Ayushman Bharat

Ayushman Bharat –

Ayushman Bharat also known as Pradhan Mantri Jan Arogya Yojana(PMJAY) is the national health assurance scheme launched on 23rd September 2018 by the Ministry of Health and Family Welfare (Government of India) as a part of the National Health Policy. The scheme aims to provide health coverage to poor households with low income .

PMJAY |Features & Achievements

  • PMJAY is the world’s largest health assurance scheme
  • Provides health coverage to 10 crore households ,covers 50 crore people in India.
  • Scheme provides Rs – 5 lakh per family in a year for medical treatment in empanelled hospitals.
  • Both public and private hospitals are empanelled in this scheme
  • More than 23,000 hospitals are empanelled under the scheme.
  • Cashless transaction & paperless recordkeeping
  • No limitation  on family size, age, or gender
  • It  covers 3 days of pre-hospitalization  as well as 15 days of post-hospitalization
  • Also providing access to free COVID-19 testing.

Achievements 

  • According to the official data by the Govt of India, in the first 200 days of implementation more than 20.8 lakhs people got benefited from the Ayushman Bharat scheme
  • In  May 2021 Prime minister Narendra Modi quoted in Mann ki Baat, Ayushman scheme has provided more than 1 crore treatments worth Rs- 13,412 crore
  • According to ehealth.eletsonline.com  more than 16.88 crore recipients have been substantiated under the scheme
  • Around 2.3 crores hospitals admission have been sanctioned worth Rs-27,500crores

Ayushman Card :

The PMJAY beneficiaries get the Ayushman card , through it recipient gets the health benefits under empanelled hospitals across the nation & enables you to get cashless treatment.

Major treatment covered under Ayushman Bharat-

  • Double valve replacement.
  • Coronary artery bypass graft.
  • COVID-19.
  • Pulmonary valve replacement.
  • Skull base surgery.
  • Prostate cancer.
  • Anterior spine fixation.
  • Laryngopharyngectomy with gastric pull-up
  • Tissue expander for disfigurement following burns.
  • Carotid angioplasty with stent.

Eligibility criteria –

The criteria are different for the citizens residing in urban and rural areas.

For Rural area

Households with one of the 6 criteria mentioned below-

  Households with one room with Kucha walls and roof.

Households headed by the female with no adult member in age group 16 to 59 years

No adult member in the age bracket between 16 and 59 years.

There should be no adult male member lies in the age between 16 and 59 years.

Disabled member and no-abled-bodied adult member in the household.

SC and ST households

Landless households which attain major sources of income by manual casual labor

  1. Living on alms
  2. Manual scavenger families
  3. Bonded Labors who are legally released
  4. Manual scavenger families
  5. Households without shelters

For urban-

Households should lie under the following categories mentioned below –

Ragpicker, Domestic worker, BeggarCobbler, Street Vendor, Hawker, Other service providers on the street, Plumber/Construction Worker, Mason, Painter, Labour, Welder, Security Guard, Coolie, Sweeper, Mali, Sanitation Worker, Handicrafts Worker, Tailor, Home-based Worker Artisan, Driver, Transport Worker, Conductor/Cart or Rickshaw Pullers, Helper to Drivers or Conductors, Shop Workers, Peon in Small Establishment, Assistant, Helper, Attendant, Delivery Assistant, WaiterMechanic, Electrician, Repair Worker, Assembler

Households that Fulfills any of the criteria mentioned below are not eligible.

•             One who owns 2,3 and 4 wheelers and motorized boat

•             Owner  of 5 acres land or more

•             Owns the refrigerator

•             Owns the  landline phone

•             Earning more than Rs -10,000

•             Holder of Kisan card with a credit limit of Rs-50,000

•             Mechanized farming equipment

•             Income taxpayer

•             Have more than 2.5 acres of irrigated land and possess 1 irrigation equipment

•             Possess 5 acres of irrigated land

•             Household who owns non-agriculture enterprises which registered with the government

•             Professional taxpayer

•             Owner of  7.5 acres of land or more and have 1 irrigation equipment

Note – Families who possess white Annapurna and Anthyodaya Anna Yojana Ration cards (both rural and urban)

Recent development-

  • On 27th September 2021 Prime Minister Narendra Modi launched Ayushman Bharat Digital mission that will link the digital health solutions of hospitals across the nation. It will provide digital health ID cards for all Indian citizens to help hospitals, insurance companies, citizens access health records electronically.

Implementation-

  • All States and Union Territories have the choice whether to enroll in the Ayushman scheme or not. Initially, 20 states participated in this scheme, and later more states engaged in it 
  • Some states rejected to take participation in this scheme due to their own existing state healthcare program.

Challenges –

  • There are lot many cases of fake medical bills that came into the limelight, so many hospitals were penalized due to this act
  • Fake surgeries and bills have been claimed by the various hospitals
  • Poor infrastructure is also a major challenge for the scheme

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