Ayushman Bharat PMJAY is a national public health insurance fund of the Government of India. PM Shri Narendra Modi, Launched it on September 23, 2018 in Jharkhand
Launched – 23 September 2018 by Shri Narendra Modi in Ranchi, Jharkhand.
Under Ministry – Ministry of Health and Family Welfare
Administer by– National Health Authority as an organization to administer the program.
Ayushman Bharat PM JAY– world’s largest health-insurance plan aiming to provide a health cover of Rs. 5 lakhs per family per year.
Official website – https://www.pmjay.gov.in/
In this article we have explained details about Ayushman Bharat PM JAY Scheme. If you are preparing for government exams or need general information about PMJAY CSC, then read the complete article and share with your friends.
In later posts we will discuss about Eligibility, Registration process, how to apply online for PMJAY card & How to download PMJAY card etc. Hospital List covered under the scheme and other general questions about the Ayushman Bharat PMJAY CSC Yojna/scheme will be discussed in posts.
Now before reading scheme details the question arises, why there is need for world’s largest health-insurance schemes Ayushman Bharat or PM JAY?
If we compare the the India’s Health care system before & after 2010, you will see the health priorities of peoples are changing, there is growing burden of infectious diseases and non-communicable diseases. Also due to economic development or rising economic growth and globalized world the robust health care industry is emerging. Due to health care costs Expenditure on health is increasing, which are presently estimated to be one of the major contributors to poverty. Therefore, a new health policy or new scheme required.
The Prime Minister of India, Shri Narendra Modi, Launched it on September 23, 2018 in Jharkhand. Ayushman Bharat PM-JAY is the world’s largest health-insurance plan aiming to provide a health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to over 10.74 crore poor and vulnerable families (approx 50 crore beneficiaries).
The Government completely funds PM-JAY, and the expense of implementation is divided by the Central and State Governments. The current sharing pattern between centre and state is 60:40. Read more details about it below.
The Ayushman Bharat Yojna is based on National Health Policy, 2017. In fact the National Health Policy, 2017 suggested for its implementation and its aim is to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in all its dimensions.
The Ayushman Bharat Yojna has of two important inter-related components, which are –
- Health and Wellness Centres (HWCs)
- Pradhan Mantri Jan Arogya Yojana (PM JAY)
Let’s understand the both components in a simple way
Health and Wellness Centers (HWCs)
As its name suggest, the first component mainly focuses on disease prevention and health promotion in order to combat the growing epidemic of noncommunicable diseases. This was to be accomplished by converting the current network of Sub centres and Primary Health Centers into Health and Wellness Centers (HWC). Over the next several years, about 150,000 HWCs will be established around the country, with the goal of lowering the population’s total illness burden and hospitalization needs.
Pradhan Mantri Jan Arogya Yojana (PM JAY)
In simple word PMJAY is a national public health insurance fund of the Government of India which aims to provide free access to health insurance coverage for poor people or low income earners in the country. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana or in short PMJAY was also referred as Ayushman Bharat National Health Protection Scheme.
Some people get confused between Ayushman Bharat Yojna and PMJAY CSC Yojna, they think both schemes are different but its not true. Both are same, PMJAY is basically a component under Ayushman Bharat Yojna.
As mentioned above, PM-JAY is fully funded by the Government and the cost of implementation is shared between the Central and State Governments. The existing sharing pattern is in the ratio of 60:40, for all States (except North-Eastern States & three Himalayan States) and Union Territories with legislature. For North-Eastern States and three Himalayan States (Jammu and Kashmir, Himachal Pradesh and Uttarakhand), the ratio is 90:10. For Union Territories without legislatures, the Central Government may provide up to 100% on a case-to-case basis.
Benefits under Ayushman Bharat PM-JAY
- As mentioned, PM-JAY is the world’s largest health insurance/ assurance scheme and fully financed by the government.
- PM-JAY provides cashless access to health care services for the beneficiary at the hospital.
- There is no restriction on the family size, age or gender.
- All pre–existing conditions are covered from day one.
The cover under the scheme includes all expenses incurred on the following components of the treatment.
- Medical examination, treatment and consultation
- Medicine and medical consumables
- Diagnostic and laboratory investigations
- Non-intensive and intensive care services
- Medical implantation services (where necessary)
- Food services
- Accommodation benefits
- Complications arising during treatment
- Post-hospitalization follow-up care up to 15 days
The benefits of Rs. 5,00,000 are on a family floater basis which means that it can be used by one or all members of the family.
In upcoming posts we will cover all the general information about scheme like PMJAY Registration, card download, hospital list, Eligibility and all about Mera PMJAY csc login.