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PMJAY Ayushman Bharat Yojana – Get To Know The Benefits And Eligibility Criteria

  • Highlights

  • PMJAY Ayushman Bharat Yojana is a national healthcare scheme

  • The annual cover of PMJAY is of Rs.5 lakh per family

  • Ayushman Bharat Yojana eligibility based on SECC 2011 data

  • Available in all public and empanelled private hospitals

India has a lot of catching up to do as far as healthcare parameters are concerned, especially when you consider that the WHO report ranks the country 112 out of 190 on the healthcare index. To inject momentum to the slow progress being made on this front, Prime Minister Narendra Modi announced the Ayushman Bharat Yojana, recently renamed the PM Jan Arogya Yojana (PMJAY) as a national healthcare scheme.

1. The key characteristics of the Ayushman Bharat Yojana or PMJAY

Nearly 70% of India’s population lives in the rural areas without being able to afford proper healthcare facilities such as hospitals and clinics. The PMJAY Ayushman Bharat Yojana benefits the lowest strata of society to overcome these deficiencies in medical care. This initiative aims to support 50 crore beneficiaries through a health cover of Rs.5 lakh per family. The Ayushman Bharat scheme aims to be one of the largest health insurance schemes in the world once it is fully implemented.

2. How the scheme will reduce the rural-urban healthcare divide

There is a striking contrast between the healthcare facilities and infrastructure available in urban areas and those in rural areas. In nearly all rural areas, the healthcare network is practically non-existent, barring a few hospitals and clinics providing primary healthcare. There are hardly any hospitals providing specialised treatments, which is why the sick from the rural areas have to travel long distances to be treated in towns and cities. Many of them neglect their health for lack of an insurance policy for the poor. The Ayushman Bharat Yojana is expected to work as a palliative for this situation that the sick in villages find themselves in. It plans to bridge the rural-urban healthcare gap by setting up more hospitals across India and empanelling private hospitals in the scheme.

3. How healthcare payment mechanisms will be made more effective

Whether you live in the urban areas or the rural areas, cashless hospital treatment in India is still a far cry. Only 5% of India’s population is covered by health insurance policies. Even with several health insurance schemes to provide a safety net, the process is not entirely free from the cash hassle. Much of it involves making out-of-pocket expenses, as many who have insurance policies have to pay cash up-front first and then file a claim for reimbursement. PMJAY Ayushman Bharat Yojana plans to lighten the burden. The most important of these steps is cashless treatment in empanelled public and private hospitals through the issue of health cards. The scheme will also be Aadhaar Card-enabled to prevent any misuse of the scheme.

4. Reduced cost of medical devices to further benefit the poor

This scheme will offer health coverage as per the data collected under the Socio Economic Caste Census of 2011. The logistics of this initiative is huge, requiring the coordination of not only manpower, but also of proper integration with equipment and healthcare devices. The medical equipment used to service such a large number of beneficiaries will not only have only have to upgraded, but also procured. Right now, the prices of life-saving medical equipment like pacemakers is nowhere in the affordable range. This presents a huge untapped market for healthcare equipment manufacturers over the world. The Ayushman Bharat Yojana scheme is expected to contribute to the growth of the pharmaceutical sector for the same reason.

5. How you and your family can gain from this scheme

Launched in September this year, the Ayushman Bharat Yojana has many unique features to its credit that many other health insurance schemes do not offer. For instance, the Rs.5 lakh health cover is given to all families irrespective of the size of the family or the age, gender, caste or creed of its members. The cover enables you to bear secondary and tertiary healthcare expenses. The government website clearly states that your family will not have to pay any money in case of hospitalisation. The scheme also covers all pre-existing diseases from the start of the policy and takes care of your pre-and post-hospitalisation costs as well.

6. Ayushman Bharat Yojana eligibility and way forward

To avail of Ayushman Bharat Yojana benefits, you need to check your eligibility online through the official website or by calling the toll-free helpline number 14555. The beneficiary can do his or her registration online as well. All you need to do is carry the prescribed ID to be able to obtain free treatment in any registered private or public hospital.

Keeping these benefits in mind, opt for the health cover provided and secure yourself and your family.

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