Ayushman Bharat Yojna: Features, Eligibility and Facts
About Ayushman Bharat Yojana or PMJAY
Date of Launch: 23 September 2018
Where: Ranchi, Jharkhand
Who started: Prime Minister Mr. Narendra Modi
Main Goal: It will offer a benefit cover of Rs 5 lac per family per year (approx. 50 crore beneficiaries)
It is a matter of great concern that approximately 63% of India's population still pays for health and hospitalization expenses by their own. Besides using their income and savings, people borrow money or sell their assets to meet their healthcare needs, thereby pushing 4.6% of the population Below Poverty Line.
In order to solve this type of problem, Prime Minister Narendra Modi launched the ambitious Ayushman Bharat Yojna so that the people get treatment without being trapped into the vicious circle of poverty.
a. Non-communicable diseases
b. Management of mental illness
c. Neonatal and infant health services
d. Pregnancy care and maternal health services
e. Chronic communicable diseases
f. Child health
g. Geriatric care Emergency medicine
h. Dental care
i. Coronary bypass
j. Knee replacements
a. Families having only one room with Kucha walls and Kucha roof.
b. SC/ST households; and landless households deriving a major part of their income from manual casual labour.
c. Disabled members and no able-bodied adult members in the family.
d. Families having no adult members between the ages of 16-59 years.
e. Female-headed households with no adult male member between the ages of 16-59 years.
In addition to the above beneficiaries these families in rural areas having any one of the following will be automatically included:
a. Households without shelter
c. Living on alms
d. Manual scavenger families
e. Primitive tribal groups
d. Legally released bonded labour
There are 11 occupational categories that are entitled to get the benefit of this Yojna. Ten categories are;
3. Domestic workers
4. Street vendors/cobblers/hawkers/ construction workers/ plumbers/ masons/ labour/ painters/ welders/ security guards/coolies and other head-load workers
5. Transport workers/ drivers/ conductors/helpers to drivers, conductors/cart pullers/ rickshaw pullers
6. Electricians/ mechanics/ assemblers/repair workers
7. Sweepers/ sanitation workers/ malis
8. Washer-men/ chowkidars
9. Home-based workers/ artisans/handicrafts workers/ tailors
10. Shopworkers/ assistants/ peons in small establishments/ helpers/ delivery. assistants / attendants/ waiters
II. Garbage collectors
III. Domestic help workers
IV. Rehdi owners
VI. Rickshaw pullers
VII. Security guards
VIII. Workers working on construction site
XIV. Cleaning workers
XV. Handicrafts workers
1. Ayushman Bharat Yojna is being run by the Ministry of Health and Family Welfare.
2. This is a holistic scheme under which girl child, women, children, and the elderly will be covered so there will be no cap on family size and age in this Mission.
3. The Yojna will be cashless & paperless at public hospitals and selected private hospitals.
4. The beneficiaries will not be required to pay any charges for the hospitalization expenses. The benefit also includes pre and post-hospitalization expenses.
5. When this Yojna will be fully implemented, the PM-JAY will be the world’s largest government-funded health protection mission.
6. About 50 crore Indians will be benefited from the Ayushman Bharat Scheme. The beneficiaries of this scheme comprise of 445 districts of 29 States / Union Territories.
7. Prime Minister Jan Swasthya Yojana (PM-JAY) has defined 1,350 medical packages covering surgery, medical and daycare treatments including medicines, diagnostics, and transport.
8. PM-JAY covers medical and hospitalization expenses for almost all secondary care and most the tertiary care procedures.
9. The PM-JAY is named Ayushman Bharat Scheme which is justifiable because the treatment under this scheme will increase the life of the beneficiaries. Other names of this scheme are; PM-JAY, Modicare and National Health Security Scheme.
It can be concluded that Ayushman Bharat Yojna assures the 50 crore peoples of the country to be sure about the treatment of some severe diseases without selling their houses, Jewellery and other immovable assets etc.
FAQs on the Ayushman Yojna
Question 1:- What benefits are available under PM-JAY?
Answer: PM-JAY provides an insurance cover upto Rs. 5 lakh/family/year for secondary and tertiary hospitalization. All pre-existing conditions are covered from day 1 of implementation of PM-JAY in the respective States/UTs.
Question 2:- What health services are available under the PM-JAY?
Answer: (PM-JAY) has defined 1,350 medical packages covering surgery, medical and daycare treatments including medicines, diagnostics, and transport.
The health services include hospitalization expenses, pre, and post hospitalization expense benefits, day care surgeries, follow-up care, and newborn child/children services etc.
Question 3:- Who is eligible to avail of the benefits of the PM-JAY?
Answer: PM-JAY covers more than 10 crore poor and vulnerable families (around 50 cr beneficiaries) across the country.
The beneficiaries of this Yojna are deprived of rural families and occupational categories of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data.
Every member of a family is covered irrespective of family size, age, gender, and seniority.
Question 4:- Will beneficiaries have to pay anything to get treatment from this scheme?
Answer: No. All eligible beneficiaries can avail free services for secondary and tertiary hospital care for identified packages under PM-JAY at public hospitals and registered private hospitals.
Beneficiaries will have cashless and paperless access to health services under PM-JAY.
It is worth mentioning that if any patient gets just diagnosis then he has to pay the doctor's fee and medicine expenses as well. So a patient needs to get hospitalised to get the free treatment under this Yojna.
Question 5:- What is the enrolment process? Is there any time period for enrolment?
Answer: Ayushman Bharat is an entitlement based mission. There is no enrolment process. Families who are identified by the government on the basis of deprivation and occupational criteria using the socio-economic database both in rural and urban areas are eligible for PM-JAY. In the rural areas, the eligible families have already got the card of PM-JAY Yojna.