AYUSHMAN BHARAT SCHEME: NATIONAL HEALTH PROTECTION MISSION
It is also called as Pradhan mantri Jan arogya abhiyaan. The scheme will offer free medical insurance to the families with poor socio economic background.
- It will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries)
- Providing coverage upto 5 lakh rupees per family per year for secondary and tertiary care hospitalization.
- It will subsume the on-going centrally sponsored schemes – Rashtriya Swasthiya Bima Yojana and the Senior Citizen Health Insurance Scheme.
- It will have a defined benefit cover of Rs. 5 lakh per family per year.
- Benefits of the scheme are portable across the country and a beneficiary covered under the scheme will be allowed to take cashless benefits from any public/private empanelled hospitals across the country.
- It will be an entitlement based scheme with entitlement decided on the basis of deprivation criteria in the SECC database.
Socio economic caste census was to assess the population that is actually below the poverty line (BPL)
- The beneficiaries can avail benefits in both public and empanelled private facilities.
- To control costs, the payments for treatment will be done on package rate (to be defined by the Government in advance) basis.
One of the core principles of Ayushman Bharat – National Health Protection Mission is to co-operative federalism and flexibility to states.
For giving policy directions and fostering coordination between Centre and States, it is proposed to set up Ayushman Bharat National Health Protection Mission Council (AB-NHPMC) at apex level Chaired by Union Health and Family Welfare Minister.
States would need to have 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.
An escrow account is a account held by a third party during the process of a transaction between two parties. It helps in making the transactions more secure by keeping the payment in a escrow account which is only released when all the requirements are met.
In partnership with NITI aayog, a robust, modular, scalable and interoperable IT platform will be made operational which will entail a paperless, cashless transaction.