Ayushman Bharat Yojana: Comprehensive Healthcare for Underprivileged in India

Why the scheme is in the news?

Ayushman Bharat Diwas, celebrated annually on April 30th, is aimed at promoting the values of Ayushman Bharat Yojana. The scheme aligns with India’s commitment to achieving the Sustainable Development Goals set by the United Nations. Ayushman Bharat Diwas signifies the Indian government’s success in fulfilling its objectives through the Ayushman Bharat Yojana.

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Ministry: – Ministry of Health and Family Welfare

Launch Year: – 2018

Implementing Body: – National Health Authority (NHA)

Objectives: –

The program aims to implement pioneering measures to address health comprehensively, covering prevention, promotion, and ambulatory care at the primary, secondary, and tertiary levels. This includes the continued implementation of centrally sponsored schemes such as the Senior Citizen Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojana (RSBY).

Beneficiaries: –

PM-JAY is specifically designed to provide healthcare support to 40% of the most vulnerable and underprivileged individuals in the country. These beneficiaries have been identified based on the deprivation and occupational criteria outlined in the 2011 Socio-Economic Caste Census. In rural areas, eligible households include those with one-room kutcha houses, those without adult members, those headed by women, those belonging to SC/ST, the homeless, and the landless. Meanwhile, in urban areas, the eligible beneficiaries include rag pickers, street sellers, domestic helpers, sanitation workers, and store workers, among others.

The scheme has replaced the Rashtriya Swasthya Bima Yojana (RSBY), which was initiated in 2008. As a result, the coverage mentioned under PM-JAY includes families who were covered under RSBY but did not appear in the SECC 2011 database. It is important to note that there is no limit on family size or age under PM-JAY, ensuring that no one is left behind, particularly women, children, and the elderly. The scheme provides comprehensive healthcare coverage, including prevention, promotion, and ambulatory care, at primary, secondary, and tertiary levels.

Eligibility criteria: –

• No restrictions on family size, age, or gender.
• Coverage of pre-existing conditions from the first day.

Funding: –

• Funding for the PM-JAY scheme is shared by the central and state governments.
• For states and Union Territories (UTs) with their legislature, the funding is shared in the ratio of 60:40.
• In Northeastern states, Jammu and Kashmir, Himachal Pradesh, and Uttarakhand, the funding ratio is 90:10.
• UTs without a legislature receive 100% funding from the central government.

Need of Ayushman Bharat

• Hospitalization costs for essential illnesses have increased by 300% over a decade.
• Over 80% of homes in India are not covered by any health plan, leaving the majority of costs to be borne by the individual.
• Only 48 crore Indians, or less than one in every three Indians, have health insurance, according to the IRDAI.
• An estimated 6 million families fall into poverty each year due to hospitalization costs.
• The use of insurance to reimburse healthcare costs allows for more households to be covered with a smaller budget outlay, providing more value for the government’s spending.
• Health insurance can protect ordinary people from financial damage caused by unexpected medical situations, contributing to inclusive growth and improving the economic situation and quality of life for the poor.

Budget Allocation: – Rs 7200 crore

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