Pradhan Mantri Jan Arogya Yojana (PM-JAY)

District Amroha National Health Protection Scheme Beneficiary List

The Government of India is cognizant that primary Health Care is currently focusing largely on Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) and communicable diseases. This poses a challenge given the epidemiological transition, where non-communicable diseases accounts for nearly 62% of deaths among men and 52% among women – most of which are premature in nature. The situation is exacerbated by the fact that there is low utilization of public health system, especially at the level of Community Health Centre (except for child birth related services). There is lack of effective gate-keeping and referral, leading to fragmentation of health care services. Families are forced to incur high out of pocket expenditure thereby leading to impoverishment and poverty on account of medical and hospitalization expenses.

Health is an important cornerstone to the Government’s vision of development, ‘Swasth Bharat, Samriddha Bharat (Healthy India, Prosperous India). To fulfil the vision of Health for All and Universal Health Coverage, enshrined in the National Health Policy 2017, the Government conceived Áyushman Bharat’ (Healthy India), a pioneering initiative led by Hon’ble Prime Minister.

Ayushman Bharat (AB) is an attempt to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. Ayushman Bharat aims to undertake path breaking interventions to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level. Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components.

The first component, pertains to creation of 1,50,000 Health and Wellness Centres which will bring health care closer to the homes of the people. These centres will provide Comprehensive Primary Health Care (CPHC), covering both maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services. The first Health and Wellness Centre was launched by the Hon’ble Prime Minister at Jangla, Bijapur, Chhatisgarh on 14 April 2018. The second component is the Pradhan Mantri Jan Arogya Yojana (PM-JAY) which provides health protection cover to poor and vulnerable families. The Health and Wellness Centres will play a critical role in creating awareness about PM-JAY, screening for non-communicable diseases, follow-up of hospitalisation cases among others.

These two far-reaching initiatives under Ayushman Bharat will build a New India 2022. This path-breaking initiative, which will be implemented at an unprecedented scale will bring a paradigm shift in India’s health sector. It will help India capitalize its demographic dividend, ensure enhanced productivity, well-being and avert wage loss and impoverishment.

About Pradhan Mantri Jan Arogya Yojana (PM-JAY)

India has achieved significant public health gains and improvements in health care access and quality over the last three decades. The health sector is amongst the largest and fasting growing sectors, expected to reach US$ 280 billion by 2020.  At the same time, India’s health sector faces immense challenges. It continues to be characterized by high out-of-pocket expenditure, low financial protection, low health insurance coverage amongst both rural and urban population. It is a matter of grave concern that we incur a high out-of-pocket expenditure on account of health and medical costs. 62.58% of our population has to pay for their own health and hospitalization expenses and are not covered through any form of health protection. Besides using their income and savings, people borrow money or sell their assets to meet their healthcare needs, thereby pushing 4.6% of the population below the poverty line. The Government of India is committed to ensuring that its population has universal access to good quality health care services without anyone having to face financial hardship as a consequence.

Under the ambit of Ayushman Bharat, a Pradhan Mantri Jan Arogya Yojana (PM-JAY) to reduce the financial burden on poor and vulnerable groups arising out of catastrophic hospital episodes and ensure their access to quality health services was conceived. PM-JAY seeks to accelerate India’s progress towards achievement of Universal Health Coverage (UHC) and Sustainable Development Goal – 3 (SDG3).

will provide financial protection (Swasthya Suraksha) to 10.74 crore poor, deprived rural families and identified occupational categories of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data (approx. 50 crore beneficiaries). It will have offer a benefit cover of Rs. 500,000 per family per year (on a family floater basis).

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

To ensure that nobody is left out (especially girl child, women, children and elderly), there will be no cap on family size and age in the Mission. The scheme will be cashless & paperless at public hospitals and empanelled private hospitals. The beneficiaries will not be required to pay any charges for the hospitalization expenses. The benefit also includes pre and post-hospitalization expenses. The scheme is an entitlement based, the beneficiary is decided on the basis of family being figured in SECC database. When fully implemented, the PM-JAY will become the world’s largest government funded health protection mission.