Ayushman Bharat, a flagship scheme of Government of India, was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to “leave no one behind.”
Benefits
- It covers all hospitalisation expenses with cashless transactions to beneficiaries.
- Accommodation during hospitalisation.
- Pre and post-hospitalisation costs.
- Any complications arising during the treatment.
- Can be used by all family members.
- No cap on family size, age or gender.
- Pre-existing conditions are included from day one
The Ayushman Bharat – Health and Wellness Centres (AB-HWCs) were launched under the Ayushman Bharat Programme in a bid to move away from selective health care to a more comprehensive range of services spanning preventive, promotive, curative, rehabilitative and palliative care for all ages.
- These centres deliver a range of comprehensive health care services like maternal and child health, services to address communicable and non-communicable diseases and services for elderly and palliative care.
- AB-HWCs provide free essential medicines and diagnostic services, teleconsultation, and health promotion including wellness activities like Yoga.
Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a Centrally Sponsored Scheme having central sector component under Ayushman Bharat Mission anchored in the Ministry of Health and Family Welfare (MoHFW). It is an umbrella of two major health initiatives, namely
- Health and wellness Centres
- National Health Protection Scheme
PM-JAY is the world’s largest health insurance/ assurance scheme fully financed by the government. It was launched in 2018, offering a sum insured of Rs.5 lakh per family for secondary care (which doesn’t involve a super specialist) as well as tertiary care (which involves a super specialist). Under PMJAY, cashless and paperless access to services are provided to the beneficiaries at the point of service, that is, hospital. Also, health benefit packages covers surgery, medical and day care treatments, cost of medicines and diagnostics.
- Beneficiaries- It is an entitlement-based scheme that targets the beneficiaries as identified by latest Socio-Economic Caste Census (SECC) data.
- Nodal Agency- The National Health Authority (NHA) has been constituted as an autonomous entity under the Society Registration Act, 1860 for effective implementation of PM-JAY in alliance with state governments whereas, the State Health Agency (SHA) is the apex body of the State Government responsible for the implementation of AB PM-JAY in the State.
- Arogya Mitras- The scheme has a dedicated workforce of Pradhan Mantri Arogya Mitras (PMAMs) who guide and assist the beneficiaries at every step of their journey under the scheme.
- Anti-fraud- The scheme has a National Anti-Fraud Unit (NAFU) that designs, implements and oversees anti-fraud initiatives. The NAFU also conducts desk and field audits (including surprise ones) to check abuse.
FAQs
Q: What is Ayushman Bharat?
Ayushman Bharat, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), is a government-sponsored health insurance scheme in India. Launched in September 2018, it aims to provide financial protection to over 500 million vulnerable and economically weaker citizens by offering coverage for secondary and tertiary healthcare services.
Q: Who is eligible for Ayushman Bharat?
Ayushman Bharat primarily targets deprived rural families and identified occupational categories of urban workers’ families. Eligibility is determined based on Socio-Economic Caste Census (SECC) data. Families falling within the defined deprivation criteria are automatically eligible for the scheme.
Q: What benefits does Ayushman Bharat offer?
Ayushman Bharat provides health insurance coverage of up to INR 5 lakhs per family per year for secondary and tertiary hospitalization expenses. It covers a wide range of medical and surgical procedures, including pre-existing conditions. Beneficiaries can avail treatment in empanelled public and private hospitals across India.
Q: How can one apply for Ayushman Bharat?
Eligible individuals can apply for Ayushman Bharat through various channels, including online portals, Common Service Centres (CSCs), or by visiting designated hospitals. The application process involves providing necessary documents to verify eligibility, such as Aadhaar card and ration card.
Q: Is Ayushman Bharat available throughout India?
Yes, Ayushman Bharat is available across all states and union territories of India. However, the implementation and coverage may vary slightly from one region to another. State governments have the flexibility to tailor the scheme according to their specific requirements while adhering to the core guidelines laid out by the central government.
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