Ayushman Bharat Pradhan Mantri Jan Arogya Yojana provides health coverage to around 10.74 crore poor and vulnerable families as per Socio-Economic Caste Census data. These are the top 10 salient features of this scheme.
1. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is a centrally sponsored scheme. The funding is shared between Centre and State governments as per the prevailing guidelines of the Finance Ministry.
2. PMJAY provides health coverage up to Rs.5 lakh per family per year for secondary and tertiary hospitalization to around 10.74 crore poor and vulnerable families.
3. PMJAY provides cashless and paperless access to services for the beneficiary at the point of service in any public or private empanelled hospitals across India.
4. A beneficiary from one state can avail benefits from an empanelled Hospital anywhere in the country.
5. The states are free to choose the modalities for implementation. They can implement the scheme through an insurance company or directly through the Trust or Society or a mixed model.
6. There is no restriction on family size. All members of designated families specifically girl child and senior citizens get coverage.
7. A well-defined complaint and public grievance redressal mechanism has been put in place through which complaints are registered, acknowledged, escalated for relevant action.
8. PMJAY has created a robust IT system for implementation and role of real-time transaction data.
9. At the national level, the National Health Authority has been set up as an attached office to the Ministry of Health and Family Welfare to manage the implementation.
10. The scheme provides cashless treatment to the entitled beneficiaries at empanelled hospitals. No money is released to the beneficiary and payment is made directly to the hospitals by the State Health Agency and Insurance companies.