#PolicyExplainer: What is Ayushman Bharat and how to avail it?
What's the story
A majority of Indians lack access to health insurance and modern healthcare, which is one of the biggest challenges faced especially by the poor. To provide free health coverage to the poor and vulnerable, the Center, in September 2018, rolled out the Ayushman Bharat or Pradhan Mantri Jan Arogya Yojana, deemed the world's largest government-funded health scheme. Here's everything you should know about it.
Information
About the Ayushman Bharat Yojana
Ayushman Bharat health scheme aims to target poor and deprived families. As many as 8.03 crore families in rural areas and about 2.33 crore in urban areas will be entitled to be covered under this scheme, which means it will roughly cover 50 crore people.
Eligibility
Who all are eligible for benefits under Ayushman Bharat?
PM-JAY covers families identified as "deprived rural families and occupational categories of urban workers' families" in the latest Socio-Economic Caste Census (SECC) data. List of eligible families is shared with respective state governments and concerned agencies. Only those families that are identified as beneficiaries are entitled to benefits. Also, there is no cap on family size and age of beneficiaries under the scheme.
Services
What are the services or benefits offered under the scheme?
Under the PM-JAY scheme, beneficiary families will be provided with an insurance cover of up to Rs. 5 lakh/family per year for almost all secondary and tertiary hospitalization expenses. All pre-existing diseases of the beneficiaries are covered from day one. The health services offered under the scheme include expenses towards hospitalization and surgeries, follow-up care, pre- and post-hospitalization expenses, and newborn/child services among others.
Enrolment
How to enroll or register for the scheme?
As Ayushman Bharat PM-JAY is an entitlement-based scheme, one doesn't need to register or enroll to claim benefits under it. There is no enrolment process as the beneficiary families are identified by the government itself based on SECC data. However, one can check if their family is a beneficiary by visiting the Mera PM-JAY portal (https://mera.pmjay.gov.in/) and log in using their mobile number.
Claim benefits
How can beneficiaries avail of PM-JAY services?
To claim the benefits under the health scheme, families need to establish their identities using a recognized identity card, such as Aadhaar, Voter ID, or ration card. They need to get themselves identified at an impaneled hospital or Community Service Center (CSC). Beneficiaries can avail the services offered by the scheme at all public hospitals as well as enrolled private hospitals.