Under the vision of Ayushman Bharat, Pradhan Mantri Jan AarogyaYojana (AB-PMJAY) shall be implemented so that each and every citizen receives his due share of health care. With Ayushman Bharat – Pradhan Mantri Jan AarogyaYojana, the government is taking healthcare protection to a new aspirational level. This is the “world’s largest government funded healthcare program” targeting more than 50 crore beneficiaries.
BENEFITS UNDER THE SCHEME:
- Ayushman Bharat- Pradhan Mantri Jan ArogyaYojana (PMJAY) will provide a cover of up to Rs. 5 lakhs per family per year, for secondary and tertiary care hospitalization.
- Over 10.74 crore vulnerable entitled families (approximately 50 crore beneficiaries) will be eligible for these benefits.
- PMJAY will provide cashless and paperless access to services for the beneficiary at the point of service.
- PMJAY will help reduce catastrophic expenditure for hospitalizations, which impoverishes people and will help mitigate the financial risk arising out of catastrophic health episodes.
- Entitled families will be able to use the quality health services they need without facing financial hardships.
- When fully implemented, PMJAY will become the world’s largest fully government-financed health protection scheme. It is a visionary step towards advancing the agenda of Universal Health Coverage (UHC).
FEATURES OF THE SCHEME
Ayushman Bharat is a progression towards promotive, preventive, curative, palliative and rehabilitative aspects of Universal Healthcare through access of Health and Wellness Centers (HWCs) at the primary level and provision of financial protection for accessing curative care at the secondary and tertiary levels through engagement with both public and private sector.
It adopts a continuum of care approach, comprising of two inter-related components: Creation of 1,50,000 Health and Wellness Centres which will bring health care closer to the homes of the people.
These centres will provide Comprehensive Primary Health Care (CPHC), covering both maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services. The first Health and Wellness Centre was launched by the Prime Minister at Jangla, Bijapur, Chhatisgarh on 14th April 2018.
The second component is the Pradhan Mantri Jan ArogyaYojana (PMJAY) which provides health protection cover to poor and vulnerable families for secondary and tertiary care.
The Health and Wellness Centres will play a critical role in creating awareness about PMJAY, screening for non-communicable diseases, follow-up of hospitalization cases among others. The features of the scheme are as follows.
Pradhan Mantri Jan ArogyaYojana: Financial protection from catastrophic expenditure:
- PMJAY primarily targets the poor, deprived rural families and identified occupational category of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data for both rural and urban areas as well as the active families under the RashtriyaSwasthyaBimaYojana (RSBY).
- Approximately 10.74 crore identified families (approximately 50 crore beneficiaries) will be entitled to get the benefits. There is no cap on family size and age as well as restriction on pre-existing conditions.
Pradhan Mantri Jan ArogyaYojana: Hospitalization cover from inpatient care to post hospitalisation care:
- The Yojana will provide a coverage up to Rs. 5,00,000 per family per year, for secondary and tertiary care hospitalization through a network of Empanelled Health Care Providers (EHCP).
Pradhan MantriAarogyaMitra (PMAM):
- The scheme is creating a cadre of certified frontline health service professionals called Pradhan MantriAarogyaMitras (PMAMs) who will be primary point of facilitation for the beneficiaries to avail treatment at the hospital and thus, act as a support system to streamline health service delivery.
- AarogyaMitras training is being conducted in collaboration with National Skill Development Corporation (NSDC) and Ministry of Skill Development to strengthen implementation and operational preparedness.
- Training has already been conducted in across 20 states and around 3519 AarogyaMitras have been trained so far. Training programs for State, District and PMAMs have been conducted in 27 states.
- A total of around 3936 personnel have been trained at state, district and PMAM levels.