What is the scheme?
- It is the World’s largest government funded healthcare scheme.
- The center’s flagship scheme has been renamed as PM Jan Arogya Yojana (PMJAY)
- Implementation Authority: National Health Agency
- It is the first scheme with the privacy policy with over 100 controls including authentication, authorization, passwords, firewalls and data encryption to protect the data of the estimated 50 crore beneficiaries.
What is the aim of the scheme?
- It aims to provide cashless benefits from any public/private empaneled hospitals across the country.
- It is an entitlement based scheme with entitlement decided on the basis of deprivation criteria in the latest Socio- Economic Caste Census 2011 (SECC) database.
- The payments for treatment will be done on package rate basis.
- The scheme is creating a cadre of certified frontline health service professionals called Pradhan Mantri Aarogya Mitras (PMAMs) who will be primary point of facilitation for the beneficiaries to avail treatment at the hospital.
What are the other provisions of the scheme?
Two major initiatives in health sector under the scheme:
- Health and Wellness Centre: These centers will provide comprehensive health care, including for non- communicable diseases and maternal and child health services. These centers will also provide free essential drugs and diagnostic services.
- National Health Protection Scheme: it will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage up to 5 lakh rupees per family per year for secondary and tertiary care hospitalization.
It is a centrally sponsored scheme that will subsume the on-going centrally sponsored schemes - Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
What is the need of the scheme?
- It aims to cover high out-of-pocket expenditure: Besides using their income and savings, people in India borrow money or sell their assets to meet their healthcare needs, thereby pushing 4.6% of the population below the poverty line.
- It aims to give give cover against low financial protection
- Considering the low health insurance coverage: 62.58% of our population has to pay for their own health and hospitalization expenses and are not covered through any form of health protection. Therefore, it becomes important.
