Ayushman Bharat Pradhan Mantri Jan Arogya Yojana | Civils OnlinEd

Ayushman Bharat

  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."

Ayushman Bharat comprising of two inter-related components, which are -

·         Health and Wellness Centres (HWCs)

·         Pradhan Mantri Jan Arogya Yojana (PM-JAY)

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. 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)

  This scheme was launched on 23rd September, 2018 in Ranchi, Jharkhand by the Hon’ble Prime Minister of India, Shri Narendra Modi.

.PM-JAY was earlier known as the National Health Protection Scheme (NHPS) before being rechristened. It subsumed the then existing Rashtriya Swasthya Bima Yojana (RSBY) which had been launched in 2008. PM-JAY is fully funded by the Government and cost of implementation is shared between the Central and State Governments.

Key Features of PM-JAY

·         PM-JAY is the world’s largest health insurance/ assurance scheme fully financed by the government.

·         It provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India.

·         Over 10.74 crore poor and vulnerable entitled families (approximately 50 crore beneficiaries) are eligible for these benefits.

·         Services include approximately 1,393 procedures

Benefit Cover Under PM-JAY

PM-JAY provides cashless cover of up to INR5,00,000 to each eligible family per annum for listed secondary and tertiary care conditions. The cover under the scheme includes all expenses incurred on the following components of the treatment.

·         Medical examination, treatment and consultation

·         Pre-hospitalization

·         Medicine and medical consumables

·         Non-intensive and intensive care services

·         Diagnostic and laboratory investigations

·         Medical implantation services (where necessary)

·         Accommodation benefits

·         Food services

·         Complications arising during treatment

·         Post-hospitalization follow-up care up to 15 days

The benefits of INR 5,00,000 are on a family floater basis which means that it can be used by one or all members of the family. The RSBY had a family cap of five members., PM-JAY has b is no cap on family size or age of members. Any eligible person suffering from any medical condition before being covered by PM-JAY will now be able to get treatment for all those medical conditions as well under this scheme right from the day they are enrolled.

Source: PMJAY