Ayushman Bharat National Health Protection Scheme – Who would get benefitted?

Ayushman-Bharat-National-Health-Protection-SchemeAyushman Bharat National Health Protection Scheme


Govt. of India has announced Ayushman Bharat National Health Protection Scheme yesterday where over 10.4 Crore families would get benefited with quality health care and proper medication. This health insurance scheme would be sponsored by both state and central governments. What are the features of this health insurance scheme? What are various benefits of Ayushman Bharat National Protection Scheme? How does Ayushman Bharat National Protection Scheme would impact India?  This article would provide the details of this health protection scheme.

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What is Ayushman Bharat National Protection Scheme all about?


With a view to provide quality health care and medication, Govt of India has now launched Ayushman Bharat National Protection Scheme. This would cover over 10 Crore poor and vulnerable families and it would benefit over 50 Crore beneficiaries. This scheme is promoted by Central Government and it would run by both state as well as central governments. This scheme would subsumes Centrally sponsored schemes like Rashtriya Swasthya Bima Yojana (RSBY) and Senior Citizens Health Insurance Scheme (SCHIS).

What are the features of Ayushman Bharat National Protection Scheme?


This scheme key features are:

1) This health protection scheme would provide health care coverage of Rs 5 Lakh per family per year.

2) This health insurance plan is portable across the country in India

3) This health insurance scheme would cover for hospitalization benefit with a cashless facility in both public and private empanelled hospitals across the country.

4) This health insurance scheme is entitled based scheme who are in poor and vulnerable families. Entitlement decision is based on deprivation criteria in SEES Database.

5) To avoid unnecessary over costing by hospitals, the payment under this scheme would be done by package rate.

What are the key benefits of this scheme?


Here are the key benefits.

1) Health insurance coverage  of Rs 5 Lakhs per family per year who are present in SECC database.

2) There is no restriction on family size, age and gender. Means, it would cover a new born or senior citizen irrespective of age.

3) All members of the family are eligible.

4) Cashless treatment in case of hospitalization.

5) All Pre-existing diseases are covered as part of this health insurance scheme.

6) Benefit would include pre and post hospitalization coverage.

7) Choice to choose from empaneled hospitals across the country

8) To avail this benefit, you need to carry prescribed ID (like Aadhaar Card) to receive treatment at the hospital.

9) 1,350 medical packages covering surgery, medical and day care treatments, cost of medicines and diagnostics.

When this scheme would be operational In India?


This scheme would be operational from 25th September, 2018 on the occasion of birth anniversary of Pandit Deendayal Upadhyay.

Who is eligible under this health protection scheme?


The scheme aims to target poor, deprived rural families and identified occupational category of urban workers' families, 8.03 care in rural and 2.33 crore in urban areas, as per the latest Socio Economic Caste Census (SECC) data, and will cover around 50 crore people.

How to check if you are eligible under Ayushman Bharat National Protection Scheme?


If you wish to check whether you are eligible under this scheme, you can follow this process:

Login to Ayushman Bharat Website here.

Check on ‘Download Beneficiary List’ tab on the homepage and click on that link

Based on your location, select ‘Rural’ or ‘Urban’.

Enter your mobile number to receive an OTP on your mobile.

Once the OTP is entered, the list can be downloaded

AB-NHPM will cover medical and hospitalization expenses for almost all secondary care and most of tertiary care procedures. AB-NHPM has defined 1,350 medical packages covering surgery, medical and day care treatments including medicines, diagnostics and transport.

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Which Insurance company would offer this Ayushman Bharat National Protection Scheme?


Currently this is yet to be declared by Govt of India.

Who would run this Ayushman Bharat National Protection Scheme?


For giving health care policy directions and fostering coordination between the Centre and States, Govt of India has proposed to set up Ayushman Bharat National Health Protection Mission Council at apex level Chaired by Union Health and Family Welfare Minister. States would need to have the State Health Agency (SHA) to implement the scheme.

To ensure that the funds reach SHA on time, the transfer of funds from Central Government through Ayushman Bharat – National Health Protection Mission to State Health Agencies may be done through an escrow account directly. In partnership with NITI Aayog, a robust, modular, scalable and interoperable IT platform will be made operational which will entail a paperless, cashless transaction.

At the national level to manage, an Ayushman Bharat National Health Protection Mission Agency would be put in place. States/ UTs would be advised to implement the scheme by a dedicated entity called State Health Agency (SHA). They can either use an existing Trust/ Society/ Not for Profit Company/ State Nodal Agency (SNA) or set up a new entity to implement the scheme.

States/ UTs can decide to implement the scheme through an insurance company or directly through the Trust/ Society or use an integrated model.

Who would bare the insurance premium for such health insurance scheme?


The expenditure incurred in premium payment will be shared between the Central and State Governments in specified ratios as per Ministry of Finance guidelines in vogue. The total expenditure will depend on actual market determined premium paid in the States/ UTs where Ayushman Bharat – National Health Protection Mission will be implemented through insurance companies. In States/ UTs where the scheme will be implemented in Trust/ Society mode, the central share of funds will be provided based on actual expenditure or premium ceiling (whichever is lower) in the pre-determined ratio.

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How does this health care scheme impact in India?


This would have significant to poor and vulnerable families in India who are not getting quality health care and medication. This would increase the benefit of healthcare coverage for 40% of population in India. This healthcare benefit is up to Rs 5 Lakh per family per year. This would really benefit a family as there is no restriction on family size. It would cover individual husband, wife and their children (irrespective of size). It would lead to increase access to quality health care and proper medication to over 50 Crore beneficiaries.

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Suresh

Ayushman Bharat National Health Protection Scheme

One comment

  • raja

    The scheme is not available at Karnataka State. In download eligible beneficiary list karnataka state is not there.unable to check eligibility.

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