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Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana

This topic of “Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana” is important from the perspective of the UPSC IAS Examination, which falls under General Studies Portion.

Introduction:

  • Ayushman Bharat is a flagship scheme of the Government of India launched in 2018 to achieve Universal Health Coverage.
  • The scheme has two components: Health and Wellness Centres (HWCs) and Pradhan Mantri Jan Arogya Yojana (PM-JAY).

Ministry/Agency:

  • Ministry of Health & Family Welfare.

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Objectives:

  • To provide health coverage of up to ₹ 5,00,000 per family per year for secondary and tertiary care hospitalization.
  • To cover over 10.74 crores poor and vulnerable families (approximately 50 crore beneficiaries) that form the bottom 40% of the Indian population.

Benefits:

  • Cashless cover of up to ₹ 5,00,000 for listed secondary and tertiary care conditions.
  • No cap on family size or age of members.
  • Pre-existing diseases are covered from the very first day.
  • Eligible persons suffering from any medical condition before being covered by PM-JAY can get treatment for all those medical conditions as well under this scheme.

Eligibility:

  • Rural and urban residents belonging to various socio-economic groups are eligible for PM-JAY.
  • Eligibility is based on deprivation and occupational criteria of the Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas, respectively.

Implementation strategy:

  • PM-JAY is fully funded by the Government, and the cost of implementation is shared between the Central and State Governments.
  • The scheme provides coverage for various components of the treatment, including medical examination, treatment, and consultation, pre-hospitalization, medicine and medical consumables, non-intensive and intensive care services, diagnostic and laboratory investigations, medical implantation services, accommodation benefits, food services, complications arising during treatment, and post-hospitalization follow-up care up to 15 days.

Exclusions:

  • Persons who own a two, three, or four-wheeler or a motorized fishing boat, those who own mechanized farming equipment, those who have Kisan cards with a credit limit of ₹ 50000, those employed by the government or in government-managed non-agricultural enterprises, those earning a monthly income above ₹ 10000, those owning refrigerators and landlines, those with decent, solidly built houses, and those owning 5 acres or more of agricultural land are excluded from the scheme.

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