Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) has significantly improved healthcare accessibility across India. Over 35.4 crore Ayushman cards have been issued, empowering millions of families with health coverage.
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), the largest health assurance scheme in the world, has completed six years of providing universal health coverage to masses, including the most vulnerable, in the country.
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The scheme, which has an ambitious goal of covering over 12 crore families or nearly 55 crore individuals, offers comprehensive secondary and tertiary care hospitalisation benefits of up to Rs 5 lakh per family annually.
Recently, the Union Cabinet expanded the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana to cover all senior citizens aged 70 and above. This move will benefit approximately 6 crore seniors, providing a distinct card and additional coverage options for existing beneficiaries, according to a PIB release.
Who is eligible for Rs 5 lakh coverage under Ayushman Bharat PM-JAY?
Around 55 crore beneficiaries from 12 crore poor and vulnerable families are eligible for the scheme’s benefits, ensuring protection for the most underserved. Each entitled family receives an annual health cover of Rs 5 lakh for secondary and tertiary care hospitalisation across public and private empanelled hospitals in India.
Options for existing scheme beneficiaries:
Senior citizens already receiving benefits from other public health insurance schemes such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), or Ayushman Central Armed Police Force (CAPF) can either continue with their current scheme or opt for AB PM-JAY. Those under private health insurance or Employees’ State Insurance scheme will also be eligible for AB PM-JAY benefits.
Key features of Ayushman Bharat PM-JAY:
Cashless Access to Healthcare: Beneficiaries enjoy cashless healthcare services at the point of care, eliminating the need for out-of-pocket payments during treatment.
Mitigating Catastrophic Health Expenditure: By covering significant medical costs, PM-JAY helps prevent over six crore Indians from falling into poverty yearly due to healthcare expenses.
Pre- and Post-Hospitalization Coverage: The scheme covers up to 3 days of pre-hospitalization and 15 days of post-hospitalization expenses, including diagnostics and medications.
No Family Size or Age Restrictions: PM-JAY imposes no restrictions on family size, age, or gender, ensuring inclusivity for all.
Coverage from Day One: All pre-existing medical conditions are covered from the very first day of enrolment, ensuring timely treatment.
Nationwide Portability: Beneficiaries can access cashless treatment at any empanelled public or private hospital across India, ensuring flexibility and ease of care.
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Equal Reimbursement for Public and Private Hospitals: Public hospitals receive reimbursements for healthcare services at par with private hospitals, ensuring equitable care delivery across all sectors.
Comprehensive Service Package: AB PM-JAY offers comprehensive coverage across 1,949 medical procedures spanning 27 medical specialties, including General Medicine, Surgery, Oncology, and Cardiology. Beneficiaries receive hospital services such as free drugs (including 15 days of post-discharge medication), diagnostics (up to 3 days before admission), food, and lodging at no cost.
Achievements of Ayushman Bharat PM-JAY:
As of September 9, 2024, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) has significantly improved healthcare accessibility across India. Over 35.4 crore Ayushman cards have been issued, empowering millions of families with health coverage. The scheme is operational in 33 states and UTs, except NCT Delhi, West Bengal, and Odisha.
