Union Cabinet has given its nod for the launch of ‘Ayushman Bharat’ – National Health Protection Mission, to provide a cover of Rs 5 lakh annually to each of the 10 crore poor and vulnerable families. Touted to be the world’s largest government-funded healthcare programme, the benefits cover will also include pre and post-hospitalisation expenses.
The Union Cabinet chaired by Prime Minister Narendra Modi on Wednesday approved the launch of a new Centrally Sponsored Ayushman Bharat -National Health Protection Mission.
The scheme has the benefits cover of Rs. 5 lakh per family per year. The target beneficiaries of the proposed scheme will be more than 10 crore families belonging to poor and vulnerable population based on Socio-Economic Caste Census database. AB-NHPM will subsume the on-going centrally sponsored schemes -RashtriyaSwasthyaBimaYojana and the Senior Citizen Health Insurance Scheme…
AB-NHPM will have a defined benefit cover of Rs. 5 lakh per family per year. This cover will take care of almost all secondary care and most of the tertiary care procedures. To ensure that nobody is left out there will be no cap on family size and age in the scheme. The benefits cover will also include pre and post-hospitalisation expenses. 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.
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 basis. The package rates will include all the costs associated with treatment. For beneficiaries, it will be a cashless, paperless transaction.
One of the core principles of AB-NHPM is to co-operative federalism and flexibility to states. There is provision to partner the States through co-alliance. States will be free to choose the modalities for implementation. They can implement through an insurance company or directly through Trust/ Society or a mixed model.
Forgiving 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. In partnership with NITI Aayog, a robust, modular, scalable and interoperable IT platform will be made operational which will entail a paperless, cashless transaction.
AB-NHPM will be rolled out across all States/UTs in all districts with an objective to cover all the targeted beneficiaries.
The NHPS comes in the backdrop of the fact that various Central Ministries and State/UT Governments have launched health insurance/ protection schemes for their own defined set of beneficiaries. There is a critical need to converge these schemes, so as to achieve improved efficiency, reach and coverage.