from the Department of Police, Ministries of Health and Education, Department of Civil Security, etc. 

Plans are underway to top up the existing covers which are generic products across the board to any public servant. Additional covers in several stages at higher premiums will be made available to higher grades of public officers, like university lecturers, etc.

While eligibility is until retirement, the Fund is planning to extend this period up to five to 10 years after retirement for a higher premium.

“Standardisation of medical surgery is our long-term objective and our collaboration with Lanka Hospitals is an initial move in that direction,” de Silva says. 

Contact the customer facilitation officer at the dedicated Agrahara counter at Lanka Hospitals on 011 5431039/[email protected].