PM Ayushman Bharat Yojana 2024 : Healthcare for All, Empowering Lives

Empowering Healthcare: Ayushman Bharat Yojana 2024

Ayushman Bharat is a comprehensive health protection scheme aimed at providing health insurance to citizens. It offers insurance coverage of up to Rs. 5 lakh on a family floater basis annually to beneficiaries, enabling them to access primary, secondary, and tertiary healthcare services. Initially known as AB-NHPS under the National Health Protection Scheme (NHPS), it is now recognized as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY). The scheme is administered through national insurance companies, consolidating existing programs such as the senior citizen health insurance scheme and the Rashtriya Swasthya Bima Yojana.

Key Features of Ayushman Bharat Yojana 2024

1. Coverage of Up to Rs. 5 Lakh Annually for Beneficiary Families: Under the Ayushman Bharat scheme, beneficiary families are entitled to health insurance coverage of up to Rs. 5 lakh per year, providing financial assistance for various medical treatments and procedures.
2. Access to Primary, Secondary, and Tertiary Healthcare Services: The scheme enables beneficiaries to access a wide range of healthcare services, including primary care for basic medical needs, secondary care for specialized treatments, and tertiary care for complex medical procedures and interventions.
3. Utilization at Government or Empanelled Private Hospitals: Beneficiaries have the flexibility to receive healthcare services at either government hospitals or private hospitals that are empanelled under the Ayushman Bharat scheme, ensuring access to quality healthcare facilities.
4. Targeting Eligibility Based on Socio-Economic Caste Census (SECC) 2011 Data: The eligibility criteria for beneficiaries are determined based on the Socio-Economic Caste Census (SECC) 2011 data, which helps identify economically disadvantaged individuals and families who are in need of healthcare support.
5. Payment through Package Model Defined by Government: The scheme follows a package model wherein the government defines specific packages covering total costs, services, and procedures, ensuring transparency and standardized pricing for various medical treatments.
6. Establishment of Ayushman Bharat National Health Protection Mission: A dedicated mission, the Ayushman Bharat National Health Protection Mission, is established to facilitate effective coordination between the Central and state governments in implementing and managing the scheme.
7. Coverage for Approximately 40% of India’s Population: Ayushman Bharat aims to provide healthcare coverage to around 40% of India’s population, particularly targeting those who are economically disadvantaged and vulnerable to health risks.
8. Comprehensive Coverage Including Pre and Post-Hospitalization Expenses: The scheme covers not only expenses incurred during hospitalization but also those related to pre-hospitalization consultations, tests, and medications, as well as post-hospitalization follow-up care and treatments.
9. Cashless Hospitalization Facility: Beneficiaries can avail themselves of cashless hospitalization, wherein the insurance company directly settles the medical bills with the hospital, eliminating the need for upfront payment by the patient.
10. Inclusion of Daycare Treatment Expenses: The scheme also covers expenses related to daycare treatments, which are medical procedures that require hospitalization for less than 24 hours but still necessitate medical supervision and care.
11. Coverage for Pre-Existing Health Conditions and Follow-Up Medical Examinations: Pre-existing health conditions of beneficiaries are covered under the scheme, ensuring that individuals with existing medical ailments can also access necessary treatments. Additionally, follow-up medical examinations for up to 15 days post-treatment are covered to monitor the patient’s recovery and well-being.

Ayushman Bharat Yojana 2024 eligibility criteria for rural families

1. Families without an earning adult member aged between 16 and 59 years.
2. Households led by female members without adult male members aged between 16 and 59 years.
3. Households living in dwellings with makeshift walls and roofs, typically comprising a single room.
4. Families belonging to Scheduled Castes and Scheduled Tribes communities.
5. Households with disabled members lacking support from able-bodied individuals.
6. Landless households relying on manual labor as their primary source of income.

Additionally, certain households are automatically considered eligible, including:

1. Destitute families dependent on alms for sustenance.
2. Families of manual scavengers.
3. Households lacking adequate shelter.
4. Families of bonded laborers.
5. Primitive and particularly vulnerable tribal groups.

Ayushman Bharat Yojana 2024 eligibility criteria for urban families

1. Street vendors, cobblers, and hawkers.
2. Domestic workers.
3. Rag pickers and beggars.
4. Construction site workers, plumbers, masons, painters, welders, and security guards.
5. Coolies.
6. Sweepers, sanitation workers, and gardeners.
7. Transport workers such as conductors, drivers, cart pullers, and others.
8. Artisans, home-based workers, handicraft workers, and tailors.
9. Washermen and watchmen.
10. Electricians, mechanics, repair workers, and assemblers.
11. Peons, helpers, shop workers, delivery assistants, attendants, and waiters.

