Benefits of Ayushman Bharat Yojana

The Ayushman Bharat Yojana adopts a continued care approach based on two components:

• Ayushman Bharat Pradhan Mantri Jan Arogya Yojana: The PMJAY is a medical insurance scheme by the Government of India that is targeted at the poor, marginalised and vulnerable strata of the society.
  Aimed to provide accessible healthcare and make secondary and tertiary healthcare cashless for the economically weaker sections, the PMJAY was launched by Hon. PM Mr Modi on 23rd September 2018 as part of the Ayushman Bharat Yojana.

• Establishing Health and Wellness Centres: This component of the Ayushman Bharat Yojana focuses on establishing 1.50 lakhs health and wellness centres across India to make healthcare easily accessible to crores of Indians.

These centres will be equipped to offer Comprehensive Primary Health Care (CPHC), along with child health services, maternity health services, non-communicable disease prevention and treatment, free diagnostic services and free essential drugs.

Let us look at the benefits enjoyed by the beneficiaries as well as the Indian healthcare system through the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana:

10 benefits of the Ayushman Bharat Yojana for the beneficiaries:

• With a family-floater health insurance policy of ₹5 lakhs per family, this health insurance welfare scheme also covers 3 days pre-hospitalisation and up to 15 days of post-hospitalisation expenses and intensive and non-intensive healthcare services.

• The PMJAY medical insurance will offer Swasthya Suraksha or health protection to approximately 10 crore families in rural (8 crore families) as well as urban (2 crore families) areas of India, primarily the poor and lower-middle-class sections of the society. The beneficiary families will be decided on the latest data of the Socio-Economic Caste Census (SECC).

• This is an entitlement-based health insurance policy wherein all the families listed in the SECC database and fulfilling the necessary conditions will get coverage. There will be no limit on the age and family size to ensure all beneficiaries, especially women, girl children and the elderly, are covered.

• The beneficiaries can avail of free, paperless and cashless treatment at government hospitals and select empanelled private hospitals.

• The scheme will give priority to girl children, women and the elderly for coverage.

• The PMJAY will cover major secondary and tertiary care hospitalisation. This medical insurance scheme has a list of almost 1350 medical packages that cover the daycare treatments, surgery, cost of medicines, diagnostics expenses, transport expenses, food services and accommodation expenses.

• The PMJAY health insurance policy will have compulsory cover for all pre-existing illnesses from day one of the policy, and no hospital can deny cover or treatment.

• All the hospitalisation costs are taken care of under PMJAY, and beneficiaries will not have to pay any amount to avail of treatment. Moreover, hospitals will be barred from charging any amount for the treatment of beneficiaries under the PMJAY.

• With national portability, the establishment of health centres and tie-up with multiple private hospitals, the PMJAY services are available pan-India for eligible beneficiaries.

• The government has set up a 24x7 helpline number - 14555 - for round-the-clock assistance and grievance resolution.

• 8 benefits of the Ayushman Bharat Yojana for the public healthcare system of India:

• Help India meet the Sustainable Development Goals (SDG) and the principle of ‘leave no one behind.

• Achieve the ambition of Universal Health Coverage (UHC).

• Ensure quality services at public hospitals and strategic partnerships with private hospitals, especially not-for-profit providers in public healthcare deficit areas, to improve the affordability and accessibility of high-quality secondary and tertiary health services.

• Reduce the financial outflow and eventual major financial liabilities for poor, vulnerable and economically disadvantaged sections of the society by ensuring reduced healthcare expenditure, especially for significant healthcare challenges and conditions.

• Ensure infusion of medical insurance money into the public healthcare units and strengthen them.

• Establish and solidify quality health and wellness infrastructure in all parts of the country, especially remote and under-served regions and rural areas.

• Improve the government health expenditure as a percentage of the GDP (Gross Domestic Product).

• Improve health outcomes, patient satisfaction and the overall quality of life for all Indian citizens.

• To avail of the Ayushman Bharat Yojana benefits, beneficiaries need to check their Ayushman Bharat Yojana eligibility.

Being an entitlement-based medical insurance scheme, the PMJAY does not entail any enrolment by the beneficiaries. Every family listed under the latest SECC database will be automatically covered under PMJAY. Beneficiaries simply have to check their Ayushman Bharat Yojana eligibility to avail of its benefits.

To check your Ayushman Bharat Yojana eligibility, follow the below steps:

1. Go to the PMJAY website https://pmjay.gov.in/ and click on “Am I Eligible?”
2. Input your mobile number and generate the OTP.
3. Select your state.
4. Search the list based on your name, ration card number or mobile number.
5. If your name appears on the list, you are an eligible beneficiary under the PMJAY health insurance policy.

Alternatively, you can get all the necessary information, including your eligibility, on the Ayushman Bharat Yojana customer care telephone numbers 14555 or 1800-111-565. Moreover, you can reach out to one of the Empanelled Health Care Providers (EHCP) under PMJAY.
If you are eligible, create an Ayushman Bharat Health Account (ABHA). Once created, you will receive a 14-digit

ABHA number and an Ayushman Bharat Health Card.

The ABHA health card benefits in India include the creation of a unique healthcare identity, unification of all benefits under a single card, easy access to all registered healthcare facilities and hassle-free sign-up for centralised health data sharing.

A health insurance policy allows you to avail of quality healthcare without affecting your savings and finances. The Ayushman Bharat Yojana in general, and the PMJAY in particular, were introduced to provide the necessary access to affordable healthcare and treatment to all, especially the marginalised sections of society.

Along with such government welfare schemes, a wide range of private health insurance providers offer attractive health insurance policies to ensure extensive health coverage and a list of benefits for the policyholder and their families.

At Tata AIG, we offer health insurance plans to suit varied insurance needs. For example, our Medicare range of health insurance provides three plan variants to ensure that all unique insurance needs are met.

Make sure you compare health insurance to choose the policy that truly matches your budget as well as coverage requirements.