The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) Social Endeavour for Health and Telemedicine (SEHAT) scheme is a recent launch by the Prime Minister of India. It was introduced via video conference, highlighting the government’s commitment to expand health insurance coverage to every resident of Jammu and Kashmir (J&K).
About AB-PMJAY SEHAT Scheme
The AB-PMJAY SEHAT scheme is designed to extend free cost insurance to all residents of J&K. The scheme offers financial cover of upto Rs. 5 lakh per family on a floater basis, meaning that this amount can be utilized by any or all members of a family. Notably, this policy ensures that the entire family is insured under a single plan.
The scheme is meant to work in sync with the existing Pradhan Mantri Jan Arogya Yojana (PMJAY), effectively leveraging its resources and network.
Benefits Encompassed
Upon the successful execution of the health plan, every one of the 21 lakh families dwelling in J&K will draw benefits. The current benefit of the Ayushman Bharat Scheme is availed by around 6 lakh families in the region.
One significant advantage of the scheme is the portability of treatment. This means patients are not confined to availing healthcare services only from government and private healthcare facilities in Jammu and Kashmir. Hospitals across the country that are connected under this scheme can offer treatment. Moreover, hospitals listed under the PM-AY scheme are also equipped to offer services under this scheme.
Universal Health Coverage
The prime focus of the AB-PMJAY SEHAT scheme is ensuring Universal Health Coverage (UHC). This includes providing all individuals and communities with quality, affordable and essential health services. Essentially, it aims to offer financial risk protection. The scheme goes beyond primary care to include health promotion, prevention, treatment, rehabilitation, and palliative care.
The primary aim of UHC is to enable everyone the accessibility to services that address significant causes of disease and death, while ensuring that the use of these services does not expose the user to financial hardship.
Ayushman Bharat PMJAY Yojana
The PMJAY is a government-funded initiative that boasts of being the world’s largest health insurance/assurance scheme. It provides a cover of Rs. 5,00,000 per family each year for secondary and tertiary care hospitalization at public and private empanelled hospitals nationwide.
Crucially, the scheme encompasses pre-hospitalisation and post-hospitalisation expenses, including diagnostics and medicines.
