by The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is a flagship health insurance program launched by the Government of India to provide cashless access to healthcare services to the economically weaker sections of the society. It was launched on September 23, 2018, by Prime Minister Narendra Modi.
Objectives and Coverage
The primary objectives of AB PM-JAY are:
1. To provide health insurance cover to over 500 million beneficiaries.
2. To ensure financial risk protection for the vulnerable population.
3. To address the healthcare needs of the middle class and low-income groups.
The scheme offers coverage to the following categories:
1. BPL (Below Poverty Line) families
2. Women (up to 45 years of age)
3. Senior citizens (up to 60 years of age)
4. Orphans
5. Disabled people
6. Transgenders
Key Features
Eligibility Criteria
The eligibility criteria for availing the benefits of AB PM-JAY are as follows:
- – Resident of India
- – Belonging to the BPL category as per the official government list
- – Not covered under any other government health insurance scheme
Coverage Details
AB PM-JAY provides coverage for the following healthcare services:
1. Pre-existing diseases
2. Diagnostic tests
3. Surgeries
4. Medicines
5. Ambulance services
6. Emergency admissions
7. Outpatient treatments
8. Maternity benefits
9. Vaccinations
10. Dialysis
Benefits and Limitations
The benefits of AB PM-JAY include:
- – Cashless treatment at any of the empanelled hospitals across the country
- – Coverage for secondary and tertiary care procedures
- – No cap on room rent charges
- – No restriction on the number of claims per year
- – No waiting period for beneficiaries
- However, the scheme also has certain limitations:
- – Coverage only for treatments availed at empanelled hospitals
- – Exclusions for certain diseases or procedures
- – Cashless facility limited to certain network hospitals
- – No coverage for cosmetic or dental treatments
Implementation and Expansion
AB PM-JAY has been implemented in all states across the country, covering both urban and rural areas. The scheme has been expanded to cover more beneficiaries, including the middle class.
Conclusion
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) plays a crucial role in providing affordable and accessible healthcare to the economically weaker sections of the society. With its comprehensive benefits, it aims to address the challenge of healthcare affordability in India, ensuring financial security and improved access to healthcare services for all.
