ayushman bharat scheme
The Union Cabinet chaired by Prime Minister Narendra Modi has approved the launch of Centrally Sponsored Ayushman Bharat-National Health Protection Mission (AB-NHPM). This includes the components of the Central Sector under the Anushmaan Mission of the Ministry of Health and Family Welfare.
A benefit of Rs.5 lakh per family has been covered per annum in this scheme. The target beneficiaries of the proposed scheme will be more than ten crore families. These families will be from poor and vulnerable population based on SPCC data base.
AB-NHPM will consist of ongoing centrally sponsored schemes- Rashtriya Swasthya Bima Yojana (RSBY) and Senior Citizen Health Insurance Scheme (SCHIS).
Key Features of Ayushman Bharat Scheme-
There are many benefits of this scheme of health department which you should know, so let us tell you the features of this scheme-
Every year will get a cover of Rs 5 lakh - AB-NHPM will provide a benefit of Rs 5 lakh per family per year. This cover covers all secondary and tertiary health facilities procedures. To ensure that no person (women, children and old age) is left out, the scheme will not have any cap on the size and age of the family. The benefit cover will cover pre and post hospitalization expenses. All conditions will be covered from the first day of the insurance policy. Transport allowance will also be paid to the beneficiary every time he is admitted to the hospital.
Benefit can be availed from any government/private hospital in the country- The benefit of this scheme will be available all over the country and the beneficiary covered under the scheme will be allowed to take cashless benefits from any government/private hospital in the empaneled country.
AB-NHPM will be an entitlement based scheme for every person between the age of 16 to 59 years and the eligibility will be decided on the basis of deprivation criteria in SECC database. Various categories in rural areas include households that have a single room with kutcha walls and kutcha ceilings, families with no adult members between the ages of 16 and 59, households headed by a woman and those with 16 There is no adult member between the ages of 59 to 59, a family consisting of a disabled member and no physically able adult member, SC/ST. Families are landless families earning a major part of the income from human casual wages. In rural areas such families are automatically included which do not have a roof to live in, destitute, subsistence, manual scavengers, primitive tribal groups, legally freed bonded labourers.
Benefits will be available in both government and private hospitals-
Beneficiaries will be able to avail benefits in both government and private hospitals empaneled. All government hospitals in AB-NHPM implementing states will be deemed empaneled for the scheme. Hospitals affiliated to Employees' State Insurance Corporation (ESIC) can also be empaneled on the basis of Bed Enrollment Ratio norm. Private hospitals will be empaneled in an online manner based on the defined criteria.
Treatment will be on package basis – To control the cost, the treatment will be paid on the basis of package rate. The package rate will include all costs related to the treatment. It will be cashless and paperless transaction for the beneficiaries. The States will have limited flexibility to revise these rates keeping in view the requirements of the State.
Scheme to be implemented in every state One of the main principles of AB-NHPM is cooperative federalism and giving flexibility to the states. It has a provision for partnership with the states through co-alliance. This will allow extension of AB-NHPM to the State Governments to ensure proper integration with the existing health insurance/ various protection schemes of Central Ministries/ Departments and State Governments (at their own cost). States will be free to choose the modalities for implementing the scheme. State can implement the scheme through insurance company or directly through trust/society or in combination.
NITI Aayog to chair - In order to give policy directions and to expedite coordination between the Center and the states, it is proposed to set up Ayushman Bharat National Health Protection Mission Council (AB-NHPM) at the apex level under the chairmanship of the Union Health and Family Welfare Minister. It proposes to form an Ayushman Bharat National Health Protection Mission Governing Board (AB-NHPMGB), which will be jointly chaired by Secretary (Health and Family Welfare) and Member (Health), NITI Aayog.
State Health Agency will implement the scheme- States will need a State Health Agency (SHA) to implement the scheme. The states will have the option to use the existing trust/society/not-for-profit company/state nodal agency in the form of SHA or to form a new trust/society/not-for-profit company/state health agency to implement the scheme. At the district level also, a framework will have to be prepared for the implementation of the scheme.
Money will be transferred directly to the individual's account- To ensure that the funds reach the SHA on time, the transfer of money to the State Health Agencies on behalf of the Central Government through AB-NHPMA can be done directly from the escrow account. Within the given time limit, the state will have to give an equal share of grant.
