Ayushman Bharat Yojana

Ayushman Bharat will have a defined benefit cover of Rs. 5 lakh per family per year. This cover will take care of almost all secondary care and most of tertiary care procedures. To ensure that nobody is left out (especially women, children and elderly) there will be no cap on family size and age in the scheme. The benefit cover will also include pre and post-hospitalisation expenses. All pre-existing conditions will be covered from day one of the policy. A defined transport allowance per hospitalization will also be paid to the beneficiary.

Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY), is a flagship scheme of Government of India to provide cashless secondary and tertiary care treatment from the empanelled public and private hospitals providing coverage to more than 10 crore poor and vulnerable beneficiary families.

National Health Authority (NHA) is the apex body responsible for the implementation of Ayushman Bharat PM-JAY.

We are pleased to announce the launch of official mobile application for citizens to:
• Get easy access to information about PMJAY
• Check eligibility
• Search empanelled hospitals

 

1. Health and Wellness Centers (HWCs)

In February 2018, the Government of India announced the creation of 1,50,000 Health and Wellness Centres (HWCs) by transforming the existing Sub Centres and Primary Health Centres. These centres are to deliver Comprehensive Primary Health Care (CPHC) bringing healthcare closer to the homes of people. They cover both, maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services.

2. Pradhan Mantri Jan Arogya Yojana (PM-JAY)

The second component under Ayushman Bharat is the Pradhan Mantri Jan Arogya Yojna or PM-JAY as it is popularly known. This scheme was launched on 23rd September, 2018 in Ranchi, Jharkhand by the Hon’ble Prime Minister of India, Shri Narendra Modi.

 

Ayushman Bharat Yojana

Type of project

Health insurance

Country

India

Prime Minister(s)

Narendra Modi

Ministry

Ministry of Health and Family Welfare

Launched

23 September 2018; 2 years ago

Budget

₹8,088 crore (US$1.1 billion) (2021 - 2022) 

Status

 Active

Website

https://www.pmjay.gov.in/

 

Features of PMJAY: Ayushman Bharat Yojana Scheme

In addition to be a life saver scheme for lower middle income the other key features of Pradhan Mantri Ayushman Bharat Yojana (PMJAY) are as follows:

  • Ayushman Bharat Yojana scheme is a family floater scheme with a sum assured of Rs. 5 lakh per family enrolled
  • This scheme is specially designed for people below the poverty line who do have access to internet or online health plans
  • PMJAY scheme facilitates cashless healthcare services to its beneficiary in any of the public sector hospitals and private network hospital
  • Moreover, Pradhan Mantri Ayushman Bharat Yojana also recompenses the transportation cost incurred by the beneficiary during the pre and post-hospitalization period
  • Along with medical treatment expenses, Ayushman Bharat Yojana insurance package also covers the day-care expenses incurred by the beneficiary
  • PMJAY scheme also covers some of the specific pre-existing diseases
  • The payment for medical expenses is to be made based on the package rate as pre-determined by the government
  • Under the government backed scheme, a considerate number of health and wellness centres will be established asper the Socio-Economic Caste Census data

 

Benefits of Ayushman Bharat Yojana Scheme

Ayushman Bharat Yojana scheme insures almost 40% of the vulnerable and needy families in India. The healthcare services and benefits that they can avail are listed below:

  • The treatment and healthcare facilities under PMJAY is available across India and is free of cost
  • The Ayushman Bharat Scheme offers 25 specialty categories and it covers a wide range of 1,354 medical and surgical packages such as neurosurgery, cardiology, etc.
  • Ayushman Bharat Yojana scheme also covers post-hospitalization expenses
  • In case of multiple surgeries, the cost shall be covered with the highest package. And for second and third surgery it should be covered 50% an 25% respectively
  • The scheme also covers the treatment cost of oncology with chemotherapy for 50 different types of Cancer. However, both medical and surgical package cannot be availed at the same time.
  • The beneficiaries under PMJAY scheme can also avail follow-up treatment coverage

 

What is the eligibility criteria under Ayushman Bharat Yojana? 

 

Rural PMJAY: Ayushman Bharat Yojana Eligibility

The primary concern for healthcare facilities in the rural area is accessibility which goes on to increase with the soaring cost of medical healthcare. Often it is observed that people fall into debt traps to repay the hefty medical bills.   The PMJAY is available to the following types of people in the rural areas -  

·         Families without any male member in the age band of 16 to 59 years.

·         Families without any adult in the age range of 16 to 59 years.

·         Family with a disabled member and no able-bodied adult members.

·         Households belonging in the Scheduled Caste and Scheduled Tribes.

·         Landless households who earn a major part of their income from manual labour.

·         Families living in a single room house with temporary walls and roofs.

·         Families working as manual scavengers.

·         Families not having any household.

·         Primitive tribal groups.

·         Legally released bonded labour.

·         Those living in extreme poverty or living on alms.

 

Urban PMJAY: Ayushman Bharat Yojana Eligibility

With a rs 5 lakh insurance cover per family, the Ayushman Bharat scheme shall benefit the following category of people in the urban regions -

·         Rag Pickers

·         Beggars

·         Domestic Workers

·         Street vendors, cobblers or hawkers or other individuals providing services on the pavements.

·         Construction workers, plumber, Labourer, painters, welders, security guards

·         Sweepers and sanitation workers

·         Individuals who offer transport services like drivers, conductors, helpers, cart or rickshaw pullers along with head load workers.

·         Home-based workers, artisans including tailors and handicraft workers.

·         Shopworkers, assistants or peons in small establishments, delivery boys, and waiters.

·         Washer-men or chowkidars.