A complete guide to ayushman bharat yojana in 2021

 Introduction

 Pradhan Mantri ayushman bharat yojana

 ABPM-JAY short form of   Ayusman Bharat Pradhan Mantri -Jan Arogya Yojana.

  A flagship public health insurance scheme in India

  Ayusman Bharat Pradhan Mantri -Jan Arogya Yojana has been proposed by the Finance Minister in the budget for the financial year 2018-2019 in the Parliament.
The ABPM-JAY or ayushman bharat yojana was launched by the Ministry of Health and Family Welfare, on 23rd September 2018 in Ranchi, of Jharkhand. It is a welfare plan to provide health care service to the 40% low-income group of people in India.
The ayushman bharat yojana aimed at providing health care to the poor and permanent-roofless working-class people. During illness after getting treatment by the local health system, when and where it requires costly health care for the more critical condition of the disease, the said yojana ABPM-JAY will stand by them and provide monetary help.
The yojana will support health care up to Rs 500,000 (five lakh) per family per year.

  Centrally sponsored scheme

  The yojana (ABPM-JAY) is a centrally sponsored scheme and will be funded by the central and state govt. of India. The ratio of funding will be 60% of the central govt. And 40% by the state govt.
The scheme may be called as world’s largest ever Govt. Sponsored Health Care Program by which over 50 crores (500 million) poor people of India will be benefitted. It also aimed at a poverty alleviation programme that will secure the low-income group during health hazards and save their pocket-money which to some extent will help to alleviate poverty in our socio-economic aspect.

The perspective of the ABPM-JAY or ayushman bharat yojana.

  The survey conducted by the Global Burden of Disease Study throughout the world in 2017 and they considered the years from 1990 to 2016 in their survey.

In their report, they depicted the health problems and henceforth the risk factors in Indian condition. The survey also identified the points on health care that could be addressed by the Indian Govt. in the form of providing free health care service to the low-income group.

In such a context, this group could not afford the costly health care and either they become poor to poorer or face death. Sometimes demise of the earning member, the family faces difficulties to earn a daily livelihood.

Now, the scheme (ABPM-JAY) may play a vital role by supporting the stated class of people in our country.
The scheme aimed at providing financial assistance to 50 crores economically vulnerable class of Indian citizens, needed health care facilities.

After launching the scheme on 23rd September 2018  the number of hospitals enrolled to participate in the scheme is 18,059 up to September 2019 all over India.

There is a total of 10.74 crore families in India as per the 2011 census report, who are potential for the benefit of the scheme.
In the last two years, the Ministry of Health and Family Welfare has released Rs 3520 crore to states under the ABPM-JAY scheme.

 The specific aspect

This ABPM-JAY scheme is a part of the National Health Policy to provide health care and strengthen the economic status of the poorer section of the country.
The features of this scheme: to provide health care services for 10 crores of the Indian family.
: the govt. has declared a coverage up to Rs 5 lakh per family per year in their health problems.
: to provide health care to the poor class some hospitals of public and private sectors have been empanelled all over India.
: to provide cashless payment of medical treatment and the record should also be paperless.
: to provide services as per the 2011 census report regarding their socio-economic status and caste.
: to provide cashless payment service benefits there will be no restriction on the size of the family, age or gender.
: to provide all previous medical conditions which are sponsored under the scheme.
: to cover 3 days pre and 15 days post hospitalisation cost of the patient.
: to include all diagnostic care and the cost of medicine.
: to avail, the facility of medical treatment under the ABPM-JAY scheme people may select any of the empanelled hospital in the state or outside the state in India.
: to provide free Covid-19 testing.

  The central scheme ABPM-JAY or ayushman bharat yojana.

  The scheme has been designed in such a manner that the states may run both the schemes simultaneously, in case of a scheme already introduced and run by the state. It encourages the spirit of co-operative federalism.
ABPM-JAY scheme provides the states to avail the benefit in the form of:-
1) National portability
2) State-of-art in IT Platform
3) Data and Fraud or Abuse Analytics
4) Aditional resources.
This is informed in a written statement by the Minister of State, Health and Family Welfare Govt. of India in Rajya Sava.

 Central and state ratio of share in ABPM- JAY Scheme
The central and state ratio of contribution in this scheme usually is 60%: 40% for all states, excepting the North-Eastern states and the three Himalayan states where the ratio is 90%: 10%
In respect of Union Territories, the Central contribution is 100% but in case they have a legislature, the ratio is 60%: 40%. The central govt. Is providing financial help to the states needed additional resources to implement the scheme.

   Eligibility criteria for enrollment to avail the facility of the ABPM-JAY scheme called ayushman bharat yojana.

Rural area:-

1) The families of scheduled caste and scheduled tribe
households
2) The families have no male member within the age of 16 to 59 years
3) Beggers and those surviving on alms
4) Families having at least one physically challenged member and without any able-bodied adult member.
5) Casual manual labourers who are landless and living on daily wages.
6) Primitive tribal communities
7) Legally released bonded labourers
8) Families living in one-room houses without proper walls or roof
9) Manual scavenger families.

  Urban area;-
1) Washerman / Chowkidars
2) Ragpickers
3) mechanics, electricians, repair workers
4) domestic help
5) sanitation workers, gardeners, sweepers
6) home-based artisans or handcraft workers, tailors

  7) cobblers, hawkers and others providing services by working on streets or pavements

  8) plumbers, masons, construction workers, porters, welders, painters and security guards,
9) transport workers like drivers, conductors, helpers, cart or rickshaw pullers.

  Who are non-eligible in ABPM-JAY Scheme?

It is clear from the above-noted eligibility criteria that the persons or families that do not exist in the parameters are clearly not entitled to get the concerned e-card of the scheme. There is another condition, the inhabitants of the states which have not implemented the scheme, could not avail it.

Some non-eligibility criteria
1) own a two/three/four wheeler or fishing motorboat
2) mechanised farming equipment
3) holder of a Kishan Card and enjoy a credit limit of Rs 50,000 (fifty thousand)
4) Govt. employee
5) employees of Govt. managed non-agricultural enterprises
6) whose income is above Rs 10,000 ( ten thousand) per month
7) owner of the refrigerator, landline Telephone connection
8) own a solidly built house with a permanent roof
9) those have 5 acres or above agricultural land.

   How to enrol in the scheme
(Ayusman Bharat Yojana)
Steps to check your name in the ABPM-JAY 2021 Scheme:-
Three different methods may be followed to check your eligibility:-
1) Visit the nearest Common Service Centre (CSC) or any empanelled hospital.
2) contact the helpline number 14555 or 1800 – 111 – 565.
3) you may visit the PMJAY website
Once you are confirmed about your eligibility to get the ayushman bharat yojana or ABPM-JAY e-card to follow the under noted steps.
Now you have to prove your identity. Visit a PM-JAY kiosk nearby and produce your Adhaar Card or Ration Card, family identification proofs with a govt. certified list of family members, PM letter and RSBY card. It will be verified there and if becomes eligible, the e-card to be printed along with the Unique ABPM-JAY ID.
This card may be used in future when needed as your eligibility proof.

States not joined in the scheme ayushman bharat yojana.

  There are 4(four) states which have not joined in this scheme are Delhi, West Bengal, Odisha and Telangana have not implemented the scheme and the poor class people of those states are unable to get the benefits of such comprehensive health care facilities.

Some critical diseases are covered :

: prostate cancer
: coronary artery bypass grafting
: double vulve replacement
: carotid angioplasty with stent
: pulmonary valve replacement
: skull-based surgery
: laringopharyngectomy with gastric pull- up
: anterior spine fixation
: tissue expander for disfigurement following burns.

  Some not covered :

: OPD
: drug rehabilitation programme
: cosmetic related procedures
: organ transplant
: individual diagnostics (for evaluation)

  I hope, the above article will help you to answer your queries about the scheme ayushman bharat yojana. Do not hesitate to ask us about your problem. We must try to help you to get the proper solution.

Thank you.

 

Leave a Comment