What is Ayushman Bharat? Salient Features of the National Health Scheme

 Olga Robert /Friday, August 10, 2018 

According to a recent report by the Confederation of Indian Industry (CII) and PWC presented at the CII Health Insurance Summit in Delhi, India only spends 1.25 percent of its GDP on healthcare. It further said that for a country that has an underperforming public health care system, it could benefit greatly if the government managed to effectively implement the Ayushman Bharat-National Health Protection Mission (AB-NHPM).

What is Ayushman Bharat?
It is a National Health Protection Scheme announced in the 2018 Union Budget. It aims to cover around 50 crore beneficiaries from over 10 crore poor and vulnerable families with an insurance coverage of up to Rs 5 lakh per family per year for secondary and tertiary medical care. Ayushman Bharat will subsume Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).

Salient Features


Rs. 5 lakh per family per year health insurance benefit cover (irrespective of family size).
Will cover almost 40 percent of the population which will include poor, deprived rural families and identified occupational category of urban workers' families as per the latest Socio-Economic Caste Census (SECC) data (conducted in 2011) covering both rural and urban. 
Beneficiaries can take cashless benefits from any public/private empanelled hospitals anywhere in the country.
Payments for the treatment will be made on a package rate basis defined in advance by the government.
A council will be set at the apex level chaired by Union Health and Family Welfare Minister to ensure that Ayushman Bharat brings co-operative federalism and flexibility to States.
State Health Agency (SHA) will be started by the states to implement the scheme.
States/ UTs can decide to implement the scheme through an insurance company or directly through the Trust/ Society or use an integrated model. 
Along with NITI Aayog, a robust IT platform will be made operational to entail a paperless, cashless transaction.

Reference

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