Ayushman Bharat Yojana – All You Need to Know About PMJAY

Prime Minister Narendra Modi launched Ayushman Bharat Yojana, the world’s largest government-funded healthcare scheme in Jharkhand’s capital Ranchi. It was later renamed as Pradhan Mantri Jan Arogya Yojana (PMJAY). Here’s a deeper insight into the details of this scheme. Ayushman Bharat will include the current centrally funded schemes.

What Is Ayushman Bharat Yojana?

Ayushman Bharat National Healthcare Protection Scheme (AB-NHPS) is targeted at the poor, deprived families of rural areas and identified occupational category of urban worker’s families. It covers approximately 50 crore people. It is planned to provide coverage of 5 lakh per year per family for tertiary and secondary care hospitalisation. 

Key Features of Ayushman Bharat Yojana:

The key features of Ayushman Bharat Yojana are listed below:

  • There isn’t any cap on the age and family size under the AB-NHPS to ensure that nobody is left out.
  • It will have pre-determined benefit coverage of five lakh rupees per year per family.
  • People can avail services under this scheme at any public hospital and private healthcare facility that is empaneled.
  • One of the main principles is to maintain co-operative federalism and flexibility of states.
  • It is an entitlement-oriented scheme wherein the entitlement is decided based on the deprivation conditions in the database of Socio-Economic Caste Census (SECC).

Eligibility Criteria for Ayushman Bharat Yojana (ABY):

The Ayushman Bharat Yojana eligibility criteria are different for rural area categories and urban area categories. 

Rural Area CategoriesThe various categories in rural places include families possessing just a single room with kucha roof and kucha walls, families with no adult member in the age group of 16 – 59 years, disabled members and no able-bodied adult member in the family, households headed by females without any adult member in the age group of 16-59 years and landless households getting a major part of their income from casual manual labour.

Urban Area Categories: For this category, eleven defined occupational categories are eligible under this scheme. These are beggars, domestic workers, cobblers, street vendors,  hawkers, other service providers working on the streets, home-based workers like tailors, artisans, handicraft workers, transport workers like drivers, rag-pickers, conductors, rickshaw-pullers, cart pullers, helpers, delivery-assistants, welders, security guards, plumbers, carpenters, electricians, mechanics, repair workers, shop workers, peons, etc.

How to Apply for Ayushman Bharat Yojana?

There isn’t any actual enrolment process in this scheme because it is a mission based on entitlement. The government identifies the families based on their poverty and occupational conditions with the help of the SECC database in urban as well as rural areas. A list of eligible families is usually shared with the respective state governments as well as state-level departments of important areas. A unique AB-NHPS identification number will be allotted to eligible families. Only the family names that are present on the list are entitled to the benefits.

Documents Required for Ayushman Bharat Yojana:

The documents required for Ayushman Bharat Yojana are listed below:

  • Respective special category certificates
  • Family structure
  • Documents for age proof
  • Identification proof
  • Contact details
  • Scanned Aadhaar card copy
  • Caste certificate 
  • Income certificate

Ayushman Bharat Yojana Registration Online: 

No registrations are required. PMJAY usually provides cashless and paperless access to services for the beneficiaries. The beneficiaries will be provided with letters, which will have QR codes. These will need to be scanned and an authentication will be conducted for identification and to verify his/her eligibility.

Ayushman Bharat Yojana Implementation Strategy:

AB-NHPMA (Ayushman Bharat National Health Protection Mission Agency) would be set up at the national level for managing things. The union territories and states would be asked to deploy the scheme through a dedicated unit known as SHA (State Health Agency). They can either establish a new unit or use an already existing society, trust, SNA (State Nodal Agency) or Not for Profit Company for implementing the scheme. The union territories or states can decide to deploy this scheme via an insurance firm or with the help of an integrated model or directly through the Society or Trust. 

The Impact of Ayushman Bharat Yojana

Ayushman Bharat Yojana will have a huge effect on the reduction of OOP (Out of Pocket) expenses on the basis of:

  • Increased coverage of benefit to the vulnerable and poorest people, which is almost 40-percent of the population
  • Covers most of the tertiary and secondary hospitalisation
  • Provides a coverage of INR 5 lakh to each family (there is no family size restriction)

This will result in better access to good quality medication and health. Furthermore, the needs that are not met will be looked after. This means there will be an improvement in the health, timely treatment, an improvement in efficiency and productivity and patient satisfaction, thus resulting in an enhancement in the kind of the life they lead. 

Expenses Involved

The expenses involved in the payment of premium get shared between the State and the Central Government in a ratio that is specified according to the guidelines of the Ministry of Finance. The total expense depends on the actual premium (as determined in the market) in union territories and states where Ayushman Bharat – NHPM gets implement through insurance firms. In union territories and states where it is implemented in Society or Trust mode, the major funds will be given depending on the premium ceiling or actual expenses in a pre-decided ratio. 

The Beneficiaries of Ayushman Bharat – NHPM

This scheme targets around 10.74 crore deprived, poor rural families in addition to certain identified urban families (which are decided based on their occupational category according to the latest SECC (Socio-Economic Caste Census)) report covering both urban and rural areas.  This is an aspirational and dynamic scheme, which would consider any possible future modifications in the inclusion, exclusion or occupational criteria in the data of SECC. 

Districts or States Covered

Ayushman Bharat – NHPM will be initiated across all union territories and states in all the districts with the goal of covering all targeted beneficiaries. 

Ayushman Bharat Yojana is a revolutionary scheme launched by the Prime Minister Narendra Modi. Besides this scheme, there are many other great schemes launched by the Indian government for the welfare of the people, few of which include Ayushman Mitra Recruitment 2018, Rashtriya Swasthya Bima Yojana (RSBY), PMAY and Pradhan Mantri Jan Dhan Yojana to name a few. All these schemes would definitely be a great source of help for the poor and deprived across the nation.

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