Ayushman Bharat- PMJAY provides health coverage to around 10.74 crore poor

AB-PMJAY covers deprived families in rural areas and families of workers of identified occupational categories in urban areas, as per the Socio-Economic Caste Census (SECC) - 2011 data.

Facilities under Ayushman Bharat – Health & Wellness Centres (AB-HWCs) are available to all. Salient features and targets of the AB- HWCs are given below:

Salient Features and Targets of Ayushman Bharat – Health and Wellness Centres

1. Under AB-HWC, Comprehensive Primary Healthcare is being provided which includes promotive, preventive, curative, palliative and rehabilitative services.

2. The AB-HWCs is envisioned to provide an expanded range of services to include care for non - communicable diseases, palliative and rehabilitative care, Oral, Eye and ENT care, mental health and first level care for emergencies and trauma as well as Health promotion and wellness activities like Yoga apart from services already being provided for Maternal and Child Health including immunization and communicable diseases.

3. To provide comprehensive health coverage to the beneficiaries, free essential drugs and diagnostic services are also being provided through these AB-HWCs.

4. The rollout plan of Ayushman Bharat - HWCs is given as below:

• FY 2018-19 = 15,000

• FY 2019-20 = 25,000 (Cumulative 40,000)

• FY 2020-21 = 30,000 (Cumulative 70,000)

• FY 2021-2022 = 40,000 (Cumulative 1,10,000)

• Till 31st December 2022 = 40,000 (Cumulative 1,50,000)

Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides health coverage to around 10.74 crore poor and vulnerable families as per Socio-Economic Caste Census (SECC) data. The salient features of Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) are given below:

Salient Features of Pradhan Mantri Jan Arogya Yojana [PMJAY]

1. Government of India has launched Ayushman Bharat Pradhan Mantri Jan ArogyaYojana (PMJAY) on 23.09.2018. PMJAY is a centrally sponsored scheme. It is entirely funded by Government and the funding is shared between Centre and State governments as per prevailing guidelines of the Ministry of Finance.

2. PMJAY provides health coverage up to Rs. 5 lakh per family per year for secondary and tertiary hospitalization to around 10.74 crore poor and vulnerable families (approx. 50 crore beneficiaries).

3. PMJAY is an entitlement based scheme. This scheme covers poor and vulnerable families based on deprivation and occupational criteria as per the SECC database.

4. PMJAY provides cashless and paperless access to services for the beneficiary at the point of service in any (both public and private) empanelled hospitals across India. In other words, a beneficiary from one State can avail benefits from an empanelled Hospital anywhere in the Country.

5. Under PMAJY, the States are free to choose the modalities for implementation. They can implement the scheme through an insurance company or directly through the Trust/ Society or a mixed model.

6. There is no restriction on family size, ensuring all members of designated families specifically girl child and senior citizens get coverage.

7. A well-defined Complaint and Public Grievance Redressal Mechanism has been put in place through which complaints/ grievances are registered, acknowledged, escalated for relevant action, resolved and monitored.

8. PMJAY has created a robust IT system for implementation and role of real-time transaction data.

9. At the National level, the National Health Authority (NHA) has been set up as an attached office to the Ministry of Health and Family Welfare to manage the implementation of the scheme.

10. The details of package, operational guidelines and key features are available at www. pmjay.gov.in

AB- PMJAY provides cashless treatment to the entitled beneficiaries at empanelled hospitals. No money is released to the beneficiary and payment is made directly to the hospitals by State Health Agency (SHA) in case of Trust Mode, and by Insurance company in case of Insurance mode.

As on 18.06.2019, the total number of claims made are 23,26,520 and total claim amount submitted is Rs.3077,51,38,624.

AB-PMJAY covers deprived families in rural areas and families of workers of identified occupational categories in urban areas, as per the Socio-Economic Caste Census (SECC) - 2011 data. All such beneficiary families under RSBY that do not feature in the targeted groups as per SECC data are also covered under PMJAY. At present, there is no proposal to extend the coverage of PMJAY.

The Minister of State (Health and Family Welfare), Shri Ashwini Kumar Choubey stated this in a written reply in the Rajya Sabha here today.

(With Inputs from PIB)