Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

Beneficiary Level

  • Government provides health insurance cover of up to Rs. 5,00,000 per family per year.
  • More than 10.74 crore poor and vulnerable families (approximately 50 crore beneficiaries) covered across the country.
  • All families listed in the SECC database as per defined criteria will be covered. No cap on family size and age of members.
  • Priority to girl child, women and and senior citizens.
  • Free treatment available at all public and empaneled private hospitals in times of need.
  • Covers secondary and tertiary care hospitalization.
  • 1,350 medical packages covering surgery, medical and day care treatments, cost of medicines and diagnostics.
  • All pre-existing diseases covered. Hospitals cannot deny treatment.
  • Cashless and paperless access to quality health care services.
  • Hospitals will not be allowed to charge any additional money from beneficiaries for the treatment.
  • Eligible beneificiares can avail services across India, offering benefit of national portability. Can reach out for information, assistance, complaints and grievances to a 24X7 helpline number – 14555

 

Health System

  • Help India progressively achieve Universal Health Coverage (UHC) and Sustainable Development Goals (SDG).
  • Ensure improved access and affordability, of quality secondary and tertiary care services through a combination of public hospitals and well measured strategic purchasing of services in health care deficit areas, from private care providers, especially the not-for profit providers.
  • Significantly reduce out of pocket expenditure for hospitalization. Mitigate financial risk arising out of catastrophic health episodes and consequent impoverishment for poor and vulnerable families.
  • Acting as a steward, align the growth of private sector with public health goals.
  • Enhanced used to of evidence based health care and cost control for improved health outcomes.
  • Strengthen public health care systems through infusion of insurance revenues.
  • Enable creation of new health infrastructure in rural, remote and under-served areas.
  • Increase health expenditure by Government as a percentage of GDP.
  • Enhanced patient satisfaction.
  • Improved health outcomes.
  • Improvement in population-level productivity and efficiency
  • Improved quality of life for the population

 

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