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Agrahara Insurance



Agrahara Insurance scheme was introduced by the Ministry of Public Administration Circular No: 5 /1997 and this scheme was under National Insurance Trust Fund from 1st of January 2006. Early stages we had a large number of claims, received from Sri Lanka Insurance and by now we have cleared the arrears and running smoothly.The main idea of this "Agrahara" medical insurance scheme is to uplift the living standards of the public service and provincial public service and their families. Therefore we have taken steps to expedite all claims received by us as early as possible.

We have implemented a new system to expedite the claims as early as possible. If we receive any claim with all the necessary requirements arrangements have being made to Pay these Claims immediately.



To Whom

The NITF cater to nearly Seven Hundred Thousand public servants and their dependents. We pay for all Medical(Hospitalizations, Childbirth, Various Operations, Bypass Operations, Spectacles and etc) , Accidents and Death claims submitted to us by them.

Beneficiaries

  •    Married Employees - Member, Spouse and Children (only if they are unmarried, unemployed and below 21years old).
  •    Unmarried Employees - Member, Parents (only if the parents below 70 years old).


  • Agrahara members monthly remittance list format. Download Here
  • Benefits are as per the circular published by Ministry of Public Administration and Home Affairs. Download Here
  • Also you can visit the Ministry of Public Administration and Home Affairs website by: www.pubad.gov.lk

The list of benefits provided by Agrahara.

Type of Benefit Max Amount (per case)
Rs.
Duration Rate (per Date)
Rs.
Limit (per Year)
Rs.
Private hospital room charges 30,000.00 10 days 3000.00 150,000.00
Gov. Hospital Room Charges 5,000.00 10 days 500.00 150,000.00
Pvt Hospital Surgical & Medical Treatment 50,000.00 - - 150,000.00
Consultation Fee 20,000.00 - - 150,000.00
Medical Test 20,000.00 - - 150,000.00
Cataract Operation 20,000.00 - - 150,000.00
Paralysis Package 100,000.00 - - 150,000.00
Heart Surgery Pkg bill for Family Member 100,000.00 - - 150,000.00
Heart Surgery Detailed bill for Family Member 100,000.00 - - 150,000.00
Cancer Insured Package 120,000.00 - - 200,000.00
Total Knee Replacement Set 50,000.00 - - 150,000.00
Total Hip Replacement Set 50,000.00 - - 150,000.00
Spinal Fusion Set 50,000.00 - - 150,000.00
Bone Metal Stents Family 50,000.00 - - 150,000.00
Gov. Hospital Childbirth * 2,500.00 5 days 500.00 2,500.00
Pvt Hospital Childbirth- Normal * 10,000.00 5 days 2,000.00 10,000.00
Pvt Hospital Childbirth- Cesarean * 40,000.00 - - 40,000.00
Spectacles ** 3,500.00 - - 3,500.00
Permenent Total Disablement 600,000.00 - - 600,000.00
Permenent Partial Disablement 300,000.00 - - 300,000.00
Temprory Partial Disablement 26,000.00 52 weeks 500.00 26,000.00
Natural Death Insured 150,000.00 - - 150,000.00
Accidental Death Insured 600,000.00 - - 600,000.00
Kidney Insured Package 200,000.00 - - 200,000.00
Pvt. Hospital Bypass for Member 500,000.00 - - 500,000.00
Bare Metal Stents- Member 120,000.00 - - 500,000.00
Drug Eluting Stent- Member 290,000.00 - - 500,000.00
Dilatation Catheter- Member 36,000.00 - - 500,000.00
PTCA Balloon- Member 39,500.00 - - 500,000.00
Guide Wire- Member 12,500.00 - - 500,000.00
Patent Ductus Arterious (PDA) 145,000.00 - - 500,000.00
Atrial Spetal Defect (ASD) 293,000.00 - - 500,000.00
Ventricular Spetal Defect (VSD) 293,000.00 - - 500,000.00
Pace Maker (Singal) 136,000.00 - - 500,000.00
Pace Maker (Dual) 272,000.00 - - 500,000.00
PFO Occluder 293,000.00 - - 500,000.00
Implantable Cardiovetor Defibrillator (ICD) 300,000.00 - - 500,000.00
Radio Frequency Ablation (RF Ablation) 225,000.00 - - 225,000.00

  • * Childbirth Claims can be made maximum 2 occurances in lifetime.
  • ** Spectacle Claims can be made once in three years only.

