Is Ayushman Bharat Implemented in Every State and UT? Know All About the Health Protection Scheme

According to the National Sample Survey Organisation, before PMJAY, 80.9% of urban Indians had no healthcare insurance. Furthermore, approximately 9% of the urban population borrowed money to pay for healthcare expenditures. In urban areas, families eligible to receive annual funding of up to Rs 5 lakh include:-

1. Ragpickers
2. Domestic workers
3. Beggars
4. Washerman, chowkidar, mechanic, electrician, repair worker, assembler
5. Sweeper, sanitation workers, gardener
6. Cobblers, hawkers, street vendors, and other service providers on the streets
7. Tailors, handicraft workers, artisans, home-based workers
8. Plumbers, masons, porters, weldors, construction workers, painters, security guards, coolies, and other head-load workers
9. Peons in small establishments, shop workers, helpers, assistants, delivery assistants, waiters, attendants
10. Drivers, conductors, transport workers, cart pullers, rickshaw pullers

The Ayushman Bharat Yojana eligibility list does not include those:-

1. With a decent solid house
2. With agricultural land of five acres or more
3. Who are government employed
4. Who works in government-managed non-agricultural enterprise
5. With a two, three, or four-wheeler or a motorised fishing boat
6. With merchandised farming equipment
7. Who have refrigerators and landlines
8. Who have Kisan cards with Rs 50000 credit limit
9. With a monthly income above Rs 10000

A total of 33 states/UTs in India have implemented the PMJAY scheme. The scheme is completely government-funded, and the costs are shared among the Central and State governments as per the ratio decided by the Ministry of Finance. Furthermore, the states and UTs have the flexibility to implement the scheme as best suited for their local situation. Thus, the states can implement the Ayushman Bharat scheme in insurance, trust, and hybrid mode. 

1. Insurance Mode: Under the insurance model, the state government pays a premium to the insurance companies that administer and pay the claim. 
2. Trust Mode: Under the trust model, every state forms its own trust that not only manages and administers the scheme but also pays the claims. 
3. Hybrid Mode: Under the hybrid or mixed model, a part of the premium is paid to the insurance company, and the balance gets pooled into a trust.

Additionally, the State government can alter the scheme specific to their state/UTs. For instance, earlier, the Ayushman Bharat Yojana in Rajasthan provided a cover of Rs 20,000 for general illness and Rs 3 lakh for serious diseases. Now, the cover has increased to Rs 50,000 for general illness and Rs 4.5 lakh for serious diseases.  

Summing it Up

To conclude, the National Health Protection Scheme, commonly known as the Ayushman Bharat Yojana, is a well-implemented government program that aims at benefitting the poor all across the country. With this scheme, the Indian government can successfully improve the healthcare sector in India. Stay tuned for more updates on the Ayushman Bharat Yojana. Or, you can consult an expert at HexaHealth for your concerns.

Contact our specialists at HexaHealth for queries on surgery, and our experts will answer with pleasure.

Q. Who is the CEO of Ayushman Bharat?
A. Dr Indu Bhushan is the CEO of Ayushman Bharat.

Q. Why was Ayushman Bharat launched?
A. Ayushman Bharat (AB) was launched to provide a complete range of services such as preventive, curative/medicinal, promotive, rehabilitative, and palliative care. It also gives health insurance to vulnerable and low-income families looking for secondary and tertiary care.

Q. What is the National Health Protection Mission?
A. National Health Protection Mission is Ayushman Bharat, which provides insurance up to five lakh rupees per family per year to the poor and vulnerable families for secondary and tertiary hospital services.

Q. What has been the experience with Ayushman Bharat health insurance schemes?
A. A study conducted from January 2020 to March 2020 concluded that the financial burden for healthcare expenses was lower in families under the Health Insurance scheme. Due to improper awareness, many people could not avail or use the scheme properly. Therefore, creating awareness among people regarding the PM-JAY scheme is very important.

Q. Who is eligible to apply for Ayushman Bharat health insurance?
A. Poor, vulnerable rural families and identified occupational categories of urban workers’ families identified by the Socio-Economic Caste Census (SECC) are eligible to apply for Ayushman Bharat health insurance.