Ayushman Bharat Yojana

Ayushman Bharat Yojana (ABY), also known as Pradhan Mantri Jan Arogya Yojana (PMJAY), is a flagship scheme of the Indian government launched in 2018 to provide free health coverage at the secondary and tertiary level to its bottom 40% poor and vulnerable population. The scheme aims to cover over 10 crore families, providing a health insurance cover of 5 lakh rupees per family per year for medical treatment in empanelled hospitals, both public and private.

Overview

The Ayushman Bharat Yojana is part of the Indian government's initiative to provide universal healthcare to its citizens. It was announced by the Prime Minister of India, Narendra Modi, in his Independence Day speech in 2018 and rolled out across the country. The scheme is a step towards achieving the goal of Universal Health Coverage (UHC) as advocated by the World Health Organization (WHO). It integrates two major health initiatives, namely, Health and Wellness Centers (HWCs) for primary healthcare services and the Pradhan Mantri Jan Arogya Yojana (PMJAY) for secondary and tertiary healthcare.

Components

The scheme has two components:

1. Health and Wellness Centers (HWCs): Aimed at providing comprehensive primary healthcare services, including disease prevention and health promotion. These centers are intended to bring healthcare closer to the homes of people.
2. Pradhan Mantri Jan Arogya Yojana (PMJAY): Provides financial protection against hospitalization to over 10 crore poor and vulnerable families, covering up to 5 lakh rupees per family per year for secondary and tertiary care hospitalization.

Eligibility

Eligibility for the scheme is based on the deprivation and occupational criteria as per the Socio-Economic and Caste Census (SECC) 2011 for rural and urban areas. The scheme is targeted at the poor, deprived rural families, and identified occupational categories of urban workers' families. There is no cap on family size and age, ensuring that all members of eligible families, including parents and dependent children, are covered.

Implementation

The Ayushman Bharat Yojana is implemented through a partnership with states, which can opt into the scheme. The central and state governments jointly fund the insurance cover, with the central government bearing a larger share of the expense. The scheme operates on an insurance model, where the government pays the premium to the insurance companies, and the beneficiaries can avail cashless treatment at empanelled hospitals.

Challenges and Impact

While the Ayushman Bharat Yojana has been hailed as a significant step towards providing affordable healthcare to the poor, it faces challenges such as fraudulent claims, the reluctance of private hospitals to join the scheme due to low package rates, and the need for more awareness among the eligible population. Despite these challenges, the scheme has made considerable progress in providing financial protection against healthcare expenses to millions of poor families and has been instrumental in saving lives through timely medical treatment.

See Also

• Healthcare in India
• Universal Health Coverage
• National Health Mission
• Public health