Ayushman Bharat Yojana

Introduction

• Ayushman Bharat Yojana, is an important health service scheme of Government of India.
• It is also known by the name of Pradhan Mantri Jan Arogya Yojana (PMJAY).
• It was launched by the Prime Minister of India on 23rd September 2018 in Ranchi, Jharkhand.
• Ayushman Bharat Yojana has two components :-
  • Health and Wellness Centres (HWCs).
  • Pradhan Mantri Jan Arogya Yojana (PM-JAY).
• Under the Health and Wellness Centres component, the Government of India announced the creation of 1,50,000 Health and Wellness Centres (HWCs) by updating existing sub centres and primary health centres.
• These centres are meant to provide comprehensive primary health care (CPHC) facilities to the people of country.
• They cover both maternal and child health services and non-communicable diseases, including essential medicines and diagnostic services free of charge.
• The Second component under the Ayushman Bharat Yojana is the Pradhan Mantri Jan Arogya Yojana or PM-JAY.
• It is the world's largest health insurance scheme which aims to provide a health cover of Rs. 5 Lakh per family per year.
• More than 10.74 crore poor and vulnerable families (about 50 crore beneficiaries)will get the benefit of this scheme.
• The families included are based on the deprivation and occupational criteria of Socio-Economic Caste Census (SECC 2011) from rural and urban areas.
• Pradhan Mantri Jan Arogya Yojana (PM-JAY) was earlier known as National Health Protection Scheme (NHPS).
• Pradhan Mantri Jan Arogya Yojana (PM-JAY) is fully funded by the Government and the cost of implementation is shared between the Central and State Governments.

Benefits of the scheme

• Under Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana provides cashless cover of Rs. 5,00,000/- per year to each eligible family.
• The cover under the scheme includes all expenses incurred on the following components of 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.
  • Accommodation Benefits.
  • Food Services.
  • Complication arising during treatment.
  • Post-hospitalization follow-up care up to 15 days.
• The benefit of Rs. 5,00,000/- can be used by one or all of the family.
• There is no limit on the size of the family or the age of the family members.
• Pre-existing diseases are also covered under this scheme.
• Any eligible person suffering from any medical condition before being covered by Pradhan Mantri Jan Arogya Yojana will now be able to get treatment for all type of medical conditions from the day beneficiary get enrolled.

Eligible Beneficiaries

Features of the Scheme

• The government of India has committed to ensure that its population has universal access to good quality health care services without facing financial hardship.
• In Ayushman Bharat Yojana, also known as Pradhan Mantri Jan Arogya Yojana, cashless and paperless treatment will be provided at public and private selected hospitals.
• The primary objective of this scheme is to provide the benefit cover of Rs. 5 Lakh per family per year to the poor people of the country.
• It also aims at reducing financial burden on poor and vulnerable groups arising out of catastrophic hospital episodes.
• Objective of this scheme to provide benefit to around 10 crores families or 50 crore Indian people.
• Medical facilities will be available in both public and private hospitals.
• There is no restriction on family size, age or gender.
• This scheme covers 3 days of pre-hospitalisation and 15 days of post hospitalization expenses incurred on treatment.
• For any grievance, a 24*7 helpline number (14555) is available for people.
• Under this scheme, the beneficiary can take benefit anywhere in the country.

Status of the Scheme

How to Avail Benefit

• To take benefit of this scheme, it is necessary for the beneficiary to have an Ayushman card.
• Beneficiary can apply in any nearest CSC center to get Ayushman Card.
• In every government and private empaneled hospitals, separate counter facility has been provided for the patients coming under Ayushman Yojana.
• It is mandatory to register first at the same counter during general treatment of beneficiary.
• But in case of emergency, first patient can be admitted and later the registration can be done.
• After the registration is done, the government will bear all the cost of the treatment.
• It is necessary to show Ayushman card while taking benefit under this scheme in any hospital.

Employees' State Insurance Corporation Joins Ayushman Bharat Yojana.

• Employees' State Insurance (ESIC) has entered into a partnership with National Health Authority (NHA).
• This convergence between Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (ABPM-JAY) and Employees' State Insurance Corporation (ESIC) will enable Employees' State Insurance Corporation (ESIC) beneficiaries to access services at Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana empaneled Hospitals and vice versa.
• In the initial phase, it was launched as a pilot project in Ahmednagar, Maharashtra and Bidar, Karnataka, Where Employees'' State Insurance beneficiaries got access to medical care services of Pradhan Mantri Jan Arogya Yojana (PM-JAY) empaneled Hospitals.
• On successful completion of this pilot project, the Employees'' State Insurance Scheme has been extended to 113 designated districts in 4 states by merging with Pradhan Mantri Jan Arogya Yojana.
• Those States are :-
  • Chhattisgarh.
  • Karnataka.
  • Madhya Pradesh.
  • Maharashtra.
• The major benefits to the Employees'' State Insurance Corporation (ESIC) beneficiaries are :-
  • Employees' State Insurance Corporation (ESIC) beneficiaries will get access to healthcare provided under Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
  • Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) beneficiaries will also able to avail the services in Employees'' State Insurance Corporation (ESIC) empanelled Hospitals.
  • Beneficiaries of Employees' State Insurance Corporation (ESIC) can use their ESIC card to access free treatment at Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) empanelled Hospitals.
  • Similarly, beneficiaries of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) can use their AB PM-JAY card to access free treatment at Employees' State Insurance Corporation empanelled hospitals.

Important Links

• Official PM-JAY Website.
• Ayushman Bharat-Health and Wellness Centre.
• Eligibility Check.
• Find Empanelled Hospital.
• National Health Portal.
• Employees'' State Insurance Corporation.
• National Health Authority.
• Ministry of Health and Family Welfare.
• Ayushman Bharat (PM-JAY) APP.

Contact details

• Toll Free Number :-
  • 14555.
  • 14588.
  • 1800111565.
• Postal Address : 9th Floor, Tower-l,
  Jeevan Bharati Building, Connaught Place,
  New Delhi - 110001