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Ayushman Bharat PM Jan Arogya Yojana

2023 SEP 26

Preliminary   > Social Justice   >   Health   >   Health

Why in news?

  • The National Health Authority (NHA), Ministry of Health and Family Welfare (MoHFW) is organizing ‘Arogya Manthan’ to celebrate five years of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)

Background:

  •  Ayushman Bharat, a flagship scheme of Government of India, was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC).
  • It has two inter-related components
    • Health and Wellness Centres (HWCs) and
    • Pradhan Mantri Jan Arogya Yojana (PM-JAY).

About Pradhan Mantri Jan Arogya Yojana (PM-JAY):

  • PM-JAY is the world’s largest health insurance/ assurance scheme fully financed by the government.
  • Launched in 2018, it offers a sum insured of Rs.5 lakh per family for secondary care as well as tertiary care.
  • It provides cashless and paperless access to services for the beneficiary at the point of service in any (both public and private) empanelled hospitals across India.
  • The scheme is portable, and a beneficiary can avail medical treatment at any PM-JAY empanelled hospital outside their state and anywhere in the country.

Coverage:

  • It covers 3 days of pre-hospitalisation and 15 days of post-hospitalisation, including diagnostic care and expenses on medicines.
  • There is no restriction on the family size, age or gender.
  • All pre–existing conditions are covered from day one.

Beneficiaries:

  • It is an entitlement-based scheme that targets the beneficiaries as identified by Socio-Economic Caste Census (SECC) data.

Funding:

  • The funding for the scheme is shared – 60:40 for all states and UTs with their own legislature, 90:10 in Northeast states and Jammu and Kashmir, Himachal and Uttarakhand and 100% Central funding for UTs without legislature.
  • Nodal Agency:
  • The National Health Authority (NHA) has been constituted as an autonomous entity under the Society Registration Act, 1860 for effective implementation of PM-JAY in alliance with state governments.
  • The State Health Agency (SHA) is the apex body of the State Government responsible for the implementation of AB PM-JAY in the State.

PRACTICE QUESTION:

With reference to ‘Pradhan Mantri Jan Arogya Yojana’, consider the following statements:

1. Cost of implementation of the scheme is shared between the Central and State Governments.

2. It aims at providing an insurance cover of Rs. 5 lakhs per family per year for primary health care.

Which of the statements given above is/are correct?

(a) 1 only

(b) 2 only

(c) Both 1 and 2

(d) Neither 1 nor 2

Answer

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