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Ayushman Bharat ( PMJAY ) Introdução

Ayushman Bharat Yojana or Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), nicknamed Modicare, is a program which aims to provide a service to create a healthy, capable and content new India. Presently it is running as a pilot project in Uttar Pradesh from 4 September 2018. It has two goals, one, creating a network of health and wellness infrastructure across the nation to deliver comprehensive primary healthcare services, and another is to provide insurance cover to at least 40 per cent of India's population which is majorly deprived of secondary and tertiary care services. Indu Bhushan appointed as a Chief Executive Officer (CEO).This centrally sponsored flagship scheme aims to provide an annual health cover of up to Rs. 5 lakh to vulnerable 10 crore families (approximately 50 crore persons – 40% of country’s population) based on Socio Economic and Caste Census database.

Ayushman Bharat Yojana will be launched on 25 September 2018. Beneficiaries will receive Ayushman Bharat Family Health Cards The key stakeholders in the scheme besides the consumers or beneficiaries are the Healthcare Providers, state governments and Insurance companies without whose support and involvement the execution of this scheme cannot happen.

Features:

Ayushman Bharat consists of two major elements.

National Health Protection Scheme - to provide cashless treatment to patients

Health and Wellness centres (HWC) - to provide primary care to the patients

In fact, the government will upgrade existing Public Health Centres to Wellness Centres. The government has roped in multiple agencies to ensure seamless coordination between the centre and states.

It offers the benefits as under :

Cashless Treatment at Public/Private Healthcare Providers

Secondary and Tertiary care hospitalization treatments coverage

5 Lakhs cover per family

No cap on size of family or age of family members

Pre-existing diseases covered from Day 1 of enrolment of the scheme

Portable across India at all empaneled healthcare Providers

Fixed Transportation Allowance payable from place of residence to hospital

AYUSH (Alternative Medicine Systems other than Allopathic) covered

Prior to launch of Ayushman Bharat Scheme RSBY (Rashtriya Swasthya Bima Yojana) has been the only scheme in India launched on a Pan India basis, which aimed at Universal Health Coverage.[9] In recent years, several developing countries have introduced tax-financed health insurance coverage to their poor populations India too, joined this effort in 2008, with the Indian Ministry of Labour and Employment (MoL&E) launching the ‘Rashtriya Swasthya Bima Yojana’ (RSBY) to protect poor Indian households from financial risks associated with hospitalization expenses. NHPS will subsume the ongoing centrally sponsored schemes such as Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme. Dubbed as Modicare, the scheme would be the largest state-funded health insurance scheme and a massive leap forward toward UHC, by decreasing OOPE and protecting around 40% vulnerable population from catastrophic health-care expenditure.The impact of the scheme can only be evaluated post roll out of the scheme when all variables constraints would come into play, learnings can be had and improvement areas will discovered by the government.

Ayushman Bharat Scheme Package List

1,350 packages under 23 medical specialities will be provided under the Ayushman Bharat scheme. 253 packages offered under general surgery while 161 packages offered under Urology. The Package cost includes Room and bed charges, nursing care, procedure cost and physician fee, consultation and diagnostics pre-hospitalisation, two-week medicine, stitch removal and follow-up consultancy for two weeks after discharge.

References

https://www.india.gov.in/spotlight/ayushman-bharat-national-health-protection-mission

https://www.abnhpm.gov.in/