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The National Health Authority (NHA) is pursuing a two-pronged strategy to expand the scope and scale of Ayushman Bharat PMJAY. Beneficiary identification and hospital utilization are examples of these. The NHA is relaunching Aapke Dwar Ayushman with zeal.
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AYUSHMAN BHARAT YOJNA VINOD K AGRAWAL & ASSOCIATES, CA
INTRODUCTION • On September 23, 2018, Prime Minister of India Shri Narendra Modi launched the National Health Protection Scheme, dubbed Ayushman Bharat Yojana. • The 'Ayushman Bharat Yojana' was launched in response to the National Health Policy 2017 recommendation, primarily to achieve the vision of Universal Health Coverage.
AMAZING FACT • Originally known as the 'Ayushman Bharat Yojana,' it has now been renamed the 'Pradhan Mantri Jan Arogya Yojana.’
FEATURES OF THE AYUSHMAN BHARAT YOJNA • It is the world's largest government-funded health insurance scheme. • It aims to cover more than 50 million Indian citizens, including over 10 million underprivileged families. • It intends to provide a health insurance coverage of INR 5 lakhs per family per year for tertiary and secondary hospitalization expenses. • It is a paperless plan. • It provides cashless hospitalization insurance. Such coverage is available at both public and network private hospitals.
It pays for the following costs, which apply to all tertiary and secondary care procedures: • The cost of hospitalization • The cost of medication • The cost of three days of pre-hospitalization • The cost of fifteen days of post-hospitalization expenses.
It covers approximately 1400 treatments, some of which are listed below: • Knee replacements • Skull surgery • Prostate cancer • Double valve replacement surgery • Anterior spine fixation
ELIGIBILITY • The person's name appears in the 'Socio Economic Caste Census 2011' data • They must have an active RSBY (RashtriyaSwasthyaBima Yojana) card.
Once the basic eligibility is met, further eligibility is determined by whether the applicant lives in a rural or urban area. The same is highlighted below.
Persons who are not eligible to receive benefits under the Ayushman Bharat Yojana include: • All government employees • Any individual with a monthly income of more than INR 10,000, • Anyone who owns a vehicle such as a two-wheeler, three-wheeler, car, etc. • Any individual who owns a motorized fishing boat. • A person who owns more than five acres of agricultural land. • A person who owns agricultural machinery and/or equipment. • Kisan card holder • A person who owns a refrigerator and/or a landline phone. • A person who lives in a properly constructed house.
Online procedures for determining eligibility for the Ayushman Bharat Yojana- • STEP 1 – Visit https://pmjay.gov.in/ • STEP 2 – Click ‘Am I Eligible’ • STEP 3 – Enter Mobile Number and captcha • STEP 4 – Click Generate OTP • STEP 5 – Enter the 6-digit OTP received on the entered mobile number • STEP 6 – Select State and category (i.e. Search by Name or HHD number or Ration card number or mobile number) from the drop-down list • STEP 7 – Provide additional details, based on the category selected at STEP 6 above • STEP 8 – Click Search
Documents required to apply for Ayushman Bharat Yojana- • Identification and age proof (Aadhaar card or PAN card) • Address proof • Caste certificate • Income certificate • Ration book • Document describing the current status of the family (joint or nuclear) that will be covered by the scheme
THANKYOU VINOD K AGRAWAL & ASSOCIATES, CA