All J&K residents to get free health insurance

The Jammu and Kashmir administration on Wednesday accorded sanction to rolling out the J&K Health Scheme to provide free of cost Universal Health Coverage to all residents of the Union Territory in convergence with Ayushman Bharat-PMJAY.

The decision was taken by the administrative council which met under the chairmanship of Lt Governor G C Murmu here, an official spokesperson said.

Terming the decision as a major relief to the people, he said now around 1.25 crore residents of the Union Territory would get all benefits provided under the centre's Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY).

At present, 31 lakh people are eligible for benefits under Ayushman Bharat-PMJAY, the official said, adding around 15 lakh additional families will be covered under the J&K Health Scheme.

As part of Universal Health Coverage, the beneficiaries will be entitled to free health insurance cover of Rs 5 lakh per family per year on floater basis and there is no restriction on family size, age or gender, the official said.

"All pre-existing illnesses shall also be covered besides; cashless services shall also be available in all the empanelled hospitals. The beneficiaries under the scheme shall have access to 20,853 (public and private) hospitals across the country and avail benefits with facility of inter-state portability," he said, adding 159 (public and private) hospitals in the UT are empanelled at present.

A total of 1,469 medical and surgical packages or procedures including life consuming diseases such as cancer and kidney failure will be covered under the scheme, he said.

"Treatment for oncology, cardiology and nephrology related illness will be covered from day one including high-end diagnostic procedures during hospitalisation. The beneficiaries shall also be eligible for coverage of three days pre-hospitalisation and 15 days post hospitalisation expenses," he said.

As per the decision of the Administrative Council, the spokesperson said all employees, pensioners and their family members are also covered under the scheme.

"The employees shall continue to get Rs 300 per month as medical allowance to take care of OPD treatment," he said.

Identification of the eligible families for getting registered for the health scheme will be done on the basis of socio-economic census of 2011.

However, the families or people who have been left out in the census can be enrolled on the basis of a defined process, the spokesperson said.