AYUSHMAN BHARAT

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Ayushman Bharat

Ayushman Bharat Eligibility, Registration process and Benefits

The Ayushman Bharat Yojana (Pradhan Mantri Jan Aarogya Yojana), which aims to benefit 500 million people, was launched by PM Modi on 23rd Sep 2018. The insurance scheme aims to provide an annual health cover of ₹5 lac per family for secondary and tertiary care hospitalization. The Ayushman Bharat Yojana, which offers health insurance for 50 crore people belonging to 10 crore families, is touted by the government as the world’s largest healthcare programme. There is no restriction on the number of family members and you can add as much as you want.

Ayushman Bharat Yojana
Ayushman Bharat Yojana

Case for Ayushman Bharat Yojana in India

As per recent economic survey insurance penetration in India has risen to 3.49%. Compare this to some of the emerging economies in Asia such as Malaysia (4.77%), Thailand (5.42%) and China (4.77%) which have higher penetration than India. A large population still is far away from any insurance benefits and due to this a large section of society is not even able to afford even basic healthcare services.

Details of Ayushman Bharat Yojana

There are two parts of the scheme –

Part – 1 takes care of setting up more Health and Wellness Centres in country

The first component, pertains to creation of 1,50,000 Health and Wellness Centres which will bring health care closer to the homes of the people. These centres will provide Comprehensive Primary Health Care (CPHC), covering both maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services. The first Health and Wellness Centre was launched by the Hon’ble Prime Minister at Jangla, Bijapur, Chhatisgarh on 14 April 2018

Part -2 defines the benefits under Pradhan Mantri Jan Arogya Yojana (PM-JAY)

It aims to provide health protection cover to poor and vulnerable families. The Health and Wellness Centres will play a central role in creating awareness about PM-JAY, screening for non-communicable diseases, follow-up of hospitalisation cases among others.

Features

  1. A cover of Rs. 5 Lacs per family per year for secondary and tertiary care.
  2. There is no restriction on family size, age or gender.
  3. All members of eligible families as present in SECC database are automatically covered.
  4. All pre-existing conditions are covered from day one of the policy. The benefit cover will include pre & post hospitalisation.
  5. No money needs to be paid by the family for treatment in case of hospitalisation.
  6. You can go to public or em-panelled private hospitals across the country and get free treatment.
  7. You need to carry any prescribed ID to receive treatment at the hospital.

Ayushman Bharat Yojana Eligibility

Am I eligible – This question comes first in the mind. To check if you are eligible and fulfil all eligibility criteria, continue reading below.

First of all, Indian citizenship is a must. The eligibility criteria selected on the basis of the Socio-Economic Caste Census (SECC) data 2011.

Ayushman Bharat Eligibility

    1. Ayushman Bharat Yojana – Check Ayushman Bharat Eligibility by providing your mobile number

Here are the steps to check your eligibility.

1) On the landing page of AM I Eligible Portal, the user has to enter an active mobile number to receive an OTP. The user has to enter this OTP and click on “Verify OTP” which directs to a page to enter the details for search.

2) An individual can search his eligibility for benefits of Pradhan Mantri Jan Arogya Yojna (PMJAY) using one of the followings –

  • Mobile number/Ration Card Number (collected during ADCD drive),
  • SECC Name
  • RSBY URN

An Additional Data Collection Drive (ADCD) was conducted on 30th April 2018 at Gram Sabha’s across India to capture active mobile number and ration card number of a family of the Socio-Economic Caste Census (SECC) database.

  1. Mobile number/Ration Card Number – If the individual got his/her Mobile number or Ration card number captured during above drive, only then it will show results on the portal. IF the details were captured during SECC drive and search is not successful then use “SECC Name” for searching again.
  2. SECC Name – An individual can search if he/she is eligible for PMJAY using his details as per the SECC database such as Name, Father’s Name, Gender, State etc. Even now, if no results are displayed, then the user should contact a nearby Ayushmaan Mitra.
  3. RSBY URN – All active families, enrolled under RSBY (till 31st March, 2018) that do not feature in the targeted groups as per SECC data will be included as well and can identify if they are eligible for PMJAY using RSBY URN.

3) If you find your name as per above process, then click on “Get SMS” to receive your HHID number/RSBY URN for future purposes on your phone.

Beneficiaries

Ayushman Bharat scheme beneficiaries will have the facility of cashless treatment.

How will the entitlement be decided? Who Are The Ayushman Bharat Scheme Beneficiaries?

  • AB-NHPM is an entitlement based scheme where it will be decided on the basis of deprivation criteria in the SECC database.
  • For Rural areas – Different deprivation categories (D1, D2, D3, D4, D5, and D7) are identified under the SECC database. This will be the basis of identification for the beneficiaries.
  • For urban areas – the 11 occupational criteria will determine entitlement.
  • In addition, Rashtriya Swasthya Bima Yojna (RSBY) beneficiaries in states where it is active are also included.

Rural area categories:

  • The different categories in rural areas include families having only one room with kucha walls and kucha roof;
  • Landless households deriving major part of their income from manual casual labour.
  • Disabled members and no able-bodied adult member in the family;
  • Female-headed households with no adult male member between the ages of 16 years and 59 years;
  • Families having no adult member between the ages of 16 years and 59 years;
  • SC/ST households;
  • Also, these families in rural areas having any one of the following will be automatically included: households without shelter, destitute, living on alms, manual scavenger families, primitive tribal groups, and legally released bonded labour.

Urban area categories: For urban areas, 11 defined occupational categories are entitled under the scheme.

