New Delhi : The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) has seen significant expansion in its beneficiary base, with the government reporting that 49% of the Ayushman Cards issued are to women. Among the 7.79 crore hospital admissions recorded, approximately 3.61 crore were utilized by women. The Health Ministry highlighted that Uttar Pradesh, Madhya Pradesh, Bihar, and Maharashtra are leading in terms of Ayushman Card creation, while Tamil Nadu, Karnataka, Andhra Pradesh, and Kerala excel in utilization.
AB PM-JAY aims to provide health coverage of up to five lakh rupees per family per year for secondary and tertiary care hospitalization, targeting around 55 crore beneficiaries from the bottom 40% of India’s population, which corresponds to approximately 12.37 crore families. States and Union Territories implementing this scheme have taken the initiative to further expand the beneficiary base at their own expense. Notably, the scheme now covers ASHA workers, Anganwadi workers and helpers, transgenders, and building and construction workers.
In a recent development, the government has approved extending benefits to senior citizens aged 70 and above, regardless of their economic status, which is expected to benefit nearly six crore individuals in this age group. Union Health Minister Jagat Prakash Nadda announced that Prime Minister Narendra Modi will launch this expanded version of the scheme next month. Additionally, the scheme has been extended to eligible sewer septic tank workers under a convergence mechanism.
As of September 1, 2024, a total of 29,648 hospitals, including 12,696 private facilities, have been empaneled under AB PM-JAY. The scheme operates in 33 states and Union Territories, excluding Delhi, Odisha, and West Bengal, providing cashless inpatient services to beneficiaries at empaneled hospitals across the country, with no restrictions on family size, age, or gender. Importantly, all pre-existing conditions are covered from day one.
The scheme utilizes a robust IT platform, ensuring that services are entirely paperless and cashless. It offers extensive coverage for 1,949 medical procedures across 27 specialties, including general medicine, surgery, oncology, and cardiology. Hospital services under AB PM-JAY include coverage for 15 days of post-discharge medications, diagnostics up to three days before admission, food, and lodging—all at no cost to beneficiaries.
A notable feature of the scheme is its portability, allowing beneficiaries to receive treatment at any empaneled hospital across India. This has led to 11.9 lakh hospitalizations worth approximately 3,100 crore rupees authorized under the portability feature, showcasing the scheme’s commitment to comprehensive and accessible healthcare for all eligible citizens. As AB PM-JAY continues to expand, it represents a significant step forward in enhancing healthcare access and equity across the nation.
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