Understanding the Ayushman Bharat Scheme

The Ayushman Bharat scheme, also known as the Pradhan Manthan Jan Arogya Yojana (PMJAY), is a flagship health initiative by the Government of India. It aims to provide health cover to the economically weaker sections of the society.

The scheme is designed to help vulnerable families access healthcare services without facing financial hardship due to medical expenses. It covers secondary and tertiary care hospitalisation.

Annual Health Cover Amount under Ayushman Bharat

One of the key aspects of the Ayushman Bharat scheme is the amount of health cover it provides per family per year. This cover helps in paying for hospitalisation expenses for eligible families.

The scheme provides a defined benefit cover. This means there is a fixed amount of insurance cover available annually for each eligible family.

Let's look at the available health cover amount:

• It provides a health cover of up to \(\text{Rs. 5 lakh}\) per family per year.
• This cover is for secondary and tertiary care hospitalisation across public and private hospitals empanelled under the scheme.
• The scheme is cashless and paperless at the point of service in empanelled hospitals.

Based on the structure of the Ayushman Bharat scheme, the annual health cover available to a family is \(\text{Rs. 5 lakh}\).

Key Features of Ayushman Bharat (PMJAY)

The Ayushman Bharat scheme has several important features aimed at benefiting eligible families:

• Portability: Beneficiaries can avail treatment in any empanelled hospital across the country.
• No Cap on Family Size or Age: The scheme covers all members of eligible families, with no restriction on family size, age, or gender.
• Pre-existing Conditions: All pre-existing diseases are covered from day one of the policy.
• Benefit Package: It covers over 1,900 medical packages, including surgery, medical and day care treatments, cost of medicines and diagnostics.

Revision Table: Ayushman Bharat Health Cover

Additional Information on Ayushman Bharat

Ayushman Bharat is the world's largest government-funded health assurance scheme. It targets over 10.74 crore poor and vulnerable families (approximately 50 crore beneficiaries) based on the Socio-Economic Caste Census (SECC) 2011 data.

The scheme aims to reduce Out-of-Pocket Expenditure (OOPE) for healthcare among the beneficiaries. By providing a substantial health cover, it prevents families from falling into poverty due to catastrophic health expenditures.

Apart from PMJAY, Ayushman Bharat also includes Health and Wellness Centres (HWCs) which provide Comprehensive Primary Health Care (CPHC), aiming to bring healthcare closer to homes.