Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is a flagship insurance scheme.
New Delhi:
The Centre on Wednesday approved health insurance for all senior citizens aged 70 and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme. The move will benefit around 4.5 crore families, with 6 crore senior citizens getting health insurance of Rs 5 lakh on a family basis.
The program, considered the world's largest government-funded health insurance, will provide comprehensive health coverage to seniors regardless of their socioeconomic status. Eligible seniors will be issued a new separate card under AB PM-JAY, which will allow them to avail the benefits of the program.
What is the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)?
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is a flagship health insurance scheme launched by the Government of India in 2018, aimed at providing affordable healthcare to the most vulnerable sections of society. It is the world's largest health insurance scheme, targeting over 12 crore poor and vulnerable families, and covers about 55 crore beneficiaries, which is about 40 percent of India's population.
Objectives
- Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is designed to realise the vision of National Health Policy 2017 of Universal Health Coverage (UHC) and ensure that no one is left behind.
- The scheme focuses on health care from primary to tertiary level and provides preventive, promotional and curative services.
Components
- Health and Wellness Centres: These centres provide primary health care services including maternal and child health and management of non-communicable diseases. Essential medicines and diagnostic services are also available free of charge.
- Pradhan Mantri Jan Arogya Yojana (PM-JAY): This feature provides health insurance up to Rs 5 lakh per family per year for secondary and tertiary hospitalisation.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana: Eligibility Criteria
- To be eligible, applicants must belong to the following categories:
- SC/ST
- Lower income group
- Economically Weaker Sectors (EWS)
National:
- Scheduled caste and tribe households
- Beggars and people who live on alms
- Families without persons between 16 and 59 years old
- Families with at least one physically disabled family member and no adult family member who is physically able to function
- Landless households who earn their living by working as casual manual laborers
- Primitive tribal communities
- Legally released forced laborers
- Families living in makeshift one-room houses without proper walls or roof
- Manual cleaning families
Urban:
- Families of urban workers in occupational categories included in the 2011 socio-economic caste census
- Families registered under the Rashtriya Swasthya Bima Yojana (RSBY)
How to check your eligibility online:
- Visit the official website
- Go to the 'Am I eligible' section
- Enter your mobile number and captcha code and then click on 'Generate OTP'
- Enter the OTP and click “Verify OTP”
- Enter the essential information and click “Send”
How to Apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
- Visit the official website
- Get your Aadhaar card or ration card verified at a PMJAY kiosk
- Provide proof of family identification
- Have your e-card printed with a unique AB-PMJAY ID
Benefits of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
- Beneficiaries are entitled to an annual health insurance of Rs 500,000, which covers expenses such as hospitalization, treatment, diagnostics, medicines, surgeries and aftercare.
- Pradhan Mantri Jan Arogya Yojana provides cashless care in public and private hospitals, reducing out-of-pocket costs for beneficiaries.
- Unlike previous care plans, there is no limit on family size, age or gender of beneficiaries.
- The scheme covers a maximum of 3 days of costs before hospital admission and 15 days of costs after hospital admission, including diagnostics and medication.
- Beneficiaries can avail the services of any affiliated hospital across India.
- From the first day of registration, all pre-existing illnesses are covered by the scheme.
- This scheme helps alleviate the financial burden caused by serious illnesses and hospital admissions and prevents families from falling into poverty.
- The scheme covers almost 1,929 procedures, including costs for doctors' fees, room costs, diagnostics, ICU care and medical implants.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Coverage Details
- The scheme covers all costs related to:
- Medical examinations, treatments and consultations.
- Prehospitalization care, up to three days before admission.
- Medicines and medical consumables.
- Non-intensive and intensive care (ICU care).
- Diagnostic and laboratory tests.
- Medical implants, if necessary.
- Accommodation and meals during hospital stay.
- Complications that occur during treatment.
- Aftercare after hospital admission, up to 15 days after discharge.