NAME : Ayushman Bharat -Pradhan Mantri Jan Arogya Yojana.
TYPE OF YOJANA : This yojana is a social welfare scheme which will provide secondary and tertiary hospitalization expenses up to Rs. 5 Lakhs free of cost per family per year. This scheme in its first phase will provide these benefits to 10 Crore BPL families ( covering around 50 crore Indians ) through cash less insurance cover.
MINISTRY : Ministry of Health and Family Welfare
WEBSITE : http:/ www.abnhpm.gov.in/
PURPOSE : The main purpose of this yojana is to provide a service to create a healthy, capable and content new India. Main goal of the yojana is of creating a network of health and wellness infrastructure across the nation to deliver comprehensive primary healthcare services.,
Another main purpose of this yojana is to provide health insurance benefits to over 10.74 crore poor and vulnerable families (approximately 50 crore beneficiaries). This yojana provides Insurance coverage upto 5 lakh rupees per family per year for secondary and tertiary care hospitalization expenses. This insurance cover is of cash less type and all expenses of pre and post hospitalizations are covered under this yojana.
Ayushman Bharat – National Health Protection Mission will subsume the on-going centrally sponsored schemes – Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS)
STRUCTURE : At the national level to manage, an Ayushman Bharat National Health Protection Mission Agency (AB – NHPMA) is established.
States/ UTs are establishing dedicated entity called State Health Agency (SHA). States have been given two options They can either use an existing Trust/ Society/ Not for Profit Company/ State Nodal Agency (SNA) or set up a new entity to implement the scheme.
In the first stage more than 10.74 Crores poor and vulnerable families from the SECC data are selected for providing benefits under this scheme. This will cover almost 50 Crores Indians.
These families will be provided health insurance cover up to Rs. 5 Lacs per family per year. Under this cover free secondary and tertiary care hospitalization will be provided to these families. Preference will be given to children and women.
Free treatment is available at all public and empanelled hospitals ( presently 15,104 ). Total 1350 medical packages covering surgeries, medical and day care treatments, cost of medicines and diagnostics have been approved.
Total treatment under this yojana is to be provided on cash less basis. Hospitals will be paid through insurance companies. Hospitals are not allowed charge any money to the patients.
To ensure that nobody is left out (especially girl child, women, children and elderly), there will be no cap on family size and age in this yojana.
LAUNCHING DETAILS : Hon’ble Prime Minister launched this Yojana at Ranchi on 23rd September 2018. The yojana came in to effect w.e.f. 25th September 2018 on the birth anniversary of Pt. Deendayal Upadhyaya.
HOW TO PARTICIPATE : – The beneficiary families included in the first state are given one Gold card. The beneficiary has to approach primary health center near by and record his /her illness. The primary health center employee will check the patient and make referral for secondary or tertiary treatment to nearest Govt. or empanelled hospital. The Arogyamitra present at the Govt. or empanelled hospital will admit the patient and arrange the necessary surgery or other treatment.
BENEFICIARIES : Till date around 11 lac Gold cards have been issued to the beneficiaries. Around 3 Lac 86 Thousand beneficiaries have registered them selves under this yojana for various treatments. Total 15000 Private Hospitals have been empanelled under this yojana for giving various treatments under this yojana.