Ayushman Bharat Yojana (ABY / PMJAY)

Ayushman Bharat Yojana, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), is a flagship healthcare scheme launched by the Government of India in September 2018.

Here’s all you need to know about Ayushman Bharat Yojana:

1. Objective:

The primary objective of ABY is to provide financial protection to vulnerable and economically disadvantaged families in India by offering them access to quality healthcare services.

2. Coverage:

This program extends health coverage of up to Rs. 5 lakhs annually per family, catering to secondary and tertiary hospitalization costs.

The coverage extends to over 10 crore economically weaker families identified based on the Socio-Economic Caste Census (SECC) database.

3. Beneficiaries:

Ayushman Bharat Yojana primarily targets poor and vulnerable families across India, including rural and urban populations.

The beneficiaries include deprived rural families and several occupational categories of urban workers’ families.

4. Services Covered:

The scheme covers a wide range of medical and surgical procedures, including pre-existing diseases, maternity benefits, newborn care, and critical illnesses.

It also covers secondary and tertiary hospitalization expenses, including room charges, doctor fees, medicines, diagnostics, and pre- and post-hospitalization expenses.

5. Empaneled Hospitals:

The scheme relies on a network of both public and private hospitals, known as empaneled hospitals, to provide healthcare services to beneficiaries.

These hospitals need to meet specific quality standards and pricing guidelines set by the government.

6. Technology Integration:

ABY leverages technology extensively for the identification of beneficiaries, verification of entitlements, and management of healthcare services.

The scheme utilizes an IT platform called Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to facilitate seamless implementation and monitoring.

7. Portability:

One significant feature of ABY is its portability, allowing beneficiaries to access healthcare services across the country.

This means that a beneficiary enrolled in one state can avail treatment in any other state where the scheme is implemented.

8. Fraud Monitoring:

The scheme incorporates robust mechanisms for fraud detection and prevention, including biometric authentication, AI-based analytics, and regular audits.

Ayushman Bharat Yojana aims to address the healthcare needs of the underprivileged sections of society and reduce the financial burden of healthcare expenses on vulnerable families.

It represents a significant step towards achieving Universal Health Coverage (UHC) in India.

FAQ’s:

1. What is Ayushman Bharat Yojana?

Ans: Ayushman Bharat Yojana, also known as Pradhan Mantri Jan Arogya Yojana (PM-JAY), is a government-sponsored health insurance scheme in India.

It aims to provide financial protection to economically vulnerable families by offering health insurance coverage of up to .

Families are eligible for up to Rs. 5 lakh annually to cover secondary and tertiary healthcare services.

The scheme covers over 500 million beneficiaries identified based on socio-economic criteria and offers cashless treatment at empaneled hospitals across the country.

ABY seeks to improve access to quality healthcare and reduce out-of-pocket medical expenses for eligible individuals and families.

2. Is Ayushman Bharat scheme for everyone?

Ans: ABY also known as the Pradhan Mantri Jan Arogya Yojana (PM-JAY), primarily targets economically vulnerable families across India.

While it aims to provide health insurance coverage to a significant portion of the population, it does not cover everyone.

The scheme identifies beneficiaries based on the Socio-Economic Caste Census (SECC) data, focusing on households categorized as economically weaker sections and vulnerable families.

Therefore, while it is a significant initiative to improve healthcare access, it is not universal and is specifically aimed at providing financial protection to those most in need.

3. When was Ayushman Bharat yojana launched?

Ans: ABY also known as the Pradhan Mantri Jan Arogya Yojana (PM-JAY), was launched on September 23, 2018, by the Government of India.

4. What is Ayushman Bharat yojana eligibility?

Ans: Ayushman Bharat Yojana eligibility is primarily based on socio-economic criteria identified through the Socio-Economic Caste Census (SECC) data.

Generally, households falling under specific socio-economic categories, such as economically weaker sections and identified vulnerable families, are eligible for the scheme.

There is no restriction based on age or gender, and the scheme covers both rural and urban areas.

5. How Ayushman Bharat scheme works?

Ans: Ayushman Bharat scheme provides health insurance coverage of up to Rs. 5 lakh per family per year for secondary and tertiary healthcare services to economically vulnerable families across India.

Beneficiaries are identified based on SECC data and provided with cashless treatment at empaneled hospitals.

The scheme covers pre-existing conditions, offers portability, and utilizes digital platforms for implementation and monitoring.

6. How to login Ayushman Bharat yojana?

Ans: To log in to Ayushman Bharat Yojana:

1. Visit the official Ayushman Bharat website: https://ayushmanbharat.mp.gov.in/
2. Click on the “Login” button.
3. Enter your username and password.
4. Complete the authentication process.
5. Once authenticated, you will be logged in to the Ayushman Bharat portal.
6. Ensure you have the necessary credentials provided by the authorities to access the portal.

7. How to avail Ayushman Bharat yojana?

Ans: To avail of Ayushman Bharat Yojana:

1. Check eligibility through the Socio-Economic Caste Census (SECC) data.
2. Visit the nearest Ayushman Bharat empaneled hospital.
3. Provide necessary identification documents.
4. Get verified and enrolled.
5. Receive a Golden Card for cashless treatment.
6. Seek treatment at any empaneled hospital for covered medical conditions.
7. Present the Golden Card for cashless treatment.
8. Receive treatment without paying upfront costs.

8. What is Ayushman Bharat yojana eligibility?

Ans: Ayushman Bharat Yojana eligibility criteria in short:

Eligible families are identified based on Socio-Economic Caste Census (SECC) data.
Covers economically vulnerable families across India.
Provides health insurance coverage of up to Rs. 5 lakh per family per year.
Both rural and urban households are included.
No specific age limit for beneficiaries.
No bar on pre-existing conditions.

9. How to claim Ayushman Bharat yojana online?

Ans: To claim Ayushman Bharat Yojana online:

Visit the official Ayushman Bharat website.
Check eligibility using the ‘Am I Eligible’ section.
If eligible, register online with required details.
Get verified and receive the e-card.
Visit empaneled hospital for treatment.
Provide the e-card details to avail cashless treatment.
The hospital will process the claim online.
Receive treatment without paying upfront.
Follow up on claim status online if needed.

10. How to enroll Ayushman Bharat yojana?

Ans: To enroll in Ayushman Bharat Yojana:

1. Check eligibility: Verify if your family is eligible based on Socio-Economic Caste Census (SECC) data.

2. Visit nearest Common Service Center (CSC), Ayushman Mitra, or online portal.

3. Provide necessary documents: Submit identification and income proof documents.

4. Get enrolled: Complete the enrollment process as per the guidelines.

5. Receive Ayushman Bharat Golden Card: Upon successful enrollment, receive your Ayushman Bharat Golden Card.

6. Avail benefits: Use the card for cashless treatment at empaneled hospitals for up to Rs. 5 lakh annually.

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