2 min read
25 May 2021

The Ayushman Bharat Yojana, now called the Pradhan Mantri Jan Arogya Yojana (PMJAY), aims to be one of the world's largest health insurance schemes.

Here are the ten primary benefits that the PMJAY scheme brings to the vulnerable sections of society and the country's healthcare landscape on the whole.

1. Healthcare cover of Rs. 5 lakh per family

Launched in September 2018 by the Prime Minister, the Ayushman Bharat Yojana aims to cater to 50 crore beneficiaries. It provides a health cover of Rs. 5 lakh to families living below the poverty line. The health cover is free, as the central and state governments pay the annual premiums in a 60:40 ratio.

Additional Read: Ayushman Bharat Yojana - Eligibility criteria and application process

2. All families listed in the SECC database to be covered

Beneficiaries for the scheme are picked up from the Socio-Economic Caste Census (SECC) of 2011. These ten crore beneficiary families comprise eight crore families from the rural areas and two crore families residing in urban India.

3. Priority to the girl child, women and senior citizens

There is no cap on the family size and age as this health cover is inclusive for all. Moreover, the scheme holds women, children, especially girls, and those over 60 in special regard.

4. It includes secondary and tertiary care

The scheme provides those in need to get secondary healthcare benefits offered by specialists like cardiologists and urologists. Moreover, advanced medical treatment like that for cancer, cardiac surgery and others is also covered.

5. All pre-existing diseases covered

The PMJAY covers pre-existing illnesses and makes mandatory treatment in all public hospitals, unlike most other insurance covers. This means that those who require medical care cannot be turned away.

6. Cashless and paperless registration and administration

Removing the burden of out-of-pocket expenses, PMJAY aims to make the entire process of paying for healthcare cashless. Additionally, PMJAY beneficiaries can seek treatment across India.

7. Substantial reduction of out-of-pocket expenditure

All public and empanelled private hospitals have been directed to not charge any extra payment for medical care from all PMJAY beneficiaries to reduce any corruption or delay in services.

8. Private sector participation in helping to achieve public health goals

Since the scheme covers such a large population, it will be purchasing services from private healthcare providers. This scheme is also expected to encourage the production of more affordable healthcare equipment and drugs.

9. Improvement of quality of life of the population

This scheme will improve the quality of life of the weaker sections of society by ensuring they get timely care and finances to tackle their health issues.

10. Broadening the health insurance network

PMJAY will lead to better infrastructure development in rural and under-served areas across the country and lead to more and more Indians having access to healthcare. The government has created 1,350 medical packages that cover day-care treatment, surgery, hospitalisation, cost of diagnosis, and medicines with the PMJAY health cover.

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