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Ayushman Bharat — National Health Protection Mission

Ayushman Bharat — National Health Protection Mission (AB-NHPM)

Relevancy

ü  G.S. Paper 2

ü  About Ayushman Bharat — National Health Protection Mission (AB-NHPM)

ü  Features and application of the scheme

Recently:

  • The Union Cabinet approved the launch of ‘Ayushman Bharat — National Health Protection Mission’ (AB-NHPM).
  • AB-NHPM will subsume the on-going centrally sponsored schemes — Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
  • The NDA government’s scheme aims to provide health cover of 5 lakh per year to 10 crore poor and vulnerable families through the Ayushman Bharat-National Health Protection Missio

What are the salient features of the AB-NHPM scheme?

  • This scheme has the benefit cover of Rs. 5 lakh per family per year.
  • The target beneficiaries of the proposed scheme will be more than 10 crore families belonging to poor and vulnerable population based on SECC database.
  • The Rs. 5 lakh per family a year cover will take care of almost all secondary care and most of tertiary care procedures.
  • To ensure that nobody is left out (especially women, children and elderly) there will be no cap on family size and age in the scheme.
  • The benefit cover will also include pre- and post-hospitalisation expenses.
  • All pre-existing conditions will be covered from day one of the policy.
  • A defined transport allowance per hospitalisation will also be paid to the beneficiary.
  • Also, 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 hospital across the country.
  • AB-NHPM will be an entitlement based scheme with entitlement decided on the basis of deprivation criteria in the SECC database.

AB-NHPM applicable to both Public and Private sectors-

  • The beneficiaries can make use of benefits in both public and empanelled private facilities.
  • All public hospitals in the States implementing AB-NHPM, will be deemed empanelled for the Scheme.
  • Keeping in view the State specific requirements, States/ UTs will have the flexibility to modify these rates within a limited bandwidth.
  • One of the core principles of AB-NHPM is co-operative federalism and to give flexibility to States.
  • There is provision to partner the States through co-alliance.
  • The expenditure incurred in premium payment will be shared between Central and State Governments in specified ratio as per Ministry of Finance guidelines.

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