Pradhan Mantri Ayushman Bharat Yojana:- The National Health Policy of 2017 recommended the launch of Ayushman Bharat, the Government of India’s flagship programme, in order to realise the goal of Universal Health Coverage (UHC). The programme aims to fulfil the Sustainable Development Goals (SDGs) and emphasises the importance of “leaving no one behind.”
The goal of Ayushman Bharat is to transition healthcare delivery from a fragmented, regional approach to a comprehensive, need-based approach. At the primary, secondary, and tertiary levels, the programme seeks to spearhead interventions that address the health care system holistically, encompassing prevention, promotion, and ambulatory care.
The goal of Ayushman Bharat is to transition healthcare delivery from a fragmented, regional approach to a comprehensive, need-based approach. At the primary, secondary, and tertiary levels, the programme seeks to spearhead interventions that address the health care system holistically, encompassing prevention, promotion, and ambulatory care.
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What IS PMJAY Rural?
A startling 85.9% of rural households do not have access to any type of healthcare assurance or insurance, according to data from the 71st round of the National Sample Survey Organisation. Moreover, loans are used by 24% of rural families to cover medical facility visits. PMJAY provides annual grants of up to Rs. 5 lakh per family to support this industry. PMJAY aims to support this sector by providing annual assistance of up to Rs. 5 lahks per family. Furthermore, 24% of rural families use loans to pay for their visits to medical facilities. In order to support this industry, PMJAY offers yearly grants of up to Rs. 5 lakh per family. Through annual assistance of up to Rs. 5 lakh per family, PMJAY seeks to assist this sector. The programme will support families that are economically disadvantaged based on information from the 2011 Socio-Economic Caste Census. The PM Jan Arogya Yojana will also apply to households registered under the Rashtriya Swasthya Bima Yojana (RSBY).
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What is PMJAY Urban?
As per the 71st round of the National Sample Survey Organisation, 82% of urban households lack health insurance. Additionally, 18% of Indians living in cities have borrowed money in one way or another to cover medical costs. The Pradhan Mantri Jan Arogya Yojana provides funding of up to Rs. 5 lakh per family annually to assist these households in accessing healthcare services. Families of urban workers in the occupational category shown in the Socio-Economic Caste Census 2011 will benefit from PMJAY. Moreover, the PM Jan Arogya Yojana will assist any family registered under the Rashtriya Swasthya Bima Yojana.
Benefits of Pradhan Mantri Ayushman Bharat Yojana
With AB PM-JAY, qualifying families can receive annual cashless coverage of up to ₹ 5,00,000 for specified secondary and tertiary care conditions. All costs related to the following treatment components are covered under the plan:
- Medical consultation, evaluation, and treatment
- Advance hospitalisation
- Pharmaceuticals and medical supplies
- Services for both non-intensive and intensive care
- Laboratory and diagnostic examinations
- Services for medical implantation (where necessary)
- Accommodation advantages
- Food services
- problems that develop while receiving treatment
- up to fifteen days of post-hospitalization follow-up care
- up to fifteen days of post-hospitalization follow-up care
The ₹ 5,00,000 benefits are available on a family floater basis, allowing any or all family members to use them. There is no upper limit on the number of family members or their ages under AB PM-JAY. Furthermore, coverage for pre-existing conditions begins on the first day.
Key Features of PMJAY
- It pays for up to three days of pre-hospitalization and fifteen days of post-hospitalization costs, including medications and diagnostics.
- The size, age, or gender of the family is not restricted.
- From the beginning, all pre-existing conditions are covered.
- Approximately 1,929 procedures are included in the services, which cover all treatment-related expenses such as medication, supplies, diagnostic tests, doctor’s fees, lodging costs, surgeon’s fees, OT and ICU fees, etc.
- For medical services rendered, public hospitals receive payment on par with private hospitals.
- The largest health insurance and assurance programme in the world, PM-JAY is fully funded by the government.
- These benefits are available to over 12 crore impoverished and vulnerable families, or roughly 55 crore beneficiaries.
- At the point of service, which is the hospital, PM-JAY gives the beneficiary cashless access to medical services.
- The goal of PM-JAY is to lessen the staggering medical costs that force almost 6 crore Indians into poverty every year.
Eligibility Criteria for Rural and Urban
Ten crore families are to receive healthcare through the PMJAY scheme. Through a health insurance programme that covers Rs. 5 lakh per family, these primarily consist of impoverished and lower middle-class individuals. Eight crore families live in rural areas and 2.33 crore families live in urban areas, making up ten crore families. Divided into more manageable parts, this implies that the programme will try to serve 50 crore distinct recipients.
However, the programme selects who is eligible to receive the health cover benefit based on a set of prerequisites. In contrast, the majority of the deprivations listed in rural areas are related to inadequate housing, low income, and other factors.
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People who are not eligible for Pradhan Mantri health coverage Jan Arogya Mission:
- People who possess a motorised fishing boat or a two, three, or four-wheel vehicle
- Those who possess agricultural machinery with motors
- Those with Kisan cards that have a Rs. 50,000 credit limit
- People who work for the government
- Individuals employed by government-run non-agricultural businesses
- Those making more than Rs. 10,000 per month
- Those with landlines and refrigerators
- Those with respectable, well-constructed homes
- Those who possess at least five acres of agricultural land
It may not be appropriate for everyone to obtain health, auto, or other general insurance policies, even though not everyone is eligible for these government programs. As a result, everyone can afford insurance and subscription plans thanks to Bajaj Finance.
How to Apply for Ayushman Bharat Yojana?
Here’s how to use the National Health Authority portal to determine your eligibility for the programme and submit an application:
- Visit the official website at mera.pmjay.gov.in to log in.
- Enter the captcha code that appears on the screen along with your mobile number now.
- You will then be able to access the PMJAY login screen by entering the OTP that was sent to your registered mobile number.
- Now choose the state from which you want to apply for this programme.
- Choose how you wish to look up your eligibility requirements: Name, RSBY URN, Ration card number, or mobile number
- If you are eligible, your name will appear on the right side of the page.
- By selecting the ‘Family Members’ tab, you can also view the beneficiary details.
Furthermore, you can verify your eligibility for PMJAY by contacting any Empanelled Health Care Provider (EHCP) or by calling the 1800-111-565 or 14555 Ayushman Bharat Yojana call centre number.
How to add my name to the Ayushman Bharat Yojana?
- If the beneficiary wants to add family members, click “Add Family Details.”
- After inputting the Ration Card number, select ‘Check Document Details’.
- The following message will show up if the family has already attached the ration card.
Avoid making these two errors when submitting an application:
- Verify your eligibility before getting an Ayushman card if you intend to get one. If not, your application might be rejected for being ineligible. You can refer to the list provided below for this.
- If you live in a mud house
- should you be a daily wage worker
- Is there a disabled member in your family?
- Do you live in a rural area?
- Do you come from a Scheduled Caste or Tribe?
- your house is mud?
- you work as a daily wage labourer
- You are deemed eligible for an Ayushman card if you are impoverished, transgender, tribal, etc.
- In addition, make sure all of your documentation is complete because your application may be denied in this case as well.
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Brief Objective
In order to realise the goal of Universal Health Coverage (UHC), the Government of India launched Ayushman Bharat, a flagship programme, as advised by the National Health Policy 2017. This initiative focuses on the Sustainable Development Goals (SDGs) and their fundamental promise to “leave no one behind”.
Conclusion
With the help of the AB-PMJAY, there is a rare chance to enhance the health of hundreds of millions of Indians and end a significant cause of poverty in the country. To ensure that the Indian population can benefit from these initiatives and that the scheme continues to advance India’s progress towards Universal Health Coverage, significant obstacles must be addressed. Under the Sustainable Development Goals, achieving Universal Health Coverage (UHC) has emerged as a critical goal for health systems worldwide in an effort to combat medical-related poverty and enhance global health.
FAQs on Pradhan Mantri Ayushman Bharat Yojana
Q.1. What is the Ayushman Bharat scheme?
Ans. The two sub-components of Ayushman Bharat, an umbrella health scheme, are Health and Wellness Centres (HWCs) and the Pradhan Mantri Jan Arogya Yojana (PM-JAY). It offers primary healthcare as well as health insurance to qualified recipients.
Q.2. Does Ayushman Bharat cover pregnancy?
Ans. Yes, pregnancy is covered under the Ayushman Bharat Scheme.
Q. 3. Who is the CEO of PM-JAY?
Ans. Indu Bhushan is the CEO of PM-JAY.
Q. 4. What is the Full Form of PM-JAY?
Ans. Pradhan Mantri Jan Arogya Yojana is the full name of the programme; it was formerly known as the National Health Protection Scheme (NHPS).
Q. 5. What services does the Ayushman Bharat Scheme provide?
Ans. Medical care services like pre- and post-hospitalization, and nursery procedures.
Q. 6. What does the PMJAY programme not cover?
Ans. Ayushman Bharat Yojana does not cover medical services like organ transplants, drug rehab, cosmetic surgery, or fertility treatment.
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