Prime Minister Narendra Modi launched the 'Ayushman Bharat -Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY)' which is regarded as the "worlds largest government-funded healthcare programme," targeting over 50 crore beneficiaries.
The scheme will provide a cover of up to Rs 5 lakh per family per year, through a system of Empanelled Health Care Providers (EHCP).
‘Each year per family the Ayushman Bharat programme will give a cover of up to Rs 5 lakh, for secondary and tertiary care hospitalization through a network of Empanelled Health Care Providers (EHCP).’
The EHCP network will provide cashless and paperless access to services for the beneficiaries at both public and private hospitals.
The services will include 1,350 procedures covering pre and post-hospitalization, diagnostics, medicines, etc.
Ayushman Bharat has two components creation of 150,000 health and wellness centers which will provide Comprehensive Primary Health Care (CPHC) and the PMJAY which provides health protection cover to poor and vulnerable families for secondary and tertiary care.
Modi launched the first Health and Wellness Centre at Jangla, Chhatisgarh on April 14.
PMJAY primarily targets the poor, deprived rural families and identified the occupational category of urban workers' families as per the latest Socio-Economic Caste Census (SECC) data for both rural and urban areas as well as the active families under the Rashtriya Swasthya BimaYojana (RSBY).
The objectives of the scheme are to reduce out of pocket hospitalization expenses, fulfill unmet needs and improve access of identified families to quality inpatient care and day care surgeries.
The scheme allows states enough flexibility regarding packages, procedures, scheme design, entitlements as well as other guidelines while ensuring that key benefits of portability and fraud detection are ensured at a national level.
States have the option to use an existing trust/society or set up a new trust/society to implement the scheme as State Health Agency and will be free to choose the modalities for implementation.
It can implement the Scheme through an insurance company or directly through the Trust/Society/Implementation Support Agency or a mixed approach.
The pilot launch of the scheme has already started in around 22 states and Union Territories, and so far 30 states and union territories have signed a Memorandum of Understanding and started working on the implementation of the mission.