Ayushman Bharat scheme is an initiative by the Union Government to address the health concerns in Primary, Secondary and the Tertiary care systems that cover Health promotion as well as prevention. This is also one of the health protection schemes introduced in the last stretch of this government’s tenure which is not a surprise anymore.
Ayushman Bharat scheme is believed to cover 10 crore vulnerable families exposed to health issues by providing coverage of up to Rs. 5 lakh per family/per year for secondary or tertiary care hospitalization. Any expenditure incurred in the premium segment is going to be a mutual expenditure between central and state governments in a pre-specified ratio basis the guidelines set by Ministry of Finance. The entire cost will heavily rely on the market determined premium payment to be carried out in individual states where Ayushman Bharat scheme shall be implemented through insurance companies.
The scheme is assumed to be very ambitious and dynamic in nature and that it would take into consideration any future changes in the exclusion occupational criteria in the SECC data. Let’s take a look at some of the key benefits that people could reap out of Ayushman Bharat scheme –
The beneficiaries of this Yojana can avail benefits in public as well as enlisted private facilities:
- Any hospitalization expenses will be charged on the package rate basis which is pre-defined by the government
- To improve the implementation of digital payments and cashless transactions, a strong IT base has been formed which will be functional in partnership with NITI Ayog
- The benefits that fall under this policy are functional across the country and the beneficiary can utilize the cashless benefits from any public/private enlisted hospitals
- The health workers and staff, including nurses will provide proximity of treatment in the rural areas
- The vulnerable sections of the society will have enough access to the surgical treatment at any level of complication
Ayushman Bharat scheme will be implemented across all the states and minor districts with a sole objective, which is to cover all the targeted beneficiaries. The states can individually take the decision with respect to its implementation through an insurance company or via a trust/society. The Common Service Centre’s (CSCs) will guide the beneficiaries in identifying their names in the Health Ministry database and their section of claims in the scheme.
The same support team is responsible for guiding the beneficiaries to get their Ayushman scheme cards printed which will further help in sourcing claim. These cards can be used in the hospitals as well to avail any benefits as stated in the scheme.
Some of the AB officers have commented that works are in progress to integrate the ESI and CGHS schemes into AB, so that a uniform insurance scheme is available in India.
But the rates provided in AB are very low, making the private hospitals not to empanel in AB scheme.
Hope the rates are revised to reasonable extend in near future.