Ayushman Bharat Scheme often referred to as ‘Modicare’ was officially announced by Prime Minister Narendra Modi in his Independence Day speech. The ambitious Ayushman Bharat-National Health Protection Mission (AB-NHPM) aims to provide coverage of Rs. 5 lakh per family annually, benefiting more than 10 crore poor families, according to a release issued by PIB (Press Information Bureau). In short, the scheme’s main focus is health maintenance for the poor and the lower middle-class income group.

More about Ayushman Bharat Scheme

An opening statement by PM Modi, in his own words, ” It is essential to ensure that we free the poor of India from the clutches of poverty due to which they cannot afford healthcare”, this is the reason and thought why this scheme has come into existence. As said, this scheme was announced to provide healthcare facilities and treatments to those sections of the society who cannot afford even the basic health facility across the country due to lack of monetary provisions. This includes 8.03 crores in rural and 2.33 crores in the urban area as per statistics provided by the Socio-Economic Caste Sensus (SECC) data.

What is covered under the Ayushman Bharat Scheme?

The scheme claims to cover medical and surgical treatments that fall under 25 specialities like cardiology, neurosurgery, oncology ( Cancer in children have been stressed first), burns etc. Only that patients cannot opt for surgery and medical packages at the same time.

Benefits of the Scheme

Being one of the biggest health scheme is the biggest benefit, but apart from it other benefits covered includes:

1. Cashless treatment ( right from registration to billing to cost of medical equipment to consultation, fees to food and care) across major government and public and private hospitals who are registered across the scheme.

2. It covers the pre and post hospitalization expense and free follow-ups.

3. Since the scheme is open to every individual, there is no age restriction and the size of the family too is not accounted for.

4. If multiple surgeries are required, the highest package price would be waved off for the first treatment, followed by 50%for the second and 25% for the third treatment.

Who are eligible under the Ayushman Bharat Scheme

As per the data provided by the Socio-Economic caste census, individuals and family that falls below the poverty line and low income group are eligible for this scheme. Few categories listed by them in the Rural area includes:

1. People staying in a Kaccha House

2. SC/ST household

3. Female headed families with n male adult memeber

4. Landless labourers

Urban area includes:

1. Daily wage workers

2. Sweepers. watchmans. electricians, mechanic, street vendors

3. beggars

4. Rickshaw, bus and truck drivers, suppliers, etc.

How to Register for the Ayushman Bharat Scheme?

This scheme has been proposed by the government in association with the National Health agency. To know whether you are eligible and to complete the registration process, one can log into the website for more information: http://www.abnhpm.gov.in/

Who Pays for the Treatment under Ayushman Bharat Scheme?

The state health agency along with the team of insurers and trust the empanelled team of doctors or hospitals have come to the rescue with this scheme. The breakup which includes:

1. The state which opts for the trust or subsidy pool, the expenditure here would be borne or shared by the central and state government in the 60:40 ratio.

2. Those opting for the insurance model, the expenses would be covered by the trust or insurer.

3. Whereas those opted for the mixed model, would claim up to 1.5 lakhs which would be covered by the insurer and anything exceeding the amount would be covered by the trust.

4. All the Union territories without a Legislature would be funded completely by the central government.

Source: Goodreturns


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