Ayushman Bharat – National Health Protection Mission (AB-NHPM)
Ayushman Bharat is National Health Protection Scheme, which will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage upto 5 lakh rupees per family per year for secondary and tertiary care hospitalization. Ayushman Bharat – National Health Protection Mission will subsume the on-going centrally sponsored schemes – Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
Important features of Ayushman Bharat – National Health Protection Mission (AB-NHPM)
- Ayushman Bharat – National Health Protection Mission will have a defined benefit cover of Rs. 5 lakh per family per year.
- 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 hospitals across the country.
- Ayushman Bharat – National Health Protection Mission will be an entitlement based scheme with entitlement decided on the basis of deprivation criteria in the SECC database.
- The beneficiaries can avail benefits in both public and empanelled private facilities.
- To control costs, the payments for treatment will be done on package rate (to be defined by the Government in advance) basis.
- One of the core principles of Ayushman Bharat – National Health Protection Mission is to co-operative federalism and flexibility to states.
- For giving policy directions and fostering coordination between Centre and States, it is proposed to set up Ayushman Bharat National Health Protection Mission Council (AB-NHPMC) at apex level Chaired by Union Health and Family Welfare Minister.
- States would need to have State Health Agency (SHA) to implement the scheme.
- To ensure that the funds reach SHA on time, the transfer of funds from Central Government through Ayushman Bharat – National Health Protection Mission to State Health Agencies may be done through an escrow account directly.
- In partnership with NITI Aayog, a robust, modular, scalable and inter operable IT platform will be made operational which will entail a paperless, cashless transaction.
Core benefits of Ayushman Bharat – National Health Protection Mission (AB-NHPM)
Benefits to beneficiaries
- Health cover of Rs. 5 lakhs to each family for secondary and tertiary care procedures.
- No restriction on the size of the family, the age of the beneficiaries, or their gender.
- Priority is given to girl child, women, and senior citizens.
- All the members of the eligible families present in the database of SECC are necessarily covered.
- The medical treatment given to the eligible families is free of cost.
- Empanelled hospitals cannot ask for extra money for the treatment from the beneficiaries.
- Paperless and cashless availability of health care services to the beneficiaries.
- Good amount of medical packages available to the beneficiaries which include surgery, medicine and diagnostics cost, and other treatments.
- Eligible candidates can avail the services of this scheme all over India
Benefits to the health system
- The scheme ensures the availability of good quality secondary and tertiary care services through empanelled private and public hospitals to the members of the poor and vulnerable families free of cost.
- It improves the health of the citizens of India, thereby strengthening the health sector of India.
- Aligns the development of the private sector with the public sector health goals.
- Improved patient satisfaction
- Helps in the setting up of fresh health framework in the rural and remote areas.
- Enhances the quality of life of the poor and deprived population.
- The scheme improves the efficiency and productivity of the population.