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Ayushman Bharat -Pradhan Mantri Jan Arogya Yojana

Posted on : 29 Nov 2019

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  • It is a centrally sponsored scheme. It is entirely funded by Government and the funding is shared between Centre and State governments as per prevailing guidelines of Ministry of Finance.
  • PMJAY provides health cover up to Rs. 5 lakh per family per year for secondary and tertiary hospitalization to around 10.74 crore poor and vulnerable families (approx. 50 crore beneficiaries).
  • PMJAY is an entitlement based scheme. This scheme covers poor and vulnerable families based on deprivation and occupational criteria as per SECC database.
  • PMJAY provides cashless and paperless access to services for the beneficiary at the point of service in any (both public and private) empanelled hospitals across India. In other words, a beneficiary from one State can avail benefits from an empanelled Hospital anywhere in the Country.
  • Under PMAJY, the States are free to choose the modalities for implementation. They can implement the scheme through insurance company or directly through the Trust/ Society or mixed model.
  • There is no restriction on family size, ensuring all members of designated families specifically girl child and senior citizens get coverage.
  • A well-defined Complaint and Public Grievance Redressal Mechanism, has been put in place through which complaints/ grievances are registered, acknowledged, escalated for relevant action, resolved and monitored.
  • PMJAY has created a robust IT system for implementation and role of real time transaction data.
  • At National level, National Health Authority (NHA) has been set up as an attached office to Ministry of Health and Family Welfare to manage the implementation of the scheme.
  • The beneficiaries will not be required to pay any charges and premium for the hospitalisation expenses.
  • The benefit also include pre- and post-hospitalisation expenses.
  • Each empanelled hospital will have an 'Ayushman Mitra' to assist patients and will coordinate with beneficiaries and the hospital. They will run a help desk, check documents to verify the eligibility, and enrolment to the scheme.
  • Benefits of the scheme are portable across the country.

Article Related Questions

  1. Consider the following statements regarding Ayushman Bharat -PradhanMantri Jan ArogyaYojana
    1. It is a centrally sponsored scheme.
    2. There is no restriction on family size in this scheme.
    3. The benefit also include pre- and post-hospitalisation expenses.
    Which of the above statement is/are correct?

  2. 1.1 and 2 only

    2.2 and 3 only

    3.1 and 3 only

    4.1, 2 and 3

    Right Ans : 1, 2 and 3

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