Key Fea­tures of Ayush­man Bharat – The World's Largest Pub­lic Funded Health­care Pro­gramme

FICCI Business Digest - - Features -

Ayush­man Bharat pro­gram aims to cover the en­tire con­tin­uum of care with 1.5 lakh Health and Well­ness Cen­tres (HWCs) pro­vid­ing pri­mary health­care close to where peo­ple live and with the health pro­tec­tion scheme – Prad­han Mantri Jan Ar­o­gya Yo­jana (PMJAY) for more than 10 crore fam­i­lies (ap­prox. 500 mil­lion ben­e­fi­cia­ries) with an an­nual cover of INR 5 lakhs per fam­ily for se­condary and ter­tiary care for over 1350 pro­ce­dures: Ÿ The pro­gramme will tar­get about 10.74 crore poor, de­prived ru­ral fam­i­lies and iden­ti­fied oc­cu­pa­tional category of ur­ban work­ers' fam­i­lies as per the lat­est So­cio-Eco­nomic Caste Cen­sus (SECC) data cov­er­ing both ru­ral and ur­ban pop­u­la­tion Ÿ To en­sure that no­body is left out (es­pe­cially women, chil­dren and el­derly) there will be no cap on fam­ily size and age Ÿ The ben­e­fits un­der PMJAY will also cover pre and posthos­pi­tal­i­sa­tion ex­penses. All pre-ex­ist­ing con­di­tions will be cov­ered from day one of the pol­icy. A de­fined trans­port al­lowance per hos­pi­tal­i­sa­tion will also be paid to the ben­e­fi­ciary Ÿ Ben­e­fits of the pro­gram are por­ta­ble across the coun­try and a ben­e­fi­ciary cov­ered un­der PMJAY will be al­lowed to take cash­less ben­e­fits from any pub­lic/pri­vate em­pan­elled hos­pi­tal across the coun­try Ÿ The pay­ments for treat­ment will be done on the pack­age rate de­fined by the gov­ern­ment in ad­vance. The pack­age rates in­clude all the costs associated with the treat­ment. Keep­ing in view the state-spe­cific re­quire­ments, States/Union Ter­ri­to­ries will have the flex­i­bil­ity to mod­ify pack­age rates at par with their ex­ist­ing health­care pro­grams.

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