Written by Aanya Krishna – a grade 6 student.

What is it and who does it benefit?

Ayushman Bharat Yojana, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), is a health insurance scheme that aims to provide free medical services to the economically weak and inferior sections of the society. Launched in September 2018 by Prime Minister Narendra Modi, it is the world’s largest government-funded scheme and it seeks to cover more than 50 crore Indians. The scheme aims to provide coverage of Rs 5 lakh per family annually.

According to news reports, since its announcement in 2018 till September 2019, around 18,000 hospitals have been empanelled under this scheme. Over 4,00,000 beneficiaries have been admitted and over 10,00,00,000 e-cards have been issued to eligible citizens. E-cards are used to avail cashless medical services at any empanelled public or private hospitals

Key features and eligibility criteria

This scheme does not put any restriction on family size, age , and gender thereby ensuring that no one is left out especially women, children, and the elderly. All pre-existing medical conditions are covered under the scheme and it also includes all pre and post hospitalisation expenses. It includes over 1300 medical procedures and allows an individual to avail services in any part of the country. The cashless format of the scheme makes it very friendly since it reduces the financial burden on the beneficiary. The Ayushman Bharat Yojana is funded with a 60 percent contribution from the central government and the remaining from the states.

The Government has specified the eligibility criteria for this scheme based on whether the beneficiary is staying in the rural or urban area. The scheme targets poor and deprived rural families and certain identified occupational categories of urban workers and their families. These have been identified on the basis of the latest SECC (Socio-Economic Caste Census) data available with the government.

A person can check his eligibility criteria by visiting the government website (https://pmjay.gov.in) or by calling the Ayushman Bharat Yojana’s customer care helpline numbers. Certain documents like identity proof, residence proof, status of income etc are required to facilitate the enrolment process.

Challenges

The PMJAY scheme has faced some challenges in its journey so far. There have been numerous reports of misuse of the scheme mainly through fraudulent medical bills as well as fake e-cards to avail benefits under the scheme. 

Since the scheme allows one to receive medical treatment at both private and public hospitals, people are seeking treatment only at private hospitals creating pressure on their facilities. In addition, the growing population is increasing the burden on the government’s shoulders making it challenging to meet the expenditure.

Written by: Aanya Krishna
Aanya is a grade 6 student. A voracious reader she also loves to draw and doodle. Like her whole family, she is also a big foodie!

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