Over 85 mn treatments availed under Ayushman Bharat-PMJAY: Govt tells RS

Over 8.5 crore treatments have been availed by the beneficiaries under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) till January 31, 2025, Union Health Minister J P Nadda told the Rajya Sabha on Tuesday.

Out of this, approximately 42 million treatments were undertaken in government hospitals and 43 million in private, Nadda said while responding to a question. 

 

All states and UTs across the country have on-boarded the scheme except for West Bengal and NCT of Delhi.

The AB-PMJAY is a flagship scheme of the government which provides health cover of Rs 5 lakh per family annually for secondary and tertiary care hospitalisation to approximately 55 crore beneficiaries corresponding to 12.37 crore families constituting economically vulnerable bottom 40 per cent of India's population.

Recently, the scheme has been expanded to cover 6 crore senior citizens, 70 years and above, belonging to 4.5 crore families irrespective of their socio-economic status under AB-PMJAY with Vay Vandana card, Nadda said.

Under the scheme, in-patient healthcare services are delivered through public and private empanelled hospitals at secondary and tertiary level.

The scheme is implemented across the country through a three-tier model -- National Health Authority (NHA), State Health Agencies (SHAs) and District Implementation Units (DIUs) at national, state and district levels respectively.

For effective implementation of the scheme at state level, state governments have set up SHAs, the minister said.

This entity is the nodal agency responsible for the implementation of AB-PMJAY in the State and is headed by a Chief Executive Officer. The CEO, SHA, is appointed by the state government.

The SHA can hire additional staff or an insurance company or an Implementation Support Agency (ISA) to perform required tasks for implementation of the scheme. The states and UTs have been provided with the flexibility to implement the scheme in the operational model best suited to the local conditions, Nadda said.

Accordingly, AB-PMJAY is implemented in trust mode, insurance mode and mixed (Hybrid) mode, he said.

Currently, 25 states and UTs are implementing the scheme in trust mode, 7 in insurance mode and 2 states in hybrid mode, the minister said.

The AB-PMJAY currently provides free healthcare access up to Rs. 5 lakh per family per year for secondary and tertiary care hospitalization in 27 different medical specialties, he said.

Expansion in treatment is done by inclusion of new procedures, empanelment of new hospitals, inclusion of new beneficiaries and other improvements as per requirements from time to time.