The Pradhan Mantri Jan Arogya Abhiyaan, also known as Ayushman Bharat - National Health Protection Mission (AB-NHPS), is an ambitious project initiated by the government of India that aims to provide health insurance coverage for the economically deprived masses of the country. Roughly, 50 crore individuals will benefit from the universal health insurance scheme.
The project, as announced by PM Narendra Modi on 15 August 2018, will be rolled out on 25 September 2018. The new health scheme will absorb the existing government-backed health insurance schemes – Rashtriya Swasthya Bima Yojana (RSBY) and Senior Citizen Health Insurance Scheme (SCHIS).
Eligibility for Pradhan Mantri Jan Arogya Abhiyaan
This health insurance scheme has been designed for the vulnerable members of the country i.e. about 40% of India’s population. The eligibility for the scheme is based on the Socio-Economic Caste Census of 2011.
- There is no restriction on the number of family members that can be covered under the scheme.
- In rural areas, families living in houses with a single room, female-headed families, SC/ST families, destitutes, tribal groups, scavenger families, and bonded labourers among others will be covered.
- In urban areas, street vendors, rag pickers, domestic workers, sweepers, rickshaw pullers, mechanics, etc. will be covered under the scheme.
Features of Pradhan Mantri Jan Arogya Abhiyaan
- Each family is covered for a sum insured amount equal to Rs.5 lakh per year.
- The benefits provided under the scheme can be availed from any part of the country.
- Insured members can avail the cashless facility from any of the public or private network hospitals of the scheme.
- Coverage for secondary and tertiary hospitalisation expenses is provided.
- Protection for pre and post-hospitalisation expenses is available.
- Pre-existing diseases are covered from the day the policy is issued to the individual.
- Each family will be provided with a health card which they can use to avail free treatment at network hospitals.
Premium for Pradhan Mantri Jan Arogya Abhiyaan
The premium for the health insurance scheme is shared between the Centre and each of the states. The premium will be shared in a ratio specified by the Ministry of Finance. Since the aim of the scheme is to provide health services to underprivileged families who cannot afford certain treatments, they need not pay any premiums towards Ayushman Bharat.
Implementation of Pradhan Mantri Jan Arogya Abhiyaan
Ayushman Bharat is based on the principle of co-operative federalism and hence the centre and each of the states will work hand in hand to provide health insurance services to the underprivileged masses. Here is how the scheme will be implemented:
- The Ayushman Bharat - National Health Protection Mission Council (AB-NHPMC) will be set up as an apex body that will help bring about coordination between the Centre and the states. The chairman of the body will be the Union Health and Family Welfare Minister.
- The Ayushman Bharat - National Health Protection Mission Agency (AB-NHPMA) will be set up for managing the scheme at the national level.
- State Health Agencies (SHA) will be created in each state to manage the scheme at individual state levels.
- The state governments have been given the option to implement the scheme through the insurance model, the trust model, or an integrated model.
- An IT platform will be created in partnership with NITI Aayog to carry out cashless, paperless transactions.
The objective of the scheme is to make quality medical treatments accessible to the economically backward section of the society. With the help of this scheme, the underprivileged people can receive treatments in a timely manner. This will help progress the overall health condition of the country which will gradually improve the efficiency of people and eventually improve the quality of life as a whole.