  • Main source of income related to household has been clarified in urban areas as beggars; rag-pickers; domestic workers; street vendors/cobblers/hawkers/other service providers working on the streets; construction workers/ plumbers/ masons/ labor/ painters/ welders/ security guards/coolies and other head-load workers;Sweepers/ sanitation workers/ malis; Home-based workers/artisans/handicrafts workers/ tailors; Transport workers/ drivers/ conductors/helpers to drivers and conductors/cart pullers/ rickshaw pullers; shop workers/ assistants/ peons in small establishments/ helpers/ delivery assistants / attendants/ waiters; electricians/ mechanics/ assemblers/repair workers; washer-men/ chowkidars; Other work/Non-work ; Non-work (Pension/ Rent/ Interest, etc.)

What are the inclusions?

Ayushman Bharat Yojana will cover hospitalisation expenses for almost all secondary care and most of tertiary care procedures.

Hospital eligibility

Ayushman Bharat Yojana benefits can be availed at all public hospitals and empaneled private health care facilities. Also, the basic empanelment criteria allows empanelment of a hospital with a minimum of 10 beds, with the flexibility provided to states to further relax this if required. Details about Empanelment of the hospitals under AB-NHPM be made available through government websites and apps. OR, you can call helpline – 14555 to know further.

Apply for Ayushman Bharat Yojana – Registration

Register for Ayushman Bharat Yojana Online | Pradhan Mantri Jan Arogya Abhiyaan

Eligible as well as interested candidates can start applying for this project from August 2018 onwards. The eligibility for Ayushman Bharat Scheme is on basis of SECC survey performed by the government. According to this list, 10.74 crore families belonging to rural also urban areas are eligible to apply for this program. The survey covers identified an occupational category of the families of the urban workers also deprived rural families. Any future changes made in the SECC data will be applicable for the Ayushman Bharat Yojana Registration Online / Scheme eligibility as well.

Ayushman Bharat Beneficiaries Registration through CSCs – Process
Follow these steps to get yourself registered at CSCs –

  • Visit the CSC centre which is near to you and validate that all eligible persons in your family are entitled for Ayushman Bharat Yojana.
    CSC Centre will validate if the person is eligible for NHPS.
  • CSC VLEs will collect the necessary details and documents like Aadhaar Card, Ration Card, PAN etc and upload them to database.
  • Information uploaded by the CSC will be reviewed by authorised persons and approved by state authorities.
  • MoH&FW has defined SLAs to get this application approved within time and revert it on Real Time Basis (RTS).
  • CSC will then provide you a card printed on paper.
  • These cards at can be used at the empanelled hospitals to avail of the benefits provided under Ayushman Bharat Yojana.

Need For Ayushman Bharat Yojana Registration Online

This program design is to eliminate all disadvantages associated with other insurance schemes and the cashless benefits of treatments. Under this scheme, all government hospitals and chosen private hospitals as well.

Treatment Rates

The health ministry has included 1,354 packages in the scheme under which treatment for coronary bypass, knee replacements and stenting among others would be provided at 15-20 per cent cheaper rates than CGHS – Central Government Health Scheme.

What is the major difference between Ayushman Bharat Scheme Treatment Packages and other health schemes?

Under the Ayushman Bharat Yojana treatment packages are available at 15 – 20% discount than CGHS (Central Government Health Schemes). There are 20 specialities including cancer care, orthopedics, cardiology, and neurosurgery.

List Of Ayushman Bharat Scheme Treatment Packages Rates:

This Ayushman Bharat Yojana provides the medical treatments along with rates by central Government under National Health Protection Mission as mentioned below. Full list will be uploaded at the government portal.

Ayushman Bharat Yojana Rates List
Ayushman Bharat Yojana Rates List for some items

Under this Ayushman Bharat Yojana increase, the number of Empanelled private Hospitals under National Health Protection Scheme and health ministry also provides the incentive up to 30% to private hospitals

This scheme also manages the RSBY (Rashtriya Swasthya Bima Yojana) and senior citizen health insurance. And the Ayushman Bharat scheme does not have any limitations on income, age, family size.

 

Extras

Ayushman Bharat Scheme Beneficiaries Are Going To Cheer The Private Players.

Ayushman Bharat scheme Beneficiaries is a fully cashless insurance program. Eligible people do not need to pay a single penny for the treatment. A beneficiary can take treatment at the government selected hospitals anywhere in the country. The insurance amount provides and share by the Central also State Governments on a ratio of 60:40 respectively. This insurance scheme is going to revolutionise the healthcare system in India implement in the best way possible.

What are the other insurance scheme/benefits provided by the government?

There are many other insurance schemes being run by the Central and States governments. Please refer here for more details about key government health insurance schemes and their benefit.

What about the Scheme premium?

Applicants have to pay only Rs 1000 to 1200 annual premium for this program. It explains the very nominal amount compared to the benefits available. Cashless treatment becomes reality with this Ayushman Bharat Scheme Details you can approach the government selected hospitals for the treatment.

FAQ

Are pre-existing ailments covered under the scheme?

Yes, All the preexisting illness are covered under the scheme.

What are the guidelines for the hospitals to be empaneled with Ayushman Bharat Yojana?

We have listed down some conditions to be met before an hospital can be empaneled, please refer eligibility criteria for hospital to enroll.

Is Ayushman Bharat Yojana operational in my state?

As many as 31 states and Union Territories have signed MoUs with the Centre and will implement the programme over the next two to three months, after its launch on Sunday. Telangana, Odisha, Delhi, Kerala and Punjab have not signed. Once they’re on board then everyone from these states can also get benefited from the scheme.

Please refer for more info on Ayushman Bharat website or contact number.

Conclusion

This is true that the illness doesn’t consider economic background, neither should the cure. The benefits defined as part of the Ayushman Bharat Yojana are going to benefit the people who do not have means to basic healthcare facilities. The programme is still in its nascent state, but if an honest attempt is made to implement the scheme then this can prove to be the biggest healthcare reform for the country.

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