Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY)

Context:

• The National Health Authority (NHA) reports that over 59 million hospital admissions have been authorized under the Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) scheme since the launch of the scheme five years ago.

Current Updates on Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) Scheme

• The top six specialties with respect to consultations amount to a combined total of around Rs 15,651 crore since the scheme’s launch. 
• Currently, the scheme provides 919 Health Benefits Packages (HBPs), covering 1,670 procedures under 26 specialties. 

What is the Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) scheme?

• The Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) is a Centrally Sponsored Scheme having a central sector component under the Ayushman Bharat Mission anchored in the Ministry of Health and Family Welfare (MoHFW). 
• Umbrella Scheme: It is an umbrella of two major health initiatives, namely Health and Wellness Centres and the National  Health Protection Scheme.
• Objectives: Ensuring comprehensive coverage for catastrophic illnesses, reducing out-of-pocket expenditure, and improving access to hospitalization care.
• Health and Wellness Centres: Under this 1.5 lakh existing sub-centers will bring the health care system closer to people’s homes in the form of Health and wellness centres. 
• • These centres will provide comprehensive health care for non-communicable diseases and maternal and child health services.

What are the Benefits Provided Under Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana?

• Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) provides a defined benefit cover of Rs. 5 lakh per family per year. This cover will take care of almost all secondary care and most of tertiary care procedures.
• Eligibility criteria: AB-PMJAY is an entitlement-based scheme with entitlement decided based on deprivation criteria in the SECC database.
• Hospitals Covered: The beneficiaries can benefit from public and empanelled private facilities. All public hospitals in the States implementing AB-PMJAY will be deemed empanelled for the Scheme. 
  • Includes pre and post-hospitalisation expenses. 
• Pre-existing Conditions: Will be covered from day one of the policy. 
• Cashless Benefits: Beneficiaries can take cashless benefits across the country.
• Implementation Strategy: A National Health Authority (NHA) has been set up at the national level. States/ UTs are advised to implement the scheme by a dedicated entity called State Health Agency (SHA).

News Source: BS

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