  • *** Monthly Premium Rs: 125/- ***
Type of Benefit Max Amount (per case)
Rs.
Duration Rate (per Date)
Rs.
Limit (per Year)
Rs.
Private hospital room charges 160,000.00 10 days 5000.00 250,000.00
Gov. Hospital Room Charges 10,000.00 10 days 1000.00 250,000.00
Pvt Hospital Surgical & Medical Treatment 60,000.00 - - 250,000.00
Consultation Fee 35,000.00 - - 250,000.00
Medical Test 30,000.00 - - 250,000.00
For obtaining in-house treatment in a private Ayurvedic hospital subjective to above categories (private Ayurvedic hospital should be a registered entity under local subjective Ministry.) - - - 160,000.00
Gov. Ayurvedic Hospital Room Charges 10,000.00 10 days 3000.00 10,000.00
Gov. Hospital Childbirth * - 5 days 1500.00 -
Pvt Hospital Childbirth- Normal * 25,000.00 - - 25,000.00
Pvt Hospital Childbirth- Cesarean * 60,000.00 - - 60,000.00
Heart related surgeries for Family Member 150,000.00 - - -
Heart surgeries (Only for Member) - - - 800,000.00
RF Ablation (Only for Member) - - - 350,000.00
Cancer Insured Package (Only for Member) - - - 400,000.00
Kidney transplantations (Only for Member) - - - 800,000.00
Brain surgeries (Only for Member) - - - 800,000.00
Implantation of knees (Only for Member) - - - 150,000.00
Implantation of hip bones (Only for Member) - - - 150,000.00
Hearing aids (Only for Member) - - - 75,000.00
Spectacles ** (Only for Member) 3,500.00 - - 3,500.00
Natural Death Insured (Only for Member) 400,000.00 - - 400,000.00
Accidental Death Insured (Only for Member) 1,000,000.00 - - 1,000,000.00
Personal Accident Insured (Only for Member) 1,000,000.00 - - 1,000,000.00

  • * Childbirth Claims can be made maximum 2 occurances in lifetime.
  • ** Spectacle Claims can be made once in three years only.

  • *** Monthly Premium Rs: 300/- ***
Type of Benefit Max Amount (per case)
Rs.
Duration Rate (per Date)
Rs.
Limit (per Year)
Rs.
Private hospital room charges 200,000.00 10 days 8000.00 350,000.00
Gov. Hospital Room Charges 30,000.00 10 days 3000.00 350,000.00
Pvt Hospital Surgical & Medical Treatment 80,000.00 - - 350,000.00
Consultation Fee 50,000.00 - - 350,000.00
Medical Test 40,000.00 - - 350,000.00
For obtaining in-house treatment in a private Ayurvedic hospital subjective to above categories (private Ayurvedic hospital should be a registered entity under local subjective Ministry.) - - - 200,000.00
Gov. Ayurvedic Hospital Room Charges 30,000.00 10 days 3000.00 30,000.00
Gov. Hospital Childbirth * - 5 days 3000.00 -
Pvt Hospital Childbirth- Normal * 50,000.00 - - 50,000.00
Pvt Hospital Childbirth- Cesarean * 100,000.00 - - 100,000.00
Heart related surgeries for Family Member 200,000.00 - - -
Heart surgeries (Only for Member) - - - 1,000,000.00
RF Ablation (Only for Member) - - - 500,000.00
Cancer Insured Package (Only for Member) - - - 600,000.00
Kidney transplantations (Only for Member) - - - 1,200,000.00
Brain surgeries (Only for Member) - - - 1,200,000.00
Implantation of knees (Only for Member) - - - 250,000.00
Implantation of hip bones (Only for Member) - - - 250,000.00
Hearing aids (Only for Member) - - - 100,000.00
Spectacles ** (Only for Member) 5,000.00 - - 5,000.00
Natural Death Insured (Only for Member) 700,000.00 - - 700,000.00
Accidental Death Insured (Only for Member) 2,000,000.00 - - 2,000,000.00
Personal Accident Insured (Only for Member) 1,500,000.00 - - 1,500,000.00

  • * Childbirth Claims can be made maximum 2 occurances in lifetime.
  • ** Spectacle Claims can be made once in three years only.

