Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is a flagship insurance scheme.
New Delhi:
The Centre on Wednesday approved health coverage for all senior citizens aged 70 and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme. This decision will benefit approximately 4.5 crore families, with 6 crore senior citizens receiving a Rs 5 lakh health insurance cover on a family basis.
The scheme, considered the world’s largest publicly funded health assurance scheme, will provide comprehensive healthcare coverage to senior citizens, regardless of their socio-economic status. Eligible senior citizens will be issued a new distinct card under AB PM-JAY, enabling them to avail benefits of the scheme.
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 assurance scheme, targeting over 12 crore poor and vulnerable families, covering approximately 55 crore beneficiaries, which is about 40 per cent of the Indian population.
ObjectivesAyushman Bharat Pradhan Mantri Jan Arogya Yojana was designed to fulfil the National Health Policy 2017’s vision of Universal Health Coverage (UHC), ensuring that no one is left behind.The scheme addresses healthcare from primary to tertiary levels, providing preventative, promotive and curative services.ComponentsHealth and Wellness Centres: These centres provide primary healthcare 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 component provides health insurance coverage of up to Rs 5 lakh per family annually for secondary and tertiary care hospitalisation.Ayushman Bharat Pradhan Mantri Jan Arogya Yojana: Eligibility criteriaTo be eligible, applicants must belong to specified categories:SC/STLower Income GroupEconomically Weaker Sections (EWS)
Rural:
Scheduled caste and scheduled tribe householdsBeggars and those surviving on almsFamilies with no individuals aged between 16 and 59 yearsFamilies having at least one physically challenged member and no able-bodied adult memberLandless households who make a living by working as casual manual labourersPrimitive tribal communitiesLegally released bonded labourersFamilies living in one-room makeshift houses with no proper walls or roofManual scavenger families
Urban:
Urban workers’ families in occupational categories present in the Socio-Economic Caste Census 2011Families enrolled under the Rashtriya Swasthya Bima Yojana (RSBY)How to check eligibility online:Visit the official websiteAccess the “Am I Eligible” sectionInput mobile number and captcha code, then click “Generate OTP”Enter OTP and click “Verify OTP”Furnish essential information and click “Submit”How to Apply for Ayushman Bharat Pradhan Mantri Jan Arogya YojanaVisit the official websiteGet your Aadhaar card or ration card verified at a PMJAY kioskProvide family identification proofsGet your e-card printed with a unique AB-PMJAY IDBenefits of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Beneficiaries are entitled to a health cover of Rs 5 lakh annually, covering costs like hospitalisation, treatment, diagnostics, medicines, surgery and post-treatment care.Pradhan Mantri Jan Arogya Yojana provides cashless services across public and private hospitals, reducing out-of-pocket expenses for beneficiaries.Unlike previous health schemes, there is no cap on the family size, age, or gender of the beneficiaries.The scheme covers up to 3 days of pre-hospitalisation and 15 days of post-hospitalisation expenses, including diagnostics and medicines.Beneficiaries can avail of services across India in any empanelled hospital.From the first day of enrollment, all pre-existing diseases are covered under the scheme.The scheme helps mitigate the financial burden caused by serious illnesses and hospitalisation, preventing families from being pushed into poverty.The scheme covers almost 1,929 procedures, including costs for physician fees, room charges, diagnostics, ICU care and medical implants.Ayushman Bharat Pradhan Mantri Jan Arogya Yojana coverage detailsThe scheme covers all expenses related to:Medical examinations, treatment and consultations.Pre-hospitalisation care, up to three days before admission.Medicines and medical consumables.Non-intensive and intensive care services (ICU care).Diagnostic and laboratory investigations.Medical implants, if necessary.Accommodation and food services during hospitalisation.Complications arising during treatment.Post-hospitalisation follow-up care, up to 15 days after discharge.
