Features of the Ayushman Bharat
- It is the world’s largest medical insurance plan, funded by the Indian government.
- The maximum coverage amount is Rs 5 lakh.
- Pre-hospitalization coverage is for three days, and post-hospitalization coverage is for fifteen days, including medications and diagnostics.
- Hospitalization in both secondary and tertiary care is covered.
- Beneficiaries are provided with cashless hospitalization coverage.
- It starts on the first day and covers pre-existing diseases.
- The system has no age, family size, or gender restrictions.
- It includes over 1,393 treatments, including the treatment cost, accommodation costs, doctor’s fees, operating room, intensive care unit, diagnostic services, surgeon charges, and so on.
- In India, hospitalization coverage is available at both private and public panel hospitals.
Features and Analysis of Ayushman Bharat Scheme
The Government of India introduced the ‘Ayushman Bharat program in 2018 (as defined in the National Health Policy 2017) to make healthcare services more accessible and affordable to residents, and to help the country meet its aim of universal health coverage (UHC) by 2030.
Ayushman Bharat has been created to achieve the SDGs and its underlying promise to “leave no one behind.” Ayushman Bharat is an endeavor to transform from a sectoral and divided approach to healthcare delivery to a comprehensive, need-based method. It aspires to implement ground-breaking programs to address health issues comprehensively (including prevention, promotion, and ambulatory care) at the basic, intermediate, and higher levels.
The two important characteristics of ‘Ayushman Bharat‘ are as follows:
A. Establish Health and Wellness Centres (HWCs):
The initiative, which was launched in February 2018, aimed to provide quality health services to individuals closer to their homes by creating 1,50,000 Health and Wellness Centres (HWCs).
B. Pradhan Mantri Jan Arogya Yojana (PM-JAY):
The initiative, which was launched in September 2018, aimed to provide hospital and community services to society’s most needy members. More than 10.74 crore poor and vulnerable families, or the bottom 40% of India’s population, were to receive medical coverage of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization under the scheme.
PM-JAY will cover practically all secondary care and most tertiary care treatments’ medical and hospitalization costs. PM-JAY has defined 1,350 medical packages that include surgery, medical and daycare treatments, medications, diagnostics, and transportation.