  • *** Monthly Premium Rs: 600/- ***
Type of Benefit Max Amount (per case)
Rs.
Duration Rate (per Date)
Rs.
Limit (per Year)
Rs.
Private hospital room charges 200,000.00 10 days 8000.00 350,000.00
Gov. Hospital Room Charges - - 3000.00 63,000.00
Pvt Hospital Surgical & Medical Treatment 80,000.00 - - 350,000.00
Consultation Fee 50,000.00 - - 350,000.00
Medical Test 40,000.00 - - 350,000.00
For obtaining in-house treatment in a private Ayurvedic hospital subjective to above categories (private Ayurvedic hospital should be a registered entity under local subjective Ministry.) - - - 200,000.00
Gov. Ayurvedic Hospital Room Charges - - 3000.00 63,000.00
Gov. Hospital Childbirth * - 5 days 3000.00 -
Pvt Hospital Childbirth- Normal * 50,000.00 - - 50,000.00
Pvt Hospital Childbirth- Cesarean * 100,000.00 - - 100,000.00
Heart related surgeries for Family Member 200,000.00 - - 200,000.00
Heart surgeries (Only for Member) - - - 1,000,000.00
Cancer Insured Package (Only for Member) - - - 600,000.00
Kidney transplantations (Only for Member) - - - 1,200,000.00
Brain surgeries (Only for Member) - - - 1,200,000.00
Implantation of knees (Only for Member) - - - 250,000.00
Implantation of hip bones (Only for Member) - - - 250,000.00
Hearing aids (Only for Member) - - - 100,000.00
Contact Lenses (Only for Member) 50,000.00 - - 50,000.00
Natural Death Insured (Only for Member) 700,000.00 - - 700,000.00
Accidental Death Insured (Only for Member) 2,000,000.00 - - 2,000,000.00
Permenent Total Disablement caused by Accidents (Only for Member) 1,500,000.00 - - 1,500,000.00
Permenent Total Disablement caused by Disease (Only for Member) 200,000.00 - - 200,000.00

  • * Childbirth Claims can be made maximum 2 occurances in lifetime.

  • *** Monthly Premium Rs: 1000/- ***

Agrahara Gold Scheme (Goverment)

Click Here

Agrahara Silver Scheme (Goverment)

Click Here

Agrahara Gold Scheme (Semi Goverment)

Click Here

Agrahara Pension Insurance Scheme

Establishment of a new insurance scheme as proposed by the budget 2005 for officer, who retire after 01/01/2016 (Agrahara)



  • Benefits are as per the circular published by Department of Pensions     Click Here
  • Download The Claim Application From -     Click Here

Type of Benefit Max Amount (per case)
Rs.
Duration Rate (per Date)
Rs.
Limit (per Year)
Rs.
Private hospital room charges 30,000.00 10 days 3000.00 -
Gov. Hospital Room Charges 5000.00 - 500.00 -
Pvt Hospital Surgical & Medical Treatment - - - 50,000.00
Consultation Fee - - - 20,000.00
Medical Test - - - 20,000.00
For obtaining in-house treatment in a private Ayurvedic hospital subjective to above categories (private Ayurvedic hospital should be a registered entity under local subjective Ministry.) - - - 120,000.00
Gov. Ayurvedic Hospital Room Charges 5000.00 - 500.00 -
Heart surgeries (Only for Member) - - - 500,000.00
RF Ablation (Only for Member) - - - 225,000.00
Cancer Insured Package (Only for Member) - - - 200,000.00
Kidney transplantations (Only for Member) - - - 200,000.00
Reanal Failure (Only for Member) - - - 150,000.00
Paralysis (Only for Member) - - - 150,000.00
Multiple Sclerosis (Only for Member) - - - 150,000.00
Primary Pulmonary Arterial (Only for Member) - - - 150,000.00
Fulminate Hepatitis (Only for Member) - - - 150,000.00
Hearing aids (Only for Member) - - - 50,000.00
Natural Death Insured (Only for Member) 150,000.00 - - 150,000.00
Accidental Death Insured (Only for Member) 600,000.00 - - 600,000.00

  • ** Retired officers are not paid for spectacles.
  • *** Monthly Premium Rs: 200/- ***

Claim Procedure
________________

Please click on the link to see the claim procedure of each category


Important notice to all customer :
To obtain any agrahara claim,you shall not to be paid any amount as tax, stamp duty or as document charges to national insurance trust fund or to any other institute or person.

Partner Hospitals
________________

Benefits of partner hospitals

  • 1. Special surgical packages
  •       +   Offer surgical packages to Agrahara Beneficiaries at a special rate.
  • 2. In Patient Discount on
  •     No Deposit on admission will be applicable for to Agrahara Beneficiaries.
  •       +   Room charges
  •       +   Laboratory investigations
  •       +   Radiology investigation
  • 3. Out Patient Discount on
  •       +   Laboratory investigations
  •       +   Radiology investigation

Private Ayurvedic Hospitals

To View the list of Private Ayurvedic hospitals     Click Here

Downloads

To Download the All necessary forms & Documents     Click Here


Feel free to Contact us

Telephone : +94 112 026 600
24 Hours Service

email : anura@nitf.lk
Fax : +94 112 323 006


Social Media: 0703007770 (Only for document forward)

_________________
  • To check your Agrahara claim details       Click Here
  • To check your Agrahara Normal / Silver / Gold Membership Status       Click Here

  • To check your Agrahara Semi Government registration details       Click Here
  • To check your Agrahara Semi Government claim details       Click Here

  • To check your Agrahara Pension claim details       Click Here
  • To check your Agrahara pension membership details       Click Here

  • To check Medical Membership details (For Hospitals)       Click Here