Ayushman Bharat Yojana


Ayushman Bharat Yojana

Overview

Prime Minister Narendra Modi on Sunday introduced the ‘Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY)‘ scheme, considered as the world’s largest government-funded healthcare programme covering over 50 crore beneficiaries. Explaining it as a “game-changer initiative to serve the poor”, PM Modi said the scheme, which would come into effect from Sunday, is a step towards serving the poor people of the country. “Ayushman Bharat is the biggest government-sponsored healthcare yojana in the world,” Modi said. “The total people of beneficiaries from Ayushman Bharat are more than the population of America, Canada and Mexico combined. Organizations across the world will examine Ayushman Bharat to study how the government funded this large-scale scheme,” said PM Modi.

About

Ayushman Bharat (AB) is a step to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. Ayushman Bharat focused to undertake path-breaking interventions to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level. Ayushman Bharat carries a continuum of care approach, comprising of two inter-related components.

The first part pertains to the creation of 1,50,000 Health and Wellness Centres which will bring health care closer to the homes of the people. These centres will give Comprehensive Primary Health Care (CPHC), covering both maternal and child health services and non-communicable diseases, covering up free essential drugs and diagnostic services. The first Health and Wellness Centre was introduced by the Hon’ble Prime Minister at Jangla, Bijapur, Chhatisgarh on 14 April 2018. The second part is the Pradhan Mantri Jan Arogya Yojana (PM-JAY) which grants health protection cover to poor and vulnerable families. The Health and Wellness Centres will play an important role in creating awareness about PM-JAY, screening for non-communicable diseases, follow-up of hospitalisation cases among others.

Goals

These two far-reaching initiatives under Ayushman Bharat will create a New India 2022. This path-breaking steps, which will be implemented at an unprecedented scale, will bring a paradigm shift in India’s health sector. It will assist India to capitalize on its demographic dividend, ensure enhanced productivity, well-being and avert wage loss and impoverishment.

Under the guidance of Ayushman Bharat, a Pradhan Mantri Jan Arogya Yojana (PM-JAY) to reduce the financial burden on poor and vulnerable groups arising out of catastrophic hospital episodes and ensure their access to quality health services was conceived. PM-JAY seeks to speed up India’s progress towards achievement of Universal Health Coverage (UHC) and Sustainable Development Goal – 3 (SDG3).

Pradhan Mantri Jan Arogya Yojana (PM-JAY) will grant financial protection (Swasthya Suraksha) to 10.74 crores poor, deprived rural families and identified occupational categories of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data (approx. 50 crore beneficiaries). It will have offered an advantage cover of Rs. 500,000 per family per year (on a family floater basis).

PM-JAY will envelope medical and hospitalization expenses for almost all secondary care and most of the tertiary care procedures. PM-JAY has defined 1,350 medical packages covering surgery, medical and daycare treatments inclusive of medicines, diagnostics and transport.

Guidelines

To ensure that nobody is left out (especially the girl child, women, children and elderly), there will be no restriction or limit on family size and age in the Mission. The Yojana will be cashless & paperless at public hospitals and empanelled private hospitals. The beneficiaries will not be needed to pay any charges for the hospitalization expenses. The advantage also includes pre and post-hospitalization expenses. The yojana is an entitlement based, the beneficiary is decided on the basis of the family being figured in SECC database. When completely implemented, the PM-JAY will become the world’s largest government-funded health protection mission.

Ayushman Bharat offers the benefits as under :

  • Cashless Treatment at Public/Private Healthcare Providers
  • Secondary and Tertiary care hospitalization treatments coverage
  • 5 Lakhs cover per family
  • No cap on the size of family or age of family members
  • Pre-existing diseases covered from Day 1 of enrolment of the scheme
  • Portable across India at all empanelled healthcare Providers
  • Fixed Transportation Allowance payable from the place of residence to hospital
  • AYUSH (Alternative Medicine Systems other than Allopathic) covered
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