In a groundbreaking 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,” Sanath C. De Silva, CEO of the NITF 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 Nilantha Ratnayake, Head of Sales and Marketing, Lanka Hospitals PLC. 

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 percent inpatient and outpatient discount on laboratory investigations, and 5 percent discount on radiology for inpatient and outpatients, as well as 10 percent discount on room tariffs. In addition, Rs. 25,000 discount on all heart surgeries, including CABG, PTCA, etc., up to 3 post consultations after surgery with the hospital fee waived, and special surgery packages for general surgeries such as hernia, appendectomy, etc., ENT, Gynecology, Vascular and Ophthalmology surgeries, ensure Agrahara recipients receive the best possible financial assistance.
The Agrahara Insurance scheme currently services over 1 million public sector employees, as well as an additional one million dependents. 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 by-pass (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.