Pradhan Mantri Jan Arogya Yojana (PMJAY), also known as Ayushman Bharat Yojana, is the flagship healthcare scheme of the government of India. The scheme was launched to provide healthcare assistance to the economically poor who form 40% of the country’s bottom population. The scheme offers medical coverage for free in case of hospitalization.
Like conventional medical insurance, the scheme covers hospitalization expenses that often break the backbone of underprivileged families.
Overview of PMJAY
PMJAY is one of the biggest healthcare schemes in the world. Launched by the Indian government in March 2018, it is an ambitious reform that aims to halt the slide of the 50–60 million Indians who fall into poverty every year due to sky-high hospitalization expenditure.
It was launched as per recommendations of the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlying commitment, which is to “leave no one behind.”
Key features of PMJAY
The government of India launched Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) on 23.09.2018. PMJAY is a centrally-sponsored scheme. It is entirely funded by the government and the funding is shared between Centre and State governments as per the guidelines of the Ministry of Finance.
Here are the key features of the scheme:
- PMJAY provides health cover up to Rs. 5 lakh per family per year for secondary and tertiary hospitalization to around 10.74 crore poor and vulnerable families.
- This is an entitlement-based scheme. This scheme covers poor and vulnerable families based on deprivation and occupational criteria as per the Socio-Economic and Cast Census database (SECC).
- The scheme provides cashless and paperless access to services for the beneficiary at the point of service in any (both public and private) empanelled hospitals across India. In other words, a beneficiary from one State can avail of benefits from an empanelled hospital anywhere in the country.
- Under the scheme, the States are free to choose the modalities for implementation. They can implement the scheme through an insurance company or directly through the Trust/ Society or mixed model.
- There is no restriction on family size, ensuring all members of designated families, especially girl children and senior citizens get coverage.
One of the most important features of the PMJAY scheme is the Ayushman Bharat e-card. Let’s understand what this card is and how it benefits the citizens of India.
What is Ayushman Bharat E-Card?
The Ayushman Bharat e-card is a cashless medical insurance card issued by the National Health Authority of India. Also known as the ABHA health card, the card enables holders to access private and public hospitals across India. Holders can avail cashless treatment at any of the network hospitals in India.
Achievements and the impact of PMJAY
PMJAY provides a medical cover of Rs. 5 Lakh to Ayushman card holders. This has eased the out-of-pocket medical expenditure of at-risk and vulnerable families.
The health department has issued 21,40,17,608 Ayushman cards as of 21 December, 2022. The families that have benefited from the scheme report a very pleasant experience that helped them get fast cashless treatment.
PMJAY played a pivotal role in COVID-19 testing and treatment from April 2020 to July 2021. Under the Centre’s Ayushman Bharat scheme, over 20 lakh tests and 7.25 lakh COVID-19-related treatments worth over Rs. 2,800 crore were authorized from April 2020 to July 2021.
Universal health coverage and future steps
According to the World Health Organization (WHO), universal health coverage means that everyone has access to the full range of quality health services they need, when and where they need them, without financial hardship. It covers the full range of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
How PMJAY contributes to achieving universal health coverage
PMJAY was launched to achieve the goal of universal healthcare coverage for all Indians. Today, it provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India. Over 12 crore poor and vulnerable families (about 55 crore beneficiaries) are eligible to get these benefits.
The positive impact of PMJAY is felt by the economically weaker sections of society as it has made healthcare affordable for all.
PMJAY is the world’s largest health insurance scheme fully financed by the government. It provides a cover of Rs 5 lakh to impoverished families for medical treatment. The scheme is a godsend for the deprived sections of society as it helps them get quality medical treatment without incurring a huge financial burden.
What is the eligibility for an Ayushman card?
The applicant must provide proof that the income earned is less than the BPL threshold. The applicant or any member of the applicant’s family should not have a pucca residence registered in their name to become eligible for this health benefit.
Can I apply for PMJAY online?
Yes, you can apply for PMJAY online.
Visit the official PMJAY website: To initiate your application process, go to the official website of Ayushman Bharat Yojana. Ensure that you have a stable internet connection and a computer or smartphone to access the website.
Who are all eligible for PMJAY coverage?
In rural areas, the PMJAY health cover is available to those who belong to scheduled caste and scheduled tribe households. Households with no adult/male members aged between 16 and 59 years. Besides these, people who have only one room tenement with kucha walls and kucha roof, and landless households that depend on manual casual labor for livelihood are also eligible.
Urban beneficiaries include beggars, ragpickers, domestic workers, street vendors, sanitation workers, artisans, electricians, mechanics, washermen, and chowkidars.
How to register for Ayushman Bharat scheme?
Find out if you’re eligible to apply for this scheme by calling any one of the following toll-free numbers – 14555 or 1800-111-565. Once you’ve ascertained your Ayushman Bharat registration eligibility, you can proceed to register yourself and your family members.
What is the income limit for an Ayushman card?
The applicant’s monthly income should not exceed Rs. 10,000 per month and should not own more than 5 acres of agricultural land. PAN and Aadhaar Card should be furnished as age and identity proof. The current status of the family (joint/nuclear) and supportive documents regarding the same should be submitted.