As a second component of Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana (AB PMJAY) was conceived. It was nationally launched by Honourable Prime Minister Shri Narendra Modi on 23rd September, 2018. Theprimary objective is toprovide free of cost, accessible quality healthcare services to the poor and vulnerable groups of the society. The scheme will provide cashless health benefits cover of Rs.5, 00,000/- per family per year for secondary and tertiary care hospitalization to over 10.74 crores poor and vulnerable families without the cap on family size. Poor families as listed under the Socio Economic Caste Census (SECC) 2011 are eligible under AB-PMJAY. State Health Agencies (SHAs) in the form of a society/trust have been set up by respective States in order to implement the scheme in all the State level.
When fully implemented, the AB PMJAYwill become the world’s largest government-funded health financing programme. AB PMJAYseeks to accelerate India’s progress towards the achievement of Universal Health Coverage (UHC) and Sustainable Development Goal – 3 (SDG3). In Manipur, there are 14, 08,348 eligible beneficiaries from 2.77 lakhs eligible families under AB-PMJAY. 25 Hospitals are currently empanelled under AB-PMJAY in Manipur out of which 17 are Public Hospitals and 8 are Private Hospitals. PMJAY beneficiaries can avail free treatment benefits across all the empanelled hospitals in India. State Health Agency Manipur is overlooking the implementation of PMJAY in Manipur.
PMJAY provides cashless cover of up to INR5, 00,000 to each eligible family per annum for listed secondary and tertiary care conditions. The cover under the scheme includes all expenses incurred on the following components of the treatment.
- Medical examination, treatment and consultation
- Pre-hospitalization
- Medicine and medical consumables
- Non-intensive and intensive care services
- Diagnostic and laboratory investigations
- Medical implantation services (where necessary)
- Accommodation benefits
- Food services
- Complications arising during treatment
- Post-hospitalization follow-up care up to 15 days
The benefits of INR 5, 00,000 are on a family floater basis which means that it can be used by one or all members of the family. PMJAYhas been designed in such a way that there is no cap on family size or age of members.
Pre-existing diseases are covered from the very first day. This means that any eligible person suffering from any medical condition before being covered by PMJAYwill now be able to get treatment for all those medical conditions as well under this scheme right from the day they are enrolled.
Benefits of the scheme are portable across the country i.e. a beneficiary can visit any empanelled public or private hospital in India to avail cashless treatment.
Below data is for PMJAY (2018-Till date)
wdt_id District No of Beneficiaries Enrolled Total Male Treated Total Female Treated Total Cases Treated Total Treated Amount
1
BISHNUPUR
39,504
4,057
3,907
7,964
113,423,355
2
TAMENGLONG
18,826
1,903
1,898
3,801
39,840,703
3
CHURACHANDPUR
61,732
5,377
4,902
10,279
128,987,516
4
CHANDEL
12,126
1,527
702
2,229
29,226,225
5
JIRIBAM
7,793
61
96
157
2,692,519
6
KAKCHING
27,352
2,722
2,300
5,022
66,962,436
7
SENAPATI
38,360
2,959
1,861
4,820
69,674,542
8
UKHRUL
32,009
1,989
2,060
4,049
70,899,492
9
KAMJONG
14,338
1,075
935
2,010
31,260,712
10
KANGPOKPI
22,729
2,913
2,689
5,602
56,005,448
District No of Beneficiaries Enrolled Total Male Treated Total Female Treated Total Cases Treated Total Treated Amount