Eligibility criteria for hospitals under Ayushman Bharat Yojana 2024

1. Registration with State Health Agencies: Hospitals must be registered with state health agencies to ensure compliance with regulatory standards and oversight.
2. Availability of Qualified Medical and Nursing Staff: Qualified medical and nursing staff should be available round-the-clock to provide timely and quality healthcare services to patients.
3. Minimum In-Patient Bed Capacity: Hospitals must have a minimum of 10 in-patient beds to accommodate patients requiring hospitalization.
4. Accessible Washroom Facilities: The medical facility must have accessible washrooms to ensure hygiene and comfort for patients and staff.
5. Interoperable IT System: An interoperable IT system should be in place to effectively manage patient data and ensure seamless communication and coordination among healthcare providers.
6. Maintenance of Patient Records: Hospitals are required to maintain complete records of Ayushman Bharat patients and share them with the government as per regulatory requirements.
7. Availability of Ambulance and Emergency Services: Hospitals must have ambulance services and other emergency facilities to address medical emergencies promptly.
8. Appointment of Dedicated Medical Officer: A dedicated medical officer should be appointed to oversee Ayushman Bharat operations and ensure efficient implementation of the scheme.
9. Presence of Blood Bank and Testing Laboratory: The medical facility should have a blood bank and testing laboratory in the vicinity to support diagnostic and therapeutic procedures.
10. Availability of Equipment and Technical Necessities: Hospitals must have all necessary medical equipment and technical resources to deliver comprehensive healthcare services.
11. Facilities for Water, Electricity, and Biomedical Waste Disposal: The hospital must ensure regulated access to water and electricity and have proper biomedical waste disposal mechanisms in place to maintain hygiene and safety standards.

How To register for Ayushman Bharat Yojana online

1. Visit the Official Website: Go to the official website dedicated to the Ayushman Bharat Yojana. Ensure that you are accessing the genuine government portal to avoid fraudulent schemes.
2. Locate the Registration Section: Look for the section on the website dedicated to registration or enrollment. This section might be labeled as “Apply Now” or “Register.”
3. Provide Required Information: Fill out the necessary details for registration. This typically includes personal information such as your name, address, contact details, and details of family members. Have relevant documents like your Aadhar card, ration card, etc., handy as they may be required.
4. Choose Eligibility Verification Method: Select the method through which you want to verify your eligibility for the Ayushman Bharat Yojana. Options may include using your mobile number, name, ration card number, RSBY URN number, etc.
5. Identity Verification: After providing the necessary information, you may need to verify your identity. This could involve receiving an OTP (One Time Password) on your registered mobile number for verification purposes.
6. Check Eligibility: Once your identity is successfully verified, the system will check your eligibility for the Ayushman Bharat Yojana based on the information provided.
7. Review and Submit: Review all the details you’ve entered to ensure accuracy. Make any necessary corrections if required. Once you are satisfied, submit your application.
8. Confirmation: After successful submission, you should receive a confirmation message or email regarding your registration. This confirmation may include details about your eligibility status and any further instructions if applicable.
9. Await Approval: Your application will be processed by the relevant authorities. If you meet the eligibility criteria, you will be enrolled in the Ayushman Bharat Yojana.
10. Utilize Benefits: Once enrolled, you can begin to avail the benefits offered by the Ayushman Bharat Yojana in accordance with the scheme guidelines. These benefits may include cashless hospitalization and coverage for various medical expenses.

Ayushman Bharat Yojana cashless claim

Certainly, here are the key points:

1. Upon enrollment in the Pradhan Mantri Ayushman Bharat Yojana 2024, beneficiaries and their family members receive an enrollment letter.
2. This letter contains a unique QR code and identification number, which serve as crucial identifiers during hospitalization claims.
3. Empaneled hospitals under the scheme provide dedicated personnel known as ‘Ayushman Mitra’ to assist insured families.
4. The Ayushman Mitra verifies eligibility by scanning the QR code against the scheme’s database during hospital visits.
5. If eligible, beneficiaries can proceed with cashless medical treatment.
6. Upon presenting valid identification proof, beneficiaries are issued a Golden Card, facilitating cashless hospitalization treatment.
7. Additionally, beneficiaries can access cashless treatment at government hospitals, all of which are empaneled under the Ayushman Bharat Yojana.
8. This streamlined process ensures eligible beneficiaries can access essential healthcare services without financial strain, promoting overall well-being.

comparison table between Private Health Insurance and Ayushman Bharat Yojana:

Frequently Asked Questions