Six Years of Ayushman Bharat PM-JAY

Syllabus: GS 2/ Health 

In News 

• Over six years, PM-JAY has transformed healthcare by offering essential coverage to millions and reducing financial burdens from medical expenses.

About AB PM-JAY

• The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) was launched on September 23, 2018.
• The scheme is a key component of India’s commitment to achieving Universal Health Coverage (UHC).
• Emergence: PM-JAY is part of the broader Ayushman Bharat initiative, which was established under the National Health Policy 2017.
• Target Population: The scheme aims to cover over 12 crore families, translating to nearly 55 crore individuals.
  • The scheme prioritizes the poorest 40% of the population, determined by the Socio-Economic Caste Census 2011.
• Coverage and Benefits: PM-JAY is recognized as the largest health assurance scheme globally.
  • It provides health coverage up to ₹5 lakh per family annually for secondary and tertiary care hospitalization.
  • The scheme focuses on providing healthcare to India’s most vulnerable sections of the population.

Features 

• 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.
• 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.

Expansion of PM-JAY:

• Recently ,the Union Cabinet approved the expansion of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
• The expansion offers comprehensive health insurance to senior citizens aged 70 and above.
• The scheme provides free health coverage up to ₹5 lakh per family, irrespective of income.

Achievements 

• Over the past six years, PM-JAY has aimed to address deep-rooted health inequities in India.
• PM-JAY represents a shift from segmented healthcare services to an integrated, need-based approach.
  • It aligns with India’s commitment to the Sustainable Development Goals (SDGs).
• The scheme ensures that “no one is left behind”, supporting health equity for all.
• As of September 9, 2024, over 35.4 crore Ayushman cards have been issued, improving healthcare accessibility for millions.
• The scheme operates in 33 States and Union Territories, excluding NCT Delhi, West Bengal, and Odisha.
• 49% of Ayushman cards have been issued to women. 30,529 hospitals are empanelled, including 17,063 public and 13,466 private hospitals, offering beneficiaries a wide range of healthcare options.
• The Ayushman Bharat program has resulted in a 21% reduction in out-of-pocket healthcare expenses.
• Financial Relief: This financial relief enables families to focus more on their well-being without the burden of financial stress.

Source : PIB