HPAS 2025 Mains GS-2 Question 3
What do you understand by Ayushman Bharat Pradhan Mantri Jan Arogya Yojna?
Solution:
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is the world’s largest health assurance scheme, launched by the Government of India in 2018. It is a key component of the broader Ayushman Bharat mission, aimed at achieving Universal Health Coverage (UHC) by providing financial protection to the poor and vulnerable.
1. Core Objective
The primary goal is to mitigate “catastrophic health expenditure,” which pushes nearly 6 crore Indians into poverty annually. It provides a safety net for approximately 55 crore beneficiaries (bottom 40% of the population).
2. Salient Features
- Health Cover: It provides a health cover of ₹5 lakh per family per year for secondary and tertiary care hospitalization.
- Cashless & Paperless: Benefits are provided at the point of service in all empaneled public and private hospitals across the country.
- Eligibility: Based on the deprivation and occupational criteria of the Socio-Economic Caste Census (SECC) 2011.
- Inclusive Design: There are no restrictions on family size, age, or gender. Furthermore, pre-existing diseases are covered from the very first day of enrollment.
- Portability: A beneficiary can avail of treatment in any empaneled hospital nationwide, regardless of their state of residence.
2024-25 Update: In a landmark expansion, the government has extended free health cover under the Ayushman Vay Vandana Yojana to all senior citizens aged 70 and above, regardless of their socio-economic status.
3. Funding and Implementation
It is a Centrally Sponsored Scheme where the cost of premium/claims is shared between the Centre and States (usually in a 60:40 ratio, or 90:10 for Himalayan states like Himachal Pradesh). It is managed by the National Health Authority (NHA) at the central level.
Concise Model Answer (150-Word Limit)
Ayushman Bharat PM-JAY is a flagship health assurance scheme aimed at achieving Universal Health Coverage. It provides an annual health cover of ₹5 lakh per family for secondary and tertiary hospitalization, targeting approximately 12 crore poor and vulnerable families identified via SECC 2011 data.
Key features include:
- Inclusivity: No cap on family size, age, or gender; pre-existing conditions are covered from day one.
- Accessibility: Offers cashless and paperless treatment at empaneled public and private hospitals nationwide through a portable system.
- Broad Coverage: Covers up to 3 days of pre-hospitalization and 15 days of post-hospitalization expenses, including diagnostics and medicines.
Recently, the scheme was expanded to cover all senior citizens aged 70+, regardless of income. By reducing “out-of-pocket” expenditure, PM-JAY serves as a vital tool for poverty alleviation and social security.