About PMJAY Scheme
PM-JAY provide cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to over 10.74 crores poor and vulnerable families (approximately 50 crore beneficiaries). There is no cap on the family size under the scheme. This scheme was earlier known as National Health Protection Scheme (NHPS) before it was rechristened to PM-JAY. This scheme was launched on 23rd September 2018 by the Hon’ble Prime Minister Shri Narendra Modi.
PM-JAY has been rolled out for the bottom 40% of poor and vulnerable population. The households included are based on the deprivation and occupational criteria of Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas respectively. The scheme subsumed then existing Rashtriya Swasthya Bima Yojana (RSBY), launched in 2008. Therefore, the coverage mentioned under PM-JAY also includes families that were covered in RSBY but were not present in the SECC 2011 database. PM-JAY is completely funded by the Government, and cost of implementation is shared between Central and State Governments.
Key Features of PMJAY
• PM-JAY provides cover of Rs. 5 lakhs per family per year, for secondary and tertiary care hospitalization across public and private empaneled hospitals in India.
• Over 10.74 crore poor and vulnerable entitled families (approximately 50 crore beneficiaries) are eligible for these benefits.
• PM-JAY provides cashless access to health care services(Indoor) for the beneficiary at the point of service, that is, the hospital.
• PM-JAY will help reduce catastrophic expenditure for hospitalizations, which pushes 6 crore people into poverty each year, and will help mitigate the financial risk arising out of catastrophic health episodes.
• No restrictions on family size, age or gender.
• All pre–existing conditions are covered from day one.
• Benefits of the scheme are portable across the country i.e. a beneficiary can visit any empanelled public or private hospital for cashless treatment.
• Public hospitals are reimbursed for the healthcare services at par with the private hospitals