Paperless and cashless transactions to be promoted - A robust, interoperable IT platform will be rolled out in partnership with NITI Aayog to enable paperless, cashless transactions. This will help in identification of potential misuse/deception and prevention of misuse. It will have well defined grievance redressal mechanism. In addition, the right to pre-treatment with moral hazards (possibility of abuse) will be made mandatory.
Reaching Benefit Scheme – To ensure that the scheme reaches the desired beneficiaries and other stakeholders, a comprehensive media and outreach strategy will be developed which will, inter alia, include print media, electronic media, social media platforms, traditional Includes media, IEC materials and outdoor activities.
Effects of planning -
The cost of hospitalization in India has increased by almost 300 percent during the last ten years. (NSSO 2015)
More than 80 percent of the expenses are met out of pocket (OOP). Rural households mainly depend on family income/savings (68%) and borrowings (25%).
Urban households depend on their income/savings (75 percent) and on borrowings (18 percent) to finance hospital expenses. (NSSO 2015)
Out of pocket expenditure is more than 60 per cent in India. As a result, 6 million households are pushed into poverty due to rising health costs.
The impact of AB-NHPM will be on reduction of out-of-pocket expenditure on the following grounds-
Enhanced benefit cover to about 40 percent of the population (the poorest and vulnerable).
All secondary and tertiary (except negative list) hospitals will be covered. Coverage of five lakhs for each family (no restriction on family size).
This will increase access to quality (health and medical) facilities. The unmet needs of the population will be met due to lack of financial resources.
This will lead to timely treatment, improved health outcomes, patient satisfaction, improved productivity and efficiency, employment generation and consequently improved quality of life.
Premium Paying Parties -
The premium payment expenses will be shared by the Central and State Governments in the specified ratio as per the guidelines of the Ministry of Finance. In States where AB-NHPM will be implemented through insurance companies, the total expenditure will depend on the actual market determined premium paid.
In the States/UTs where the scheme will be implemented through the Trust/Society, the actual expenditure or premium limit (whichever is lower) will be provided by the Central funds in the pre-determined ratio.
Who will get the benefit of Ayushman Bharat Yojana 2018?
Launching the scheme, Finance Minister Shri Arun Jaitley said that Ayushman Bharat Yojana 2018 is being operated for the poor families of the country. The benefit of this scheme will be provided to the economically poor and backward families of the country. So that the health problems of such poor families of the country can be removed. Therefore, the benefit of Ayushman Bharat Yojana 2018 will be provided directly to the poor, low level and BPL card holders of the country.
Benefits of Ayushman Bharat Yojana 2018
Ayushman Bharat Yojana 2018 is a very big scheme. The benefit of this scheme will be directly provided to the poor people of the country. Some of the major benefits of Ayushman Bharat Yojana 2018 are as follows -
Benefit to the poor
Ayushman Bharat Yojana has been formed only for the poor of the country. As a result of this scheme, benefits will be provided to such poor families. Those who could not get treatment for major diseases. Due to which many poor people died. Apart from this, those who used to get poor treatment also. Their deposits were completely destroyed. After which he had to face financial crisis. But now as a result of Ayushman Bharat Yojana 2018, such poor families will get rid of such problems to a large extent.
Easy treatment of major diseases
With the operation of Ayushman Bharat Yojana 2018, treatment of deadly major diseases like cancer, TV etc. can be done easily. Because till now the treatment of such diseases is not available in the village. But now with the operation of this scheme, these facilities will be available in villages also.
India will become disease free
Ayushman Bharat scheme will help in making India disease free to a great extent. Because now from Ayushman Bharat Yojana 2018 even poor families will be able to get treatment.
TV patients will get fund -
Funds will also be provided to TV patients under Ayushman Bharat Yojana 2018. Every year 14% of patients in India die from TV. This figure is quite shocking. In India, about 300,000 people register themselves in patient hospitals every year. Under Ayushman Bharat Yojana 2018, now TV patients will be provided assistance at the rate of ₹ 6000 annually ( ₹ 500 monthly).
Number of Beneficiaries – AB-NHPM will target 10.7 crore poor, disadvantaged rural households and identified occupational category of urban workers as per the latest data from Socio Economic Caste Census (SECC) covering both rural and urban.
The plan is dynamic and aspirational and the plan will take into account future segregation/inclusion and deprivation in SECC data.
Toll Free Helpline Number for Ayushman Bharat Yojana
0805-928-2008,0808-328-0131,
0803-979-6126,0806-574-4100,
0805-901-5854