Ayushman Bharat Programme
- The Ayushman Bharat programme was launched in 2018 to address health issues at all levels – primary, secondary, and tertiary.
- Ayushman Bharat is an integrated approach comprising health insurance and primary, secondary and tertiary healthcare.
- The HWCs are aimed at improving access to cheap and quality healthcare services at the primary level.
- PM-JAY will cover the financial protection for availing healthcare services at the secondary and tertiary levels.
- Ayushman Bharat is the largest government-funded healthcare programme in the world with over 50 crore beneficiaries.
Components:
- Pradhan Mantri Jan Arogya Yojana (PM-JAY), earlier known as the National Health Protection Scheme (NHPS)
- Health and Wellness Centres (HWCs)
Pradhan Mantri Jan Arogya Yojana (PM-JAY)
- PMJAY is one of India’s most ambitious health sector schemes.
- It was launched as the National Health Protection Mission and renamed later.
- It is the largest government-funded health insurance scheme in the world.
- The scheme offers eligible families an insurance cover of Rs. 5 lakh per annum per family.
- This amount is intended to cover all secondary and most tertiary care expenditures incurred.
- There is no cap on family size and age under the scheme, to ensure that nobody is left behind.
- Components of treatment covered under the scheme:
- Medical examination, consultation, and treatment
- Medical consumables and medicines
- Intensive and non-intensive care services
- Medical implant services
- Lab and diagnostic investigations
- Complications arising out of treatment
- Accommodation benefits and food services
- The beneficiary will also receive a defined transport allowance per hospital.
- The beneficiaries can take cashless treatment from any empanelled hospital anywhere in the country. This includes both public and private hospitals.
Health and Wellness Centres
- The Ayushman Bharat – Health and Wellness Centres (AB-HWCs) were launched under the Ayushman Bharat Programme in a bid to move away from selective health care to a more comprehensive range of services spanning preventive, promotive, curative, rehabilitative and palliative care for all ages.
Range of services
- Care in pregnancy and childbirth.
- Neonatal and infant health care services
- Childhood and adolescent health care services.
- Family planning, Contraceptive services and Other Reproductive Health Care services
- Management of Communicable diseases: National Health Programs
- Management of Common Communicable Diseases and General Out-patient care for acute simple illnesses and minor ailments
- Screening, Prevention, Control and Management of Non-Communicable diseases and chronic communicable disease like TB and Leprosy
- Basic Oral health care
- Care for Common Ophthalmic and ENT problems
- Elderly and Palliative health care services
- Emergency Medical Services
- Screening and Basic management of Mental health ailment
Benefits
- It is a visionary scheme that aims at the fulfilment of the concept of Universal Health Coverage (UHC).
- It will reduce medical expenditure for many families, which is currently, mostly out-of-the-pocket expense.
- Eligible families can avail of quality medical services without getting into debt.
- The insurance cover provided by this scheme includes items that are generally excluded from standard medi-claims (for example, pre-existing conditions, internal congenital diseases, and mental health conditions).
- The scheme requires hospitals to maintain a certain minimum standard.
- Insurers and third-party administrators will have access to the large new market that opens up because of the scheme.
- The scheme has the potential to initiate wide reforms in India’s healthcare system.
- After one year of the scheme’s beginning, beneficiary families are said to have saved over Rs.13000 crores.
- Over 60% of the treatments have been done by private hospitals.