Ayushman Bharat Healthcare Scheme – Features and Eligibility

PM Shri Narendra Modi is being looked up as a ‘game changer’ in his four years of serving the nation. This especially holds true with respect to his vision of making India disease-free by 2025. The world has witnessed another phenomenal ‘Modicare’ launch in the form of Ayushman Bharat Yojana or the National Health Protection Scheme. Ayushman Bharat is being said to be the biggest government-sponsored healthcare scheme in the world as of now.

The official name of the project “Ayushman Bharat” means “Long Life India”. It aims to offer cashless and paperless healthcare services to the poor and lower strata of the population.  This centrally sponsored scheme, National Health Protection Scheme, was launched throughout India on 25 September 2018 under the Ayushman Bharat Mission of the Ministry of Health and Family Welfare (MoHFW) for a new India. This healthcare plan is one of the two major health programs covered under PMJAY which targets to secure the country’s poorest 40 percent who still lack basic services.

Salient Features:
  • The project offers a defined benefit cover of INR 5 lakh per family per year across 10 crore families covering approximately 50 crore beneficiaries. The scheme does not put any bar on family size, age, or gender.
  • The scheme is available to the beneficiaries covered under the scheme across India making them eligible for cashless benefits from either public or private empaneled hospitals. This means the families covered will not be required to pay any cash money to pay the bills for the treatment in case of hospitalization.
  • It is an entitlement based scheme where entitlement is decided on the basis of deprivation criteria in the Socio Economic and Caste Census (SECC) database.
  • The Government would pre-define the package rates for treatments so as to keep the treatment costs in control.
  • It will cover all pre-existing conditions and pre and post hospitalization costs.
  • One of the core principles of this healthcare mission is to extend co-operative federalism and flexibility to states.
  • An apex level Ayushman Bharat National Health Protection Mission Council (AB-NHPMC) has been proposed to pass policy directions and foster coordination between Centre and States. This shall be chaired by Union Health and Family Welfare Minister
  • State Health Agency (SHA) will work towards implementing the scheme in their respective states.
  • Delay in funds cannot be tolerated in healthcare services. An escrow account has been proposed for timely release of funds to SHA.
  • The registration ID would be linked to Aadhar card so as to enable paperless, cashless transaction. This will be done through a robust IT platform in partnership with NITI Aayog.
Eligibility:

The high hopes from this ambitious Ayushman Bharat National Health Protection Mission (ABNHPM) are steered by Indu Bhushan as the Chief Executive Officer (CEO). The National Health Agency (NHA) is the apex body responsible for implementing the scheme.
The scheme covers the poor, the deprived rural families and some urban workers’ families. These families are chosen from the SECC 2011 data. The entitlement criterion is decided on the basis of deprivation criteria in the SECC database. As of now, the deprivation categories D1 to D5 and D7 are identified for rural areas. There will be 11 occupational criteria for determining entitlement in urban areas.

Concerned about your eligibility for Ayushman Bharat Scheme? Don’t worry as it’s very easy. You can either call up the helpline number ‘14555’ or you can login online on NHA’s portal mera.pmjay.gov.in. All you require is a mobile number, your state, and one of the following information to check eligibility like name, ration card number, or Rashtriya Swasthya Bima Yojna URN number. If you are entitled, your details will show up at the right side along with the list of ‘Family Members’ who are covered in the scheme.

What if you crossed your fingers to see your name there, but it is not? You can apply for Ayushman Bharat Scheme by submitting your application for Ayushman Bharat Yojana Registration Online. The documents required to be scanned and submitted online include aadhar card, income certificate, and caste certificate.

The reality of India still remains that healthcare for all is a tough, mammoth responsibility for even the politically strong. Medical costs are pushing millions of Indians below the poverty line every year. The idea behind such policies is to support the cause of making healthcare available to those needy who cannot afford it or struggle to manage the costs. That’s what would be the success of living in ‘Ayushman Bharat’.

Plot no. 3, Sector 18A, Dwarka, Phase-II, 
New Delhi - 110075 India
Phone:- 011-3041890

Comments

Post a Comment

Popular posts from this blog

Evidence Matters: Value of Evidence in Health Governance in India

Image
An efficient health governance system is a prerequisite for well-functioning health system and achieving national health policy objectives; and SDG targets and ensuring Universal Health Coverage for all. Evidence helps health governance to create a road map for achieving health targets, it augments knowledge driven policy formulation and encourages community to take ownership of their health through behavior and lifestyle changes. Most importantly, as the below framework indicates, evidence encourages innovative partnerships to strengthen national health systems and allows the government and health providers to be accountable for their decisions and their actions.   Although efforts in health governance have led to significant progress in India (U5MR-126 in 1990 to 48 in 2015, MMR-560 in 1990 to 174 in 2015 and IMR-80 in 1990 to 38 in 2015), we are yet to achieve many MDG targets at national levels and are farther off on most targets in some states. An evid
Read more

Health Managers: Exploding Demand Moderate Supply

A recent analysis carried out by IIHMR, Delhi shows that we have over 50 institutions in the country which are conducting MBA /PGDHM in Hospital and Health Management. The admission capacities in these institutions is approximately 3000/year. Only a few institution like IIHMR , Delhi offer specialization in Healthcare Information Technology. The IIHMR, Delhi has been emphasizing that one of the weakest link in the healthcare delivery system in the country is the poor management of the hospital and health services. This results not only in poor quality of services but also inappropriate utilization of the healthcare facilities at all levels, mainly, at the primary healthcare, secondary healthcare and tertiary care facilities. The only way to overcome these bottlenecks in the health sector is to post the trained and qualified health and hospital managers at all levels of care. This in turn, will improve the credibility of our public health institutions and also increase the utilization
Read more

Indian Government Is Not Spending Enough on the Health of Its People

Image
The Indian healthcare industry has been gaining momentum and transforming immensely in the recent years. Currently, the Indian healthcare market is worth around 100 million and in the coming years, this is expected to grow at a CAGR of 22.9%. Market researchers estimate that it would reach around USD 275 Billion in the next 10 years. This tremendous growth of the healthcare industry has a prominent influence on the thriving economy of the country. At the same time, the fast evolving Indian economy, coupled with the rise of healthcare spending and the surge in lifestyle diseases has created immense possibilities for growth of the Indian healthcare sector in coming years. In such a scenario, it is expected that the government will make the necessary amendments and policies to further catalyze the growth of the sector. However, the government spending on healthcare sector, somewhat, seems to be lagging behind when compared to other sectors. Current Scenario: The current
Read more