Ayushman Bharat or “Healthy India” is a national initiative launched by Prime Minister Narendra Modi as the part of National Health Policy 2017, in order to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed on the lines as to meet SDG and its underlining commitment, which is “leave no one behind”.

AyushmanBharat is an attempt to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. Ayushman Bharat aims to undertake path breaking interventions to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level.

Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components, which are -

Establishment of Health and Wellness Centres

Pradhan Mantri Jan Arogya Yojana (PM-JAY)

1. Establishment of Health and Wellness Centres–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.
2. Pradhan Mantri Jan Arogya Yojana (PM-JAY) –PM-JAY is one significant step towards achievement of Universal Health Coverage (UHC) and Sustainable Development Goal - 3 (SDG3).It aims to provide health protection cover to poor and vulnerable families against financial risk arising out of catastrophic health episodes.

Pradhan Mantri Jan Arogya Yojana (PM-JAY) will provide financial protection (Swasthya Suraksha) to 10.74 crore poor, deprived rural families and identified occupational categories of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data (approx. 50 crore beneficiaries). It will have offer a benefit cover of Rs. 500,000 per family per year (on a family floater basis).

PM-JAY will cover medical and hospitalization expenses for almost all secondary care and most of tertiary care procedures. PM-JAY has defined 1,350 medical packages covering surgery, medical and day care treatments including medicines, diagnostics and transport.

To ensure that nobody is left out (especially girl child, women, children and elderly), there will be no cap on family size and age in the Mission. The scheme will be cashless & paperless at public hospitals and empaneled private hospitals. The beneficiaries will not be required to pay any charges for the hospitalization expenses. The benefit also includes pre and post-hospitalization expenses. The scheme is an entitlement based, the beneficiary is decided on the basis of family being figured in SECC database. When fully implemented, the PM-JAY will become the world’s largest government funded health protection mission.

Benefits of PM-JAY

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

READ MORE -https://www.pmjay.gov.in/
https://ab-hwc.nhp.gov.in/