Ayushman Bharat- PM Jan Arogya Yojana

Table of Contents

AB-PMJAY: What is it?

Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a Centrally Sponsored Scheme under Ministry of Health and Family Welfare (MoHFW).
It is an umbrella of two major health initiatives, namely
- Health and wellness Centres and
- National Health Protection Scheme.

Under this component, 5 lakh existing health sub centres will be referred as Health and wellness centres and their primary responsibility will be to bring health care system closer to the people.
These centres will provide comprehensive health care, including for non-communicable diseases and maternal and child health services.

This component will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries).
Ayushman Bharat – National Health Protection Mission has subsumed two centrally sponsored schemes – Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).

AB-PMJAY provides a cover of 5 lakh per family per year for almost all secondary care and most of tertiary care procedures.
There is no cap on family size and age in the scheme to ensure that nobody is left out (especially women, children and elderly).
The benefit cover will also include pre and post-hospitalisation
- A defined transport allowance per hospitalization will also be paid to the beneficiary.
Benefits of the scheme are portable across the country and a beneficiary covered under the scheme will be allowed to take cashless benefits from any public/private empanelled hospitals across the country.
The beneficiaries can avail benefits in both public and empanelled private facilities.
Hospitals belonging to Employee State Insurance Corporation (ESIC) may also be empanelled based on the bed occupancy ratio parameter.
To control costs, the payments for treatment will be done on package rate (to be defined by the Government in advance) basis.