Ayushman Bharat Yojana
Ayushman Bharat Yojana also popularised as the Pradhan Mantri Jan Arogya Yojana (PMJAY) is a governmental scheme that is specially targeted to help economically vulnerable and weak Indian citizens who need healthcare facilities but can’t afford.
Prime Minister Narendra Modi gave assent and introduced this health insurance scheme on 23 September 2018 to give medical services around 50 crore citizens in India under this scheme and already has flagged with multiple success stories to its credit. As of September 2019, it was reported that 18,059 hospitals have been impaneled, over 4,406,461 lakh beneficiaries have been admitted and over 10 crore e-cards have been issued.
About Ayushman Bharat Yojana –
National Health Protection Scheme, which has now been renamed as pradhan Mantri Jan arogya yojana, the plan in this yojana is to make healthcare services cashless. People who take the scheme will be given a card that can be used at private or governmental healthcare services, provided that health care provider accepts the card It can be used anywhere in the country. With it, you can walk into a hospital and can avail of cashless treatment.
The cards give you 3 days of pre-hospitalization and 15 days of a post-hospitalization expense coverage. Including, approximately 1,400 procedures like OT expenses and others are covered. Summing up, PMJAY and the e-card provides support of Rs. 5 lakh per family, per year, through this disadvantaged class of economy gets access to healthcare services which previously wasn’t possible.
Further, the Ayushman Bharat Yojana scheme has some pre-conditions by which it is decided who are eligible for the scheme. While in the rural areas the list is mostly categorized on lack of housing, less income and other monetary setbacks, the urban list of PMJAY beneficiaries is settled upon the basis of occupation and earning.
PMJAY Health Cover Categories: Eligibility Criteria for Rural & Urban People
The PMJAY scheme has the vision to provide healthcare to 10 crore families, who are mostly poor and deprived sections of society, through a health insurance scheme providing a cover of Rs. 5 lakh per family. In a number of 10 crore families comprise 8 crore families in rural areas and 2.33 crore families in urban areas. By simplifying the number, this means the scheme will be reachable to 50 crore individual beneficiaries.
However, the scheme has certain pre-conditions by which it filters who can avail of the health cover benefit. While in the rural areas the list is mostly categorized on lack of basic security and suffering from financial issues, the urban list of PMJAY beneficiaries is drawn up on the basis of jobs and services they are doing.
Ayushman Bharat Yojana Rural Details:
The 71st round of the National Sample Survey Organisation came up with that 85.9% of rural households have not taken health or assurance. Approximately, 24% of rural families arrange money for healthcare facilities by borrowing. PMJAY’s goal is to help this sector through avoiding the debt traps and giving medical facilities of ₹5 lac per year, per family. The scheme is a boon for disadvantaged families as per data in the Socio-Economic Caste Census 2011.
In the rural areas, for taking PMJAY health cover eligibility:
- 1) Those living in scheduled caste and scheduled tribe households
- 2) Families with no male member aged 16 to 59 years
- 3) Beggars and those surviving on alms
- 4) Families with no individuals aged between 16 and 59 years
- 5) Families having at least one physically challenged member and no able-bodied adult member
- 6) Landless households who make a living by working as casual manual laborers
- 7) Primitive tribal communities
- 8) Legally released bonded laborers
- 9) Families living in one-room makeshift houses with no proper walls or roof
- 10) Manual scavenger families.
PMJAY Urban Details:
According to the National Sample Survey Organisation (71st round), 82% of urban households do not have a reach towards health insurance. Adding on, 18% of Indians in urban areas have addressed to meet healthcare expenses by borrowing money in one form or the other. Pradhan Mantri Jan Arogya Yojana supports these households by up to Rs. 5 lakh per family, per year. PMJAY will benefit urban workers’ families in the occupational category present as per the Socio-Economic Caste Census 2011. Additionally, any family enrolled under the Rashtriya Swasthaya Bima Yojana will be eligible for getting support from the PM Jan Arogya Yojana as well.
In the urban areas, those who are covered for the government-sponsored scheme :
- 1. Washerman /chowkidars
- 2. Ragpickers
- 3. Mechanics, electricians, repair workers
- 4. Domestic help
- 5. Sanitation workers, gardeners, sweepers
- 6. Home-based artisans or handicraft workers, tailors
- 7. Cobblers, hawkers and others providing services by working on streets or pavements
- 8. Plumbers, masons, construction workers, porters, welders, painters and security guards
- 9. Transport workers like drivers, conductors, helpers, cart or rickshaw pullers
- 10. Assistants, peons in small establishments, delivery boys, shopkeepers, and waiters.
People who are not eligible for the Health Cover under Pradhan Mantri Jan Arogya Yojana:
- 1. Those who own a two, three or four-wheeler or a motorized fishing boat
- 2. Those who own mechanized farming equipment
- 3. Those who have Kisan cards with a credit limit of Rs.50000
- 4. Those employed by the government
- 5. Those who work in government-managed non-agricultural enterprises
- 6. Those earning a monthly income above Rs.10000
- 7. Those owning refrigerators and landlines
- 8. Those with decent, solidly built houses
- 9. Those owning 5 acres or more of agricultural land.