Ayushmann Bharat Yojana or Pradhan Mantri Jan Arogya Yojana was termed as the game changer by World Health Organisation (WHO) as it said to be the World's biggest government scheme. The health care yojana aimed for benefiting 10 crore families with cashless secondary and tertiary health care for upto Rs 5 lakh per family per year for in public/private empanelled hospitals. Introduced by Modi-led center government, the scheme is also being touted as Modi-care or Namo-care.
Introduced during Union Budget in 2018 for the first time, Ayushman Bharat Yojana was launched in September 2018 to benefit Below Poverty Line and other under privileged families who are are unable to bear the whopping expenditure of medical treatment in private as well as government hospitals across the country. Under the scheme, 50 crore people are estimated to be benefited per year. Majority of the state governments had agreed to implement the scheme to their as well but states like West Bengal, Telangana, Karnataka and a few other, have rejected to adopt the scheme citing that they either have their own medical health schemes like Ayushmann Bharat or they planned to introduce such scheme on their own for the state.
What is Ayushmann Bharat Yojana or Pradhan Mantri Jan Arogya Yojana?
The proposed name of this scheme is Ayushmann Bharat National Health Protection Mission which aims to remove the Out Of Pocket expanses (expanses bear by the patient or the patient's family) of people from the Economically Weak Section. This scheme is a 'No premium' insurance scheme which means that without paying the annual or monthly premiums, the beneficiary will get the insurance cover upto 5 lakh in the time of need. It will subsume the on-going centrally sponsored schemes - Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
Around 1.5 lakh health centers will provide comprehensive health care for all secondary and many tertiary care including communicable disease and maternal health care. These centers will be directly linked by the district hospitals, where facilities like check up, medicines and treatment for upto 5 lakh will be provided to economically deprived families. These centers will also provide free essential drugs and diagnostic services.
How to check your entitlement for Ayushman Bharat Scheme?
There are three ways to know if your family is eligible or entitled for the benefit of insurance cover under the Ayushmann Bharat scheme :
Check entitlement for Ayushman Bharat Scheme online:
Step 1: Visit the official website -- mera.pmjay.gov.in.
Step 2: Enter your mobile number, captcha and click on Submit button.
Step 3: Enter State, Name, Father's Name, Mother's Name, Gender, Age, District, Town and click on search.
Step 4: Your details for the entitlement will appear on the screen.
Check entitlement for Ayushman Bharat Scheme offline:
Give a call to the Toll Free Number 14555 and inquire about your entitlement.
You can visit the empanelled hospitals and meet Ayushman Mitra, an official who works as bridge between the patient and hospital, to known about your eligibility.
Determination of families for health cover under AB-NHPM:
Health cover of 5 lakh will be granted for each family which entitled for the benefits under the following criteria:
1. The families' entitlement will be determined by 2011 socio-economic caste census (SECC).
2. Families having only one room with kucha walls and kucharoof.
3. Families with no adult member between age 16 to 59.
4. Female or disabled member headed households and with no-abled adult male member between age 16 to 59.
5. SC/ST, primitive tribal groups, legally released bonded labour, landless, involved in manual casual labour and other defined categories of unorganized workers.
6. In urban areas, a household with monthly income over Rs 10,000 is not able to claim coverage under Ayushman Bharat.
Benefits covered under Ayushmann Bharat Yojana:
1. All the secondary and most of the tertiary care of a family irrespective of the number and age of members in the family.
2. The benefits cover will also include pre and post-hospitalization expenses.
3. All pre-existing conditions will be covered from day one of the policy.
4. A defined transport allowance per hospitalization will also be paid to the beneficiary.
5. Benefits are portable across the country which means that the beneficiary can take the health cover to any other state as well provided that hospital in which the patient is being treated must be public/private empanelled hospitals.
6. The transfer of funds from Central Government through Ayushman Bharat - National Health Protection Mission to State Health Agencies may be done through an escrow account directly to ensure that the funds reach State Health Agency (SHA) on time.
Official websites for Ayushmann Bharat Yojana: narendramodi.in or india.gov.in
To check your entitlement visit mera.pmjay.gov.in.