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Introduction : –
Ayushman Bharat Yojana is a health cover scheme. It is also known as PMJAY (Pradhan Mantri Jan Arogya Yojana). The main objective of this scheme is to provide health facilities to economically weaker Indians.
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The scheme was launched by Hon’ble Prime Minister of India, Shri Narendra Modi from Ranchi, (Jharkhand) on September 23, 2018. This scheme (PM-JAY) is the world’s largest HCS (health cover scheme). The aim is to provide health cover to poor Indians.
This scheme is also based on one principle. This is the principle “Leave no one behind”. As of September 2019, about 18,069 hospitals have been listed. Under this scheme more than 10.1 crore e-cards have been issued.
The Ayushman Bharat Scheme adopts a continuum based on the care approach, which includes a total of two inter-related components, which are as follows –
- Health and Wellness Center (HWCs)
- Pradhan Mantri Jan Arogya Yojana (PM-JAY)
Health and Wellness Center (HWCs) :-
In February 2018, it was announced by the Government of India to change its existing sub-centers and primary health centers to 1,50,000 Health and Wellness Centers (HWCs). These centers were established to make primary health care (CPHC) closer to people’s homes. These centers cover both maternal and child health services and non-communicable diseases, including free essential medicines and diagnostic services.
Pradhan Mantri Jan Arogya Yojana (PM-JAY) :-
PM-JAY was earlier known as NHPS (National Health Protection Scheme). This scheme has taken over the already existing National Insurance Scheme (RSBY). Which was launched in the year 2008. PM-JAY is a fully government funded scheme.
The cost of implementation is shared both. Cost shared between the central and state government. Under this, the government intends to make secondary and tertiary healthcare completely cashless. An e-card is provided to the beneficiaries of PM Jan Arogya Yojana.
This e-card can be used anywhere in the country, anytime, to avail services in a private hospital. With this you can get cashless treatment.
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Salient features of PMJAY: –
- PM-JAY is the world’s largest health insurance scheme / assurance scheme, fully funded by the government.
- The scheme provides each family a cover of Rs.
- These are the plans for secondary and tertiary care hospitalization in public and private hospitals all over India.
- The maximum amount limit under this scheme has been fixed at Rs 5 lakh per family per year.
- Treatment is provided under this scheme ie you do not need to make any kind of payment.
- This scheme helps in reducing the dreaded expenditure on medical treatment.
- Which pushes about 60 million Indians into poverty each year.
- This includes a maximum of 3 days of pre-hospitalization and up to a maximum of 15 days of hospitalization with diagnosis and medications.
- There is no restriction on the size, age or gender of the family.
- The benefits of the scheme are portable across the country.
- That is, a beneficiary can avail cashless treatment in any public or private hospital in India.
- The plan covers about 1,393 procedures related to treatment, including medicines, physician fees, room fees, surgeon fees, OT and ICU fees, etc.
Some important dates related to PMJAY :-
- 1 February 2018 – Announcement during Union Budget
- 21 March 2018 – Cabinet approval
- 27 March 2018 – Appointment of CEO
- 23 September 2018 – Launching of Ayushman Bharat Scheme
Norms / eligibility conditions set for availing PMJAY: –
Under this scheme different eligibility conditions have been laid for rural and urban areas. Which are as follows –
Rural area :-
Out of the total seven deprivation criteria for rural areas, PM-JAY has included all such families. Which of the following six absence criteria (D1 to D5 and D7) fall into at least one of the absence criteria.
- D1 – Only one room with rough walls and rough roof.
- D2- No adult members are in the family between 16 and 59 years.
- D3- No adult male member between 16 and 59 years of age is in the family.
- D4-disabled members and no competent adult members are in the family.
- D5-SC / ST Household Family |
- D7- Landless families who get a major portion of their income from daily Majduri.
Urban Areas :-
Persons residing in urban areas are eligible for the scheme under the following 11 occupational categories: –
- domestic servant
- Yacht Street vendors / cobblers / hawkers / other service providers
- working on the roads Construction workers / plumber / mason / labor / painter / welder / security guard / porter and other head-load workers
- Sweeper / sanitation worker / gardener Home-Based Worker / Artisan / Handicraft Worker / Tailor
- Transport worker / driver / conductor / helper to driver and conductor / cart puller / rickshaw puller
- Shopkeeper / assistant / assistant in small establishment / assistant / distribution assistant / attendant / waiter Electrician / mechanic / assembler / repair worker
- Washer-man / Watchman
How can you search for a hospital in any city –
First of all, you will open the official website. After this, you click on the “hospital” menu displayed in the “menu bar”. The dropdown list will be open at the bottom / side, in which you click on the “Find Hospital” tab.