Last month, there were reports claiming that over 1.5 lakh people have already benefited from the PM Narendra Modi’s flagship healthcare scheme called Pradhan Mantri Jan Arogya Yojana (PMJAY). Launched with much fanfare on September 23, 2018, the scheme has been appreciated as well as criticised by a various section of the society. While it is yet to be seen whether or not the ‘grand health insurance schemes’ delivers on its promises, let’s take stock of what this scheme is all about.
Ayushman Bharat is a flagship scheme of the Modi government that aims to provide Rs. 5 lakh health insurance coverage to poor families for secondary and tertiary healthcare. PM Modi has launched this scheme simultaneously in 445 districts of 30 states across the country.
PMJAY health insurance scheme is touted as one of the biggest government-funded schemes in the world as its expected beneficiary base is almost equal to the population of the European Union. This national health protection mission (NHPM) aims to cover around ten crore poor households (50 crore people) to provide cashless and paperless medical services in any government / private empanelled hospitals across the country.
The central government has included 1,350 medical packages including surgery, medical and daycare treatments, cost of medicines and diagnostics. NHPM treatment package rates have already been fixed for these surgeries and treatment processes. People can avail cashless and paperless treatment worth up to Rs. 5 Lakh per annum. No insurance premium has to be paid by the beneficiary of the scheme.
There is no bar on the age, income limit of the family members in the PM Jan Arogya Yojana which is launched with the objective of ensuring “Health for All”. All those people whose name appears in the Socio-Economic Caste Census (SECC-2011) data are automatically included in this scheme. AB-PMJAY scheme is not based on caste, gender or religion but includes deprived rural and urban families.
People can easily check their eligibility by checking their name in the PMJAY final list of beneficiaries at PMJAY website and the official website for Ayushman Bharat. All existing diseases are covered from day 1, and no hospital can deny treatment to any poor person.
People can avail treatment facility simply in any nearby hospital which can be located in the list of empanelled hospitals, and this list carries the name of hospitals, address, contact numbers and specialities covered. Arogya Mitras would be deployed at each of the empanelled hospitals to assist people in claim settlement.
It is important to note that there is no need to make registration or fill an online application form to avail treatment under PMJAY mega health insurance scheme. All the eligible beneficiaries can avail treatment just by showing their Aadhar card or Ayushman family cards or Ration card or Voter card. However, for second-time treatment under PM Jan Aogya Yojana, Aadhar card is a mandatory document.
In case of any problem, people can contact the PMJAY helpline number at 14555 or 1800-111-565.