Ayushman Bharat Yojana or National Health Protection Scheme or also known as Modicare is a program which aims to provide a service to create a healthy, capable and content new India. The Pradhan Mantri Jan Arogya Abhiyaan (Modicare) is a government-sponsored health insurance scheme that will provide free medical coverage of up to Rs 5 lakh per family per year at any government or even private hospitals all over India. This centrally sponsored flagship scheme aims to provide an annual health cover to vulnerable 10 crore families.
It has two goals, one, creating a network of health and wellness infrastructure across the nation to deliver comprehensive primary health care services, and another is to provide insurance cover to at least 40 percent of India’s population which is majorly deprived of secondary and tertiary care services. Ayushman Bharat Yojana will be launched on 23 September 2018.
So here are some features and eligibility criteria of Ayushman Bharat Yojana, Pradhan Mantri Jan Arogya Abhiyaan (Modicare):
- Once rolled out across the country, Ayushman Bharat will provide a cover of Rs 5 lakh per family per year for secondary and tertiary medical care facilities.
- If you are eligible under the health insurance scheme, you get automatic coverage. Eligibility is based on Socio-Economic Caste Census (SECC) database.
- In case of hospitalisation, you or your family members do not need to pay anything under the scheme provided, you can go to any government or private hospital.
- Ayushman Bharat is unlike other medical insurance schemes where there is a waiting period for pre-existing diseases. All kinds of diseases are covered from day one of the Ayushman Bharat policy. The benefits cover includes both pre and post hospitalization expenses.
- The benefits cover will also include pre and post-hospitalization expenses. All pre-existing conditions will be covered from day one of the policy. A defined transport allowance per hospitalization will also be paid to the beneficiary.
Eligibility criteria for Ayushman Bharat scheme:
In rural areas the scheme includes families living in only one room with “kuchcha walls and kuchcha roof”. Families with no adult members aged between 16 and 59. Female-headed family with no adult male member in the 16-59 age group. Families having at least one disabled member and no able-bodied adult member. SC/ST households. Also, automatically includes families in rural areas having any one of the following: households without shelter, destitute, living on alms, manual scavenger families, primitive tribal groups, legally released bonded labor.
For urban areas, 11 defined occupational categories are entitled under the scheme.