Is Ayushman Bharat Implemented in Every State and UT? Know All About the Health Protection Scheme

1. Medanta - The Medicity
2. Fortis Healthcare Ltd.
3. Rathi Hospital
4. Gupta Multispeciality Hospital
5. Apex Healthcare and Research Center
6. Narang Eye Institute
7. Tarak Hospitals India Pvt. Ltd.
8. Park Hospital
9. Sonia Hospital
10. Vision Eye Hospital
11. Dr Chaudhary’s Moral Hospital Pvt. Ltd.
12. Maharaja Agrasen Hospital
13. Karuna Sindhu Charitable Hospital
14. Shakuntala NH and Hospital
15. Bhagwan Mahavir Hospital
16. Goyal Hospital and Urology Center
17. Rosewood Hospital
18. Khandelwal Hospital and Urology Center
19. Siwach Dental Hospital
20. Jeewan Nursing Home and Hospital
21. National Institue of Tuberculosis and Respiratory Diseases
22. Ansari Hospital
23. Tirath Ram Shah Charitable Hospital
24. Kalra Hospital SRCNC Pvt. Ltd.
25. Panchsheel Hospitals Pvt. Ltd.
26. Center for Sight
27. Cygnus MLS Superspeciality Hospital
28. Surya Kiran Hospital Pvt. Ltd.
29. Ayushman Hospital and Health Services
30. Kukreja Hospital and Heart Center Pvt. Ltd.
31. Dr Shroff’s Charity Eye Hospital
32. Metro Hospital and Heart Institute
33. RLKC Hospital Metro Heart Institute
34. NKS Hospital
35. World Brain Center Hospital
36. Unit Hospital SS Battalion ITBP
37. Batra Hospital and Medical Research Center
38. Bhagwan Mahavir Hospital
39. Oncoplus Hospital
40. MGS Super Speciality Hospital
41. Swasthik Hospital
42. NDMC Charak Palika Hospital
43. Bhatia Global Hospital and Endosurgery Institute
44. Hakim Abdul Hameed Centenary Hospital
45. Medlife