Ayushman Bharat: A step towards a healthy India

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Last Updated on July 6, 2023 by Shabnam Sengupta

India’s overall healthcare expenses have long been burdened by households’ significant out-of-pocket expenditures (OOPE). According to a report in Down to Earth, the National Health Accounts indicate that despite improvements in recent years, these expenses are still high. The World Health Organization (WHO) reported in March 2022 that high OOPE on healthcare annually impoverishes around 55 million Indians, with over 17% of households facing catastrophic levels of health expenses each year. In such a grave situation, health insurance becomes crucial. The Indian Government launched Ayushman Bharat in 2018, which can have positive impacts on our healthcare expense burdens.

Ayushman Bharat, a national health protection scheme, aims to provide secondary and tertiary care hospitalisation coverage to over 10 crore poor and vulnerable families, benefiting approximately 50 crore individuals. Under this scheme, each family will receive up to 5 lakh rupees of coverage per year. Ayushman Bharat – National Health Protection Mission, incorporates the existing centrally sponsored schemes, namely the Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).

What does this scheme offer?

Following are covered under Ayushman Bharat Health Insurance:

  • Medical examination, treatment, and consultation fee
  • Pre-hospitalisation expenses
  • 15 days of post-hospitalisation expenses
  • Medicine and medical consumables
  • Hospital admission and accommodation charges
  • Non-intensive and ICU facilities
  • Diagnostic procedures
  • Medical implantation services
  • Food services

Eligibility criteria

In the Ayushman Bharat Health Insurance scheme, the eligibility criteria is different for urban and rural areas. This differentiation acknowledges the specific challenges faced by rural populations, such as limited livelihood opportunities and vulnerable living conditions. Meanwhile, urban categorisation encompasses a range of occupations prevalent in urban areas, ensuring inclusivity for individuals engaged in informal or marginalised professions.

Individuals in rural areas must meet one or more of the following criteria:

  • Families with no adult/male/earning member aged between 16-59 years
  • Living in a one-room Kaccha house (roof and walls)
  • Eligible for benefits in the absence of a healthy adult
  • Manual scavenger families
  • Landless manual labourers and their families
  • Families with Divyaang (disabled) head members

Individuals in urban areas must meet one or more of the following criteria:

  • Beggar
  • Ragpicker
  • Home-based artisans/tailors
  • Sweeper/handicrafts worker/sanitation worker/Mali
  • Construction worker/labourer/painter/welder/security guard/coolie
  • Washer-man/plumber/mason
  • Electrician/mechanic/assembler/repair worker
  • Transport worker/rickshaw puller/conductor/cart puller
  • Waiter/shop worker/assistant/peon/delivery assistant
  • Street vendors/hawkers/cobblers

Some other Government insurance schemes:

Pradhan Mantri Suraksha Bima Yojana

It is a government-backed accident insurance scheme in India, aiming to provide insurance coverage to the people of the country. The scheme is available to individuals between the ages of 18 and 70 who have a bank account. Under this policy, policyholders can avail of an annual cover of Rs 2 lakh for total disability and death, and Rs 1 lakh for partial disability. The premium for the policy is automatically deducted from the policyholder’s bank account. It provides a valuable safety net to insured individuals, offering financial protection in case of accidents and disabilities.

Aam Aadmi Bima Yojana (AABY)

Aam Aadmi Bima Yojana (AABY) is a National Health Insurance scheme established in October 2007, primarily targeting individuals between the ages of 18 and 59, particularly those living in rural and upcountry areas of India. The scheme also covers landless citizens, including urban and rural tenants, and extends benefits such as scholarships to underprivileged children. It specifically targets individuals who contribute to the country’s economy but are not typically employed in regular salaried positions, such as fishermen, cobblers, and auto drivers.

Janshree Bima Yojana

It was launched in 2008 and is a social security scheme designed for economically disadvantaged individuals aged 18-59. It includes features like women’s self-help groups and Shiksha Sahyog Yojana.

There are various other government health insurance schemes that can benefit people and save them from medical poverty.

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Last Updated on July 6, 2023 by Shabnam Sengupta

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

Last Updated on July 6, 2023 by Shabnam Sengupta

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

Last Updated on July 6, 2023 by Shabnam Sengupta

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

Last Updated on July 6, 2023 by Shabnam Sengupta

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

Last Updated on July 6, 2023 by Shabnam Sengupta

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

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Last Updated on July 6, 2023 by Shabnam Sengupta

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

Last Updated on July 6, 2023 by Shabnam Sengupta

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

Last Updated on July 6, 2023 by Shabnam Sengupta

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

Last Updated on July 6, 2023 by Shabnam Sengupta

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

Last Updated on July 6, 2023 by Shabnam Sengupta

Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.

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