About the Ayushman Bharat Scheme

About the Ayushman Bharat Scheme

  • In March 2018, the Union Cabinet chaired by the Prime Minister has approved the launch of a new Centrally Sponsored Ayushman Bharat -National Health Protection Mission (AB-NHPM) having central sector component under Ayushman Bharat Mission anchored in the MoHFW.
  • It is a scheme designed to provide health insurance cover of upto Rs 5 lakhs to identified beneficiaries, which include poor and deprived rural families, occupational unorganized workers and their families, among others.
  • The target beneficiaries of the proposed scheme will be more than 10 crore families belonging to poor and vulnerable population based on SECC database.
  • AB-NHPM will subsume the on-going centrally sponsored schemes Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
  • 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.
  • 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 AB-NHPM is to co-operative federalism and flexibility to states. There is provision to partner the States through co-alliance. 
  • 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 AB-NHPMA to State Health Agencies may be done through an escrow account directly. 
  • In partnership with NITI Aayog, a robust, modular, scalable and interoperable IT platform will be made operational which will entail a paperless, cashless transaction. 
  • In order to ensure that the scheme reaches the intended beneficiaries and other stakeholders, a comprehensive media and outreach strategy will be developed.
  • Ayushman Bharat’ programme is aimed to address health holistically, in primary, secondary and tertiary care system, covering both prevention and health promotion.
  • In May, the government published the rates that insurance companies would pay hospitals for the 1,350 procedures covered under the scheme.
  • Since the scheme involves expenditure from the Consolidated Fund of India, it would fall under the purview of the Aadhaar Act.
  • Specifically, this implies that this is a benefit under Section 7 of the Aadhaar Act, which mandates Aadhaar for recipients of subsidies, benefits and services, whose expenditure is incurred from the Consolidated Fund of India.
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