Ayushman Bharat Yojana Eligibility & Features
Updated On Nov 02, 2020
PMJAY: Ayushman Bharat Yojana, Eligibility & Features
Ayushman Bharat is an ideal scheme launched by the government of India. It comprises two components that include Health and Wellness Centres (HWCs) and Pradhan Mantri Jan Arogya Yojana (PM-JAY).
Pradhan Mantri Jan Arogya Yojana (PM-JAY)
PM-JAY, formerly known as National Health Protection Scheme (NHPS), is counted as the biggest health assurance scheme in the world. Currently, more than 20 percent of the population in India is poor and vulnerable. Including such a huge population under the health insurance program is challenging, as they cannot pay the premium and are difficult to reach. Besides, the PM-JAY scheme has covered all such people under the health insurance program based on deprivation and occupational criteria of the Socio-Economic Caste Census (SECC).
The SECC ranked these populations based on their socio-economic status; it uses inclusion and exclusion criteria that automatically segregate the households. The rural households who are included are then categorized based on their status of six deprivation criteria (D1 to D7), while Urban households are categorized based on their occupation.
Read more: Ayushman Bharat Yojana Eligibility And Application Process Explained
Eligibility for Rural Population
Families who come under one of the following six deprivation criteria, i.e. D1 to D5 and D7 in a rural area are considered under the PM-JAY scheme.
- D1- Those are having only one room with kucha walls and kucha roof
- D2- Families with no adult member aged between 16 -59
- D3- Families with no adult male member between ages 16 - 59
- D4- Families with disabled member and no able-bodied adult member
- D5- Families living in scheduled caste and scheduled tribe
- D7- Landless families who generate most of the income working as manual casual labor
Eligibility for Urban Population
People who come under the following 11 occupational categories are eligible for the scheme.
- Ragpickers
- Beggar
- Domestic workers
- Hawker, Street vendor, cobbler and other service provider work on streets
- Plumber, labor, welder, painter, security guard, construction workers, coolie, and other head-load workers
- Sanitation worker, sweeper, and mali
- Home-based worker, handicrafts worker, artisan and tailor
- Driver, transport worker, a helper to conductors and drivers, conductor, a rickshaw puller, and cart puller.
- Assistant, shop worker, helper, a peon in a small establishment, delivery assistant, waiter, and attendant
- Mechanic, electrician, assembler, and repair worker
- Chowkidar and washer-man
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Key Features of PM-JAY
The National Health Insurance Scheme has various feature points and some of the key features of PM-JAY include the following:
- PM-JAY is completely financed by the government and is considered the largest health assurance/insurance scheme in the world.
- For hospitalizations including secondary and tertiary care, the scheme provides overall coverage of 5 lakhs per family over empanelled hospitals (private and public) in India.
- More than 10.74 families that are at-risk and poor can avail of the benefits of this scheme.
- At hospitals, cashless permission to use health care services is provided by PM-JAY.
- An expense for 15 days of post-hospitalization and three days of pre-hospitalization including medicines and diagnostics is covered under the scheme.
- From day one, covers all pre-existing conditions.
- The scheme ideates to help reduce the high expenditure on hospitalizations and medical treatment.
- Avails benefits to the beneficiary irrespective of gender, age, and family size.
- PM-JAY provides benefits that are portable in all parts of the country.
- A total of 1,393 procedures including physicians fees, diagnostic services, surgeon charges, supplies, drugs, ICU, operation theater charges, etc. are covered under the services.
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Conclusion
The Indian government is focusing on strengthening its healthcare sector, and PM-JAY Ayushman Bharat Yojana is part of it. Millions of people in India will be benefited from this scheme. PM-JAY will not only provide free health coverage to poor people, but it will also improve their view towards medical treatments.
Disclaimer: This article is issued in general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.
