Srinagar: The Jammu and Kashmir government has provided 86000 free and cashless treatments worth Rs. 86 crore to the beneficiaries under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT, since the first six months of launch of this world’s largest health insurance scheme fully financed by the government.
A senior government official informed that out of 70000 claims worth Rs. 75 crore submitted by empanelled hospitals, 50000 claims worth Rs. 40 crore have been paid till date under AB-PMJAY and AB-PMJAY SEHAT schemes.
Chief Executive Office, State Health Agency (SHA) J&K, Dr. Doifode Sagar Dattatray, while elaborating on progress of the schemes told, “AB-PMJAY and AB PMJAY SEHAT are the most ambitious schemes of government of Jammu and Kashmir. “We are introducing several innovations in the ecosystem of the scheme like implementation of Standard Treatment Guidelines, Establishment of District Implementation Units (DIUs), reforms in functioning of Pradhan Mantri Arogya Mitras, real time-based monitoring system for Insurance Company and Empanelled Hospitals, strengthening of supply side and introduction of smart Ayushman Cards to further streamline these schemes so that residents may avail free, cashless and hassle free benefits from reputed empanelled hospitals across the country,” he maintained.
This being the most prestigious scheme is being monitored regularly by Additional Chief Secretary Health and Medical Education, Atal Dulloo, who in a statement maintained that, “this ambitious health insurance scheme is going to be the game changer as far as provision of healthcare services is concerned. It will on one hand help residents of J&K to avail quality healthcare services and on the other hand will strengthen and streamline the supply-side in the health service delivery paradigm.”
Pertinently, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) SEHAT, launched by the Prime Minister on 26th December 2020, aims to provide Universal Health Insurance Coverage of Rs. 5.00 lakh per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India on a floater basis. AB PM-JAY SEHAT has the same benefits as available under AB-PMJAY. This scheme covers all residents of Jammu and Kashmir including employees and pensioners of Government of Jammu and Kashmir and their families.
AB PM-JAY SEHAT in convergence with PM-JAY provides cashless access to health care services for the beneficiary at the point of service, that is, the hospital. AB PM-JAY SEHAT in convergence with PM-JAY envisions to help mitigate catastrophic expenditure on medical treatment to all the residents of the Union Territory. It covers up to 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines. Benefits of the scheme are portable across the country i.e. a beneficiary can visit any of the more than 24000 empanelled public or private hospitals including 218 hospitals empanelled within Union Territory of Jammu & Kashmir under AB PM-JAY in India to avail cashless treatment.
