Ayushman Bharat
About the scheme
- Ayushman Bharat is a flagship scheme of Government of India launched to achieve the vision of Universal Health Coverage (UHC). It aims to holistically address the healthcare system at the primary, secondary and tertiary level, by adopting a continuum of care approach. It was launched in 2018.
- Ayushman Bharat is an umbrella of two major health initiatives, namely Health and Wellness Centres and Pradhan Mantri Jan Arogya Yojana (PM-JAY).
Health and Wellness Centres
- Under this component, the Government of India aims at creation of 1,50,000 Health and Wellness Centres (HWCs) by transforming the existing Sub Centres and Primary Health Centres.
- These centres will deliver Comprehensive Primary Health Care that is universal and free to users, with a focus on wellness and the delivery of an expanded range of services closer to the community.
- HWC are envisaged to deliver expanded range services that go beyond Maternal and child health care services to include care for non-communicable diseases, palliative and rehabilitative care, Oral, Eye and ENT care, mental health and first level care for emergencies and trauma, including free essential drugs and diagnostic services.
Pradhan Mantri Jan Arogya Yojana
- Ayushman Bharat PM-JAY is the largest health assurance scheme in the world which aims at providing a health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to over 12 crores poor and vulnerable families (approximately 55 crore beneficiaries) that form the bottom 40% of the Indian population.
- The households included are based on the deprivation and occupational criteria of Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas respectively.
- PM-JAY is fully funded by the Government and cost of implementation is shared between the Central and State Governments.
- To ensure that nobody is left out (especially women, children and elderly) there will be no cap on family size and age in the scheme. The benefits of INR 5,00,000 are on a family floater basis which means that it can be used by one or all members of the family.
- The benefit cover will also include 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines.
- A defined transport allowance per hospitalization will also be paid to the beneficiary.
- Benefits of the scheme are portable across the country and a beneficiary covered under the scheme will be allowed to take cashless benefits from any public/private empanelled hospitals across the country.
Implementation Strategy
- At the national level to manage, the National Health Authority has been set up. It is an attached office of the Ministry of Health and Family Welfare with full functional autonomy.
- NHA is governed by a Governing Board chaired by the Union Minister for Health and Family Welfare.
- To implement the scheme at the State level, State Health Agencies (SHAs) in the form of a society/trust have been set up by respective States. SHAs have full operational autonomy over the implementation of the scheme in the State including extending the coverage to non SECC beneficiaries.
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