The Central government of India recently announced that the Ayushman Bharat Scheme, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), will be extended to include free testing and treatment for the novel coronavirus.
Objective: To Increase Testing and Treatment Capacities
The primary goal of this move is to boost COVID-19 testing and treatment facilities. By including the private sector through AB-PMJAY, as per the standards set by the Indian Council for Medical Research (ICMR), accessibility to these essential services is expected to increase significantly.
This policy measure will enable more than 50 crore beneficiaries under the Ayushman scheme to avail of free testing and receive timely and well-standardised treatment in designated private hospitals across India. This initiative from the government will not only expand their healthcare capacity but also lessen the severe impact of this pandemic on impoverished populations.
States have proactively involved private-sector hospitals, converting them to cater exclusively to COVID-19 patients. These hospitals can utilise their own authorised testing units or form partnerships with other ICMR approved, authorised testing facilities.
Testing procedures will follow the protocol established by the ICMR and relevant private labs. Information concerning symptoms, testing methods, and treatment options for COVID-19 can be sourced from the Ministry of Health and Family Welfare website or via the national COVID-19 helpline – 1075.
Ayushman Bharat: A Comprehensive Health Insurance Scheme
The Ayushman Bharat, a government-sponsored health insurance program, offers free coverage of up to ₹5 lakh per family annually. It is applicable at any government-run or empanelled private hospital all over India, providing secondary and tertiary medical care facilities.
Ayushman Bharat, colloquially known as Modicare, serves approximately 74 crore beneficiary families and about 50 crore Indian citizens. Eighty percent of the beneficiaries have been identified based on the Socio-Economic Caste Census (SECC) data in rural and urban areas. Importantly, there are no restrictions related to family size, age, or gender.
Unlike other medical insurance plans that typically involve a waiting period for pre-existing diseases, Ayushman Bharat covers all kinds of diseases from the first day of the policy. The scheme also includes both pre and post-hospitalization expenses.
Ayushman Bharat: Funding and Premium Details
The costs associated with premium payments under this scheme are shared between the Central and State Governments, as per specific ratios. For all states and Union Territories (UTs) with their own legislature, the funding allocation is 60:40. In Northeast states and regions such as Jammu & Kashmir, Himachal Pradesh, and Uttarakhand, it is 90:10. For UTs without a legislature, the Central Government fully funds the program.
Additional resources are drawn from the Health and Education Cess, and state funding also serves to supplement the Central allocation. Premiums are priced between ₹1,000-₹1,200 per annum. The scheme underwrites hospitalization costs for its beneficiaries by strategically sourcing from public and private hospitals.
