Targets of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

RAJYA  SABHA 

TARGETS OF AYUSHMAN BHARAT YOJANA 

3143 SHRI SYED ZAFAR ISLAM

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether Government is implementing the Ayushman Bharat Yojana covering nearly half the population of the country, if so, the salient features and targets of the scheme;

(b) the amount for which applications have been received under the said Yojana till date and the quantum of amount released to the beneficiaries for Uttar Pradesh; and

(c) whether Government plans to include economically poor persons in addition to BPL Card holders under the said scheme and, if so, the details thereof along with the number of persons benefited under the said scheme till date in Uttar Pradesh?

(SHRI ASHWINI KUMAR CHOUBEY)

(a): Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), launched on 23rd September 2018, is an entitlement based scheme. Under the scheme, 10.74 Crores poor and vulnerable families (approximately 50 crore individuals) identified as per SECC 2011 database are covered. The States/UTs implementing AB-PMJAY have the flexibility to run their own Health Protection schemes in alliance with AB-PMJAY. Accordingly, the States/UTs implementing AB-PMJAY have expanded the coverage of the scheme to include 13.17 crore families (approximately 65 crore individuals). This ensures coverage to about 50% of the total population in the country. Information regarding salient features and targets of AB-PMJAY is at Annexure-I.

(b) & (c): As on 19.03.2021, a total of 6.62 Lakh hospital admissions worth over Rs. 695 Crore have been authorized under AB-PMJAY in Uttar Pradesh. Under the scheme, no funds are released to the beneficiaries directly.

The beneficiaries under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB- PMJAY) have been identified from the Socio-Economic Caste Census (SECC) of 2011 based on select deprivation and occupational criteria across rural and urban areas respectively.  The detailed description of eligibility criteria under AB PM-JAY is provided as Annexure-II. At present, there is no plan to expand coverage of beneficiaries under PMJAY.

1. AB-PMJAY is the world’s largest government funded health protection scheme.

 Annexure-I

 2. AB-PMJAY provides health assurance of up to Rs.5 Lakhs per family per year for secondary and tertiary healthcare hospitalization.

3. AB-PMJAY is a completely cashless and paperless scheme.

4. AB-PMJAY is  an  entitlement-based scheme  i.e. all the eligible  beneficiary families  are covered from day one of the implementation of the scheme in the State/UT. The scheme does not require enrolment. However, beneficiary verification process is being undertaken to verify the genuineness of the beneficiary. E-cards are issued to all eligible beneficiaries as part of this process to facilitate easy availing of benefits.

5. The benefits under AB-PMJAY are portable across the country.

6. There is no cap on family size, or age or gender.

7. The beneficiary families under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB- PMJAY) have been identified from the Socio-Economic Caste Census (SECC) of 2011 on the basis of select deprivation and occupational criteria across rural and urban areas. Details are at  Annexure-II.

8. AB-PMJAY is being implemented in 32 States and UTs across India. States of West Bengal, National Capital Territory of Delhi, Odisha and Telangana are not implementing the scheme.

9. AB-PMJAY is completely funded by the Government and costs are shared between Central and State Governments in the ratio as per the extant guidelines issued by Ministry of Finance.

10. The States/UTs have been given the flexibility to implement the scheme in the operational model best suited to them. Thus, AB-PMJAY is being implemented in Insurance mode, Mixed mode and Trust mode.

11. Targets are not fixed for AB-PMJAY as the scheme operates on the basis of beneficiary demand for healthcare services. All the eligible beneficiaries of the implementing States/UTs are entitled for services under the scheme from the day of launch of the scheme viz. 23.09.2018.

 Annexure-II

Detailed list of criteria for eligibility under AB-PMJAY as per SECC 2011

Automatically included:

1. Households without shelter
2. Destitute/ living on alms
3. Manual scavenger families
4. Primitive tribal groups
5. Legally released bonded labour

Deprivation criteria in rural area:

D1: Only one room with kutcha walls and kutcha roof D2: No adult member between age 16 to 59

D3: Female headed households with no adult male member between age 16 to 59 D4: Disabled member and no able-bodied adult member

D5: SC/ST households

D7: Landless households deriving major part of their income from manual casual labour

Occupational criteria in urban area:

1. Rag picker
2. Beggar
3. Domestic worker
4. Street vendor/ Cobbler/hawker / Other service provider working on streets
5. Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard/ Coolie and other head-load worker
6. Sweeper/ Sanitation worker / Mali
7. Home-based worker/ Artisan/ Handicrafts worker / Tailor
8. Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart puller/ Rickshaw puller
9. Shop worker/ Assistant/ Peon in small establishment/ Helper/ Delivery assistant / Attendant/ Waiter
10. Electrician/ Mechanic/ Assembler/ Repair worker/Washer-man/ Chowkidar