Coverage Under Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana

GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT
OF HEALTH AND FAMILY WELFARE

LOK SABHA 

STARRED QUESTION NO. 141
TO BE ANSWERED ON THE 16TH DECEMBER, 2022

COVERAGE UNDER AYUSHMAN BHARAT YOJANA

141. SHRIMATI JASKAUR MEENA
        SHRI CHUNNI LAL SAHU

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) the details of the targets fixed and achievements made so far under the Ayushman Bharat Yojana;

(b) whether the Government proposes to cover senior citizens and disabled persons under the Yojana;
Coverage Under Ayushman Bharat
(c) if so, the details thereof and the date by which such persons are likely to be covered under the Yojana;

(d) whether the Government has issued any guidelines to the States/UTs regarding the treatment of vulnerable, disabled persons under the Yojana and if so, the details thereof; and

(e) the number of Ayushman Cards issued to the vulnerable and disabled persons along with the total number of beneficiaries in the country, State/ UT-wise including Chhattisgarh?

ANSWER
THE MINISTER OF HEALTH AND FAMILY WELFARE 

(DR MANSUKH MANDAVIYA)

(a) to ( e) A Statement is laid on the Table of the House.
 
STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 141* FOR 16TH DECEMBER, 2022

(a) to (e): Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is an entitlement based scheme. Targets are not fixed thereunder as the scheme operates on the basis of beneficiary demand for healthcare services. All the eligible beneficiaries of the implementing States/UTs are entitled for cashless services under the scheme from day one of the launch of the scheme. The scheme does not require enrolment. However, beneficiary verification process is undertaken to verify the identity of the beneficiary. Further, verified beneficiaries are issued Ayushman Card in order to create awareness about the scheme and to improve their health seeking behaviour. Eligible beneficiaries cannot be denied treatment in absence of Ayushman Card.

The scheme provides health coverage of Rs. 5 lakh per beneficiary family per annum to approximately 10.74 crore poor and vulnerable families identified on the basis of select deprivation and occupational criteria in rural and urban areas respectively as per SECC database of 2011. Senior citizens and disabled persons who meet the eligibility criteria are eligible to avail benefits under the scheme. Details of eligibility criteria are at Annexure-I.

As of 4th December 2022, a total of 20.96 crore beneficiaries have been provided with Ayushman cards and over 4.18 crore hospital admissions worth Rs. 48,954.33 crore have been authorized through a network of 26,267 empanelled health care providers including 11,700 private hospitals. State/UT-wise details of eligible beneficiary families in the country are at Annexure-II.

As per instructions issued by Ministry of Health & Family Welfare to States/UTs on 23.06.2022, States/UTs may use their own datasets for identification of beneficiaries. Government of India shall, however, provide its share of funding for all such beneficiaries limited to the number of eligible households as per SECC 2011 database. States/UTs may add additional beneficiaries at their own cost under the scheme.

Annexure-I Detailed list of criteria for eligibility under AB-PMJAY as
per SECC 2011:

Automatically included:
  • Households without shelter
  • Destitute/ living on alms
  • Manual scavenger families
  • Primitive tribal groups
  • Legally released bonded labour
Deprivation criteria in rural area:
  • D1: Only one room with kutcha walls and kutcha roof D2: No adult member between age 16 to 59

  • D3: Female headed households with no adult male member between age 16 to 59 D4: Disabled member and no able-bodied adult member

  • D5: SC/ST households

  • D7: Landless households deriving major part of their income from manual casual labour
Occupational criteria in urban area:
  • Rag picker
  • Beggar
  • Domestic worker
  • Street vendor/ Cobbler/hawker / Other service provider working on streets
  • Construction  worker/  Plumber/  Mason/  Labour/  Painter/  Welder/  Security guard/ Coolie and other head-load worker
  • Sweeper/ Sanitation worker / Mali
  • Home-based worker/ Artisan/ Handicrafts worker / Tailor
  • Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart puller/ Rickshaw puller
  • Shop  worker/  Assistant/  Peon  in  small  establishment/  Helper/  Delivery assistant / Attendant/ Waiter
  • Electrician/ Mechanic/ Assembler/ Repair worker/Washer-man/ Chowkidar

 Annexure-II State/UT-wise details of the number of eligible beneficiary families in the country

State / UT

Number of Eligible Families under AB-PMJAY

A&N Islands

11,500

Andhra Pradesh

54,67,524

Arunachal Pradesh

88,611

Assam

26,96,996

Bihar

1,08,11,015

Chandigarh

30,074

Chhattisgarh

36,50,364

DNH&DD

26,342

Goa

36,431

Gujarat

43,83,948

Haryana

15,45,936

Himachal Pradesh

4,78,985

Jammu And Kashmir

5,97,801

Jharkhand

28,05,753

Karnataka

62,09,073

Kerala

22,05,505

Ladakh

10,904

Lakshadweep

1,425

Madhya Pradesh

83,57,257

Maharashtra

83,63,664

Manipur

2,73,250

Meghalaya

3,47,013

Mizoram

1,94,859

Nagaland

2,33,328

Puducherry

1,03,434

Punjab

14,64,802

Rajasthan*

58,95,363

Sikkim

39,738

Tamil Nadu

77,70,928

Telangana

25,90,010

Tripura

4,90,964

Uttar Pradesh

1,16,84,453

Uttarakhand

5,23,536

Note: Above list does not include eligible beneficiary family count of SECC 2011 from West Bengal, Odisha and NCT of Delhi as they are not implementing AB-PMJAY.

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