Ayushman Bharat Health Scheme, Achievements, Important Facts

Union Cabinet has approved free health coverage for all senior citizens aged 70 years and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). Get all about Ayushman Bharat Scheme.

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Context: The Lieutenant Governor urged Delhi’s CM to Implement Centre’s Ayushman Bharat health scheme.

Union Cabinet Approves Health Coverage for Senior Citizens

The Union Cabinet, led by Prime Minister Narendra Modi, has approved free health coverage for all senior citizens aged 70 years and above under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). This move provides ₹5 lakh annual health insurance per family, benefiting 4.5 crore families and approximately 6 crore senior citizens.

Key Highlights:

Eligibility: All senior citizens aged 70+ will receive coverage, irrespective of income or socio-economic status.
Top-Up for Existing Members: Senior citizens already covered under AB PM-JAY will get an additional top-up of ₹5 lakh, separate from other family members.
Choice of Schemes: Those enrolled in CGHS, ECHS, or private health insurance can opt for AB PM-JAY.

This initiative expands the world’s largest publicly funded health scheme, ensuring quality healthcare for India’s elderly population.

Ayushman Bharat Health Scheme

The Ayushman Bharat Health Scheme, also known as Pradhan Mantri Jan Arogya Yojana (PMJAY), is a flagship healthcare initiative launched by the Government of India. Introduced in September 2018, the scheme aims to provide financial protection to economically vulnerable families against catastrophic health expenditures.

Under Ayushman Bharat, eligible beneficiaries are entitled to receive health coverage of up to INR 5 lakhs per family per year, covering secondary and tertiary healthcare services. The scheme primarily targets poor and marginalized sections of society, providing them with access to quality healthcare services without facing financial distress.

Ayushman Bharat Health Scheme Overview

Ayushman Bharat Health Scheme Overview
Category	Universal Health Coverage (UHC)
Type	Centrally Sponsored Scheme
Launched	2018
Purpose	To address the healthcare system (covering prevention, promotion and ambulatory care) at the primary, secondary and tertiary level.
Implementing Agency	National Health Authority (NHA).
Components	Health and Wellness Centres (HWCs) Pradhan Mantri Jan Arogya Yojana (PM-JAY)

What are Health and Wellness Centres (HWCs)?

Health and Wellness Centres (HWCs) deliver Comprehensive Primary Health Care (CPHC) bringing healthcare closer to the homes of people.
They cover both, maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services.
Funding is through the National Health Mission (NHM)

Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Provides cashless cover of up to ₹ 5,00,000 to each eligible family per annum for listed secondary and tertiary care conditions.
The households included are based on the deprivation and occupational criteria of Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas respectively.
PM-JAY was earlier known as the National Health Protection Scheme (NHPS).
PM-JAY is fully funded by the Government and cost of implementation is shared between the Central and State Governments.

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Important Facts About Ayushman Bharat Health Scheme

33 states and union territories have adopted the AB-PMJAY, with the exceptions of West Bengal, the National Capital Territory (NCT) of Delhi, and Odisha.
Ayushman Bharat Digital Mission (ABDM):
- Initiated: 2021,
- Aim: To issue Unique Digital Health IDs (UHID) to every citizen in India.
- This endeavour facilitates electronic access to health records for individuals, healthcare providers, and insurance companies as needed.

Features of Ayushman Bharat Health Scheme

Key features of the Ayushman Bharat Health Scheme include:

Coverage: The scheme covers over 10 crore families identified based on socio-economic criteria, making it one of the largest health insurance schemes globally.
Cashless Treatment: Beneficiaries can avail of cashless treatment at empanelled public and private hospitals across India for specified medical conditions and procedures.
Portability: Ayushman Bharat provides portability of benefits, allowing beneficiaries to avail treatment at any empanelled hospital within the country.
Emphasis on Wellness: In addition to providing financial protection against hospitalization expenses, the scheme also focuses on promoting preventive healthcare measures and wellness initiatives.
Technology Integration: The scheme utilizes technology-driven tools such as the Ayushman Bharat digital platform to streamline beneficiary identification, eligibility verification, and claims processing.

Achievements Of Ayushman Bharat Health Scheme

Approximately 15.5 crore families are covered.
The creation of over 24 crore Ayushman Cards has been accomplished.
Beneficiaries have collectively saved in excess of Rs 1 lakh crore, a figure often linked to reduced Out of Pocket Expenditure (OOPE).
11 states/UTs have pushed for 100% coverage of their respective population.
The World Bank highlights that India’s out-of-pocket healthcare expenses, constituting 50.59%, stand as the highest amongst emerging nations.

Ayushman Bharat Health Scheme FAQs

What is Ayushman Bharat Health Scheme?

Ayushman Bharat Health Scheme, also known as Pradhan Mantri Jan Arogya Yojana (PMJAY), is a healthcare initiative by the Government of India aimed at providing financial protection to economically vulnerable families against high medical expenses.

Who is eligible for Ayushman Bharat Health Scheme?

The scheme primarily targets poor and marginalized families identified based on socio-economic criteria. Eligibility is determined through the Socio-Economic Caste Census (SECC) database.

What benefits does Ayushman Bharat Health Scheme offer?

Under the scheme, eligible beneficiaries are entitled to receive health coverage of up to INR 5 lakhs per family per year for secondary and tertiary healthcare services. This coverage includes hospitalization expenses for specified medical conditions and procedures.

Where can beneficiaries avail treatment under Ayushman Bharat Health Scheme?

Beneficiaries can avail cashless treatment at empaneled public and private hospitals across India. The scheme provides portability of benefits, allowing beneficiaries to access treatment at any empaneled hospital within the country.

How does one enroll in Ayushman Bharat Health Scheme?

Beneficiaries are identified and enrolled through the Socio-Economic Caste Census (SECC) database. They receive a unique identification number (UHID) which allows them to avail benefits under the scheme.