Prime Minister Narendra Modi will roll out the Centre’s flagship Ayushman Bharat-National Health Protection Mission (AB-NHPM) from Jharkhand Sunday.
The ambitious scheme, which was renamed the Pradhan Mantri Jan Arogya Abhiyan (PMJAY), aims to provide a coverage of Rs five lakh per family annually, benefiting more than 10 crore poor families.
Eligible people can avail the benefits in the government and listed private hospitals.
The scheme will target poor, deprived rural families and identified occupational category of urban workers’ families, 8.03 crore in rural and 2.33 crore in urban areas, as per the latest Socio-Economic Caste Census (SECC) data. It will cover around 50 crore people.
The entitlement is being decided on the basis of deprivation criteria in the SECC database. The beneficiaries are identified based on the deprivation categories (D1, D2, D3, D4, D5, and D7) identified under the SECC database for rural areas. For the urban areas, the 11 occupational criteria will determine entitlement.
Eleven occupational categories of workers include rag pickers, beggars, domestic workers, street vendors, cobblers/ hawkers/ other service providers working on streets, construction workers/ plumbers/ masons/ labours/ painters/ welders/ security guards/ coolies and other head-load workers and sanitation workers.
In addition, the Rashtriya Swasthya Bima Yojna (RSBY) beneficiaries in states where it is active are also included.
There is no cap on family size and age in the scheme, ensuring that nobody is left out.
One would only need to establish one’s identity to avail benefits under the scheme and it could be through Aadhaar card or election ID card or ration card. Having an Aadhaar card is not mandatory to avail the scheme’s benefit.
In case of hospitalisation, members of the beneficiary families do not need to pay anything under the scheme, provided one goes to a government or an empanelled private hospital.
The National Health Agency (NHA), the apex body implementing the AB-NHPM has launched a website and a helpline number to help prospective beneficiaries check if their name is there in the final list.
One can visit the website mera.pmjay.gov.in or call up the helpline (14555) to check their enrolment. A beneficiary needs to key in his or her mobile number, which is verified through an OTP and then complete the KYC (know your customer) online without any need for human interface with other documents.
They can also call the helpline number to check their enrolment.
Each empanelled hospital will have an ‘Ayushman Mitra’ to assist patients and will coordinate with beneficiaries and the hospital. They will run a help desk, check documents to verify the eligibility and enrolment to the scheme.
Also, all the beneficiaries will be given letters having QR codes which will be scanned and a demographic authentication conducted for identification and to verify his or her eligibility to avail the benefits of the scheme.
The Health Ministry has included 1,354 packages in the scheme under which treatment for coronary bypass, knee replacements and stenting, among others, would be provided at 15-20 per cent cheaper rates than the Central Government Health Scheme (CGHS).
Modi had announced the launch of the scheme from ramparts of the Red Fort during his Independence day speech.
As many as 31 states and Union Territories have signed MoUs with the Centre and will implement the programme over the next two to three months, after its launch on Sunday.
Remaining states and UTs which include Telangana, Odisha, Delhi, Kerala and Punjab have not signed, so the scheme will not be implemented in those states till they come on board.
Over 8,735 hospitals, both public and private, have been empanelled for the scheme.
“The prime minister will launch the scheme on September 23 but effectively it will become operational from September 25 on the birth anniversary of Pandit Deendayal Upadhyay,” said Niti Aayog member V K Paul, who is the chief architect of the scheme.
He said in the current fiscal, the burden on the Centre is likely to be around Rs 3,500 crore.
Billed as the world’s largest government healthcare programme, it will be funded with 60 per cent contribution coming from the central government and the remaining from the states.
“We have received applications from 15,000 hospitals for being empanelled … Out of this half, that means 7,500 applications for empanelment are private hospitals,” Paul said, adding in some states the process for empanelment is yet to start.
Asked about the cost to the exchequer in the current fiscal, he said, “Around Rs 3,500 crore has been budgeted by the central government for the scheme this year.”
He said Rs 2,000 crore had been provided in the budget for 2018-19 as token money for the scheme.
“We are six months into this fiscal and we also know that only 27 states will go immediately into operations. Therefore full uptake is still be building up. Accordingly, Rs 1,500 crore more has been sought, so we now have Rs 3,500 crore as the central government budget,” he said.