New Delhi: Till November 30, 8.39 crore hospital admissions worth over Rs. 1.16 lakh crore have been authorised under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PMJAY), Minister of State for Health Prataprao Jadhav told Lok Sabha on Friday.
There has been significant saving towards out-of-pocket-expenditure (OOPE) for beneficiaries related to hospitalisation costs, he said in a written reply.
The AB-PMJAY is being implemented in 33 states and Union territories across the country except West Bengal, Delhi and Odisha.
The AB-PMJAY provides free in-patient care only i.e. hospitalisation. OPD services are not covered under the scheme. The amount incurred on the in-patient treatment of beneficiaries under the scheme for the last five years (i.e. FY 2019-20 to FY 2023-24) is Rs. 88,499.91 crore.
Around 36 crore beneficiaries have been verified under AB PMJAY till November 30, Jadhav said.
The Ayushman Bharat Pradhan Mantri- Jan Arogya Yojana (AB PMJAY) is a flagship scheme of the government that provides health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalization to approximately 55 crore beneficiaries corresponding to 12.37 crore families constituting economically vulnerable bottom 40 per cent of India’s population.
Many of the states and Union territories implementing the scheme have converged their respective State Health Insurance Schemes with AB PMJAY, thereby increasing the population covered under government-funded medical insurance to include more than 18 crore families, Jadhav said.
In March, 37 lakh families of ASHA, Anganwadi workers, and Anganwadi helpers were also included in the scheme.
Further, on October 29, the government expanded AB PMJAY to provide free treatment benefits of up to ‘¹5 lakh per year to all senior citizens aged 70 years and above, irrespective of their socio-economic status.
The estimated number of beneficiary families aged 70 years and above across the country is 4.5 crore corresponding to the 6 crore individuals under the scheme, Jadhav said.
The states and Union territories have been provided flexibility to implement the scheme in the operational model best suited to the local conditions, including the customisation of health benefit packages, operational activities such as hospital empanelment, mode of implementation and IEC strategies etc.
