Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana along with number of beneficiaries enrolled under the Scheme
GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF
HEALTH AND FAMILY WELFARE
LOK SABHA
UNSTARRED QUESTION NO. 3915
TO BE ANSWERED ON 24THMARCH, 2023
AYUSHMAN BHARAT–PRADHAN MANTRI JAN AROGYA YOJANA
3915. SHRI RAMCHARAN BOHRA
SHRI NIHAL CHAND
SHRI NIHAL CHAND
SHRI HEMANT TUKARAM GODSE
SHRI DIPSINH SHANKARSINH RATHOD
SHRI BHARTRUHARI MAHTAB
SHRIMATI SANGEETA AZAD
SHRI DULAL CHANDRA GOSWAMI
Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:
(a) the salient features of Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana along with number of beneficiaries enrolled under the Scheme so far, State/UT-wise;
(b) the details of targets fixed and achievements made so far under the Scheme;
(c) ) the funds allocated, released and utilized under the Scheme, State/UT-wise;
(d) whether a large number of Ayushman Bharat Cards are yet to be distributed, if so, the details thereof along with the reasons therefor, State/UT-wise;
(e) whether a Government proposes to cover Freedom Fighters, Senior Citizens, disabled and vulnerable persons under the Scheme and if so, the details thereof along with the time by which such persons are likely to be covered under the Scheme, State/UT-wise; and
(f) whether diseases like leprosy, skin diseases and cancer etc. are covered under the Scheme and if so, the details thereof?
ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE
DR. BHARATI PRAVIN PAWAR
(a) to (f): The salient features of Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB- PMJAY) are at Annexure-I. State/UT-wise details of the number of beneficiaries verified/ Ayushman cards created under the scheme are at Annexure-II. AB-PMJAY is the largest publicly funded health protection scheme in the world which provides health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to 60 crore beneficiaries. Many States/UTs implementing AB-PMJAY have expanded the beneficiary base to approximately 15.5 crore families at their own cost. Targets are not fixed for AB-PMJAY 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 services under the scheme from day one of the launch of the scheme.
As of 20th March 2023, a total of 23.3 crore beneficiaries have been verified under the scheme and over 4.49 crore hospital admissions worth Rs. 54,241 crore have been authorized through a network of 26,434 empanelled health care providers including 11,500 private hospitals.
State/UT-wise details of Central share of funds released under the scheme are at Annexure-III. Funds are released to States/UTs only after utilization certificate is submitted by them.
Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is an entitlement-based scheme. No enrolment or registration of beneficiary is required to avail benefits under the scheme. The beneficiary may directly visit any empanelled hospital (public or private) across the country to avail cashless treatment benefits. Eligible beneficiaries cannot be denied treatment in absence of Ayushman Card.
Out of approximately 45 crore individuals in 33 implementing States/UTs, Ayushman card has been created for 23.3 crore beneficiaries. Further, NHA has launched special drive to expedite the Ayushman card creation in the country.
Any individual including freedom fighters, senior citizens and disabled persons who meet the eligibility criteria are eligible to avail benefits under the scheme. Flexibility has been provided to States/UTs to use non-SECC beneficiary family database for tagging against the leftover (unauthenticated) SECC families.
AB-PMJAY provides treatment corresponding to a total of 1,949 procedures under 27 different specialties including diseases such as Cancer, Diabetes, Heart Disease, and other diseases. 26 procedures related to skin diseases and 549 procedures related to cancer are covered under the scheme.
Annexure-I
1. Ayushman Bharat, a flagship scheme of Government of India, was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to “leave no one behind.”
2. AB-PMJAY is the world’s largest Government funded health assurance scheme.
3. AB-PMJAY provides health assurance of up to Rs.5 Lakh per family per year for secondary and tertiary healthcare hospitalizations to 60 crore beneficiaries.
4. AB-PMJAY is a completely cashless and paperless scheme.
5. The benefits under AB-PMJAY are portable across the country.
6. There is no cap on family size, or age or gender.
7. Initially, the beneficiary families under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) had been identified from the Socio-Economic Caste Census (SECC) of 2011 on the basis of select deprivation and occupational criteria across rural and urban areas. Details are as below:
Detailed list of criteria for eligibility under AB-PMJAY as per SECC 2011: Automatically included:
- 1. Households without shelter
- 2. Destitute/ living on alms
- 3. Manual scavenger families
- 4. Primitive tribal groups
- 5. 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
8. 33 States/UTs implementing AB-PMJAY have further expanded the coverage of the scheme to 15.5 crore families.
9. AB-PMJAY is implemented in all States and UTs barring West Bengal, NCT of Delhi and Odisha.
10. The scheme is implemented across the country through a three-tier model. National Health Authority, an attached office of the Ministry of Health and Family Welfare with full functional autonomy, is the apex body implementing AB-PMJAY across the country. For effective implementation of AB-PMJAY at States/UTs level, State Health Agencies (SHAs) have been established. District Implementation Units (DIUs) have been set up for ensuring on-ground coordination between scheme stakeholders and for smooth implementation.
11. AB-PMJAY is completely funded by the Government and costs are shared between Central and State Governments in the ratio as per the extant directives issued by Ministry of Finance.
Annexure-II
State/UT-wise details of the number of beneficiaries verified/ Ayushman cards created under the scheme
|
State/UT |
Number of beneficiaries verified /Ayushman cards created |
|
Andaman And Nicobar Islands |
40,616 |
|
Andhra Pradesh |
11,709,939 |
|
Arunachal Pradesh |
82,607 |
|
Assam |
7,502,411 |
|
Bihar |
7,768,696 |
|
Chandigarh |
141,662 |
|
Chhattisgarh |
17,041,356 |
|
Dadra and Nagar Haveli & Daman and Diu |
430,863 |
|
Goa |
27,076 |
|
Gujarat |
17,743,275 |
|
Haryana |
8,137,302 |
|
Himachal Pradesh |
1,131,516 |
|
Jammu And Kashmir |
8,142,855 |
|
Jharkhand |
10,582,316 |
|
Karnataka |
13,697,728 |
|
Kerala |
7,146,371 |
|
Ladakh |
130,420 |
|
Lakshadweep |
26,031 |
|
Madhya Pradesh |
35,534,316 |
|
Maharashtra |
9,161,278 |
|
Manipur |
482,457 |
|
Meghalaya |
1,779,340 |
|
Mizoram |
434,506 |
|
Nagaland |
435,497 |
|
Puducherry |
409,804 |
|
Punjab |
7,990,610 |
|
Rajasthan |
10,091,251 |
|
Sikkim |
52,614 |
|
Tamil Nadu |
18,550,814 |
|
Telangana |
4,198,258 |
|
Tripura |
1,313,815 |
|
Uttar Pradesh |
26,156,403 |
|
Uttarakhand |
5,017,750 |
Note: Above list does not include eligible beneficiary family count from West Bengal, Odisha and NCT of Delhi as they are not implementing AB-PMJAY.
Annexure-III State/UT-wise details of Central share of funds released under AB-PMJAY
|
State/UT |
Funds released (in crore of Rupees) |
|
Andaman Nicobar Islands |
2.59 |
|
Andhra Pradesh |
1527.52 |
|
Arunachal Pradesh |
4.75 |
|
Assam |
446.45 |
|
Bihar |
346.29 |
|
Chandigarh |
15.24 |
|
Chhattisgarh |
1029.36 |
|
DNH & DD |
18.26 |
|
Goa |
2.32 |
|
Gujarat |
1380.37 |
|
Haryana |
390.87 |
|
Himachal Pradesh |
133.13 |
|
Jammu and Kashmir |
212.52 |
|
Jharkhand |
404.97 |
|
Karnataka |
1638.88 |
|
Kerala |
558.4 |
|
Ladakh |
4.05 |
|
Lakshadweep |
0.46 |
|
Madhya Pradesh |
1376.81 |
|
Maharashtra |
1597.63 |
|
Manipur |
91.21 |
|
Meghalaya |
139.3 |
|
Mizoram |
85.68 |
|
Nagaland |
62.18 |
|
Puducherry |
10.84 |
|
Punjab |
261.83 |
|
Rajasthan |
923.61 |
|
Sikkim |
6.31 |
|
Tamil Nadu |
1694.37 |
|
Telangana |
236.45 |
|
Tripura |
122.7 |
|
Uttar Pradesh |
946.87 |
|
Uttarakhand |
191.27 |
Note: Above list does not include eligible beneficiary family count from West Bengal, Odisha and NCT of Delhi as they are not implementing AB-PMJAY.
Source: Click here to view/download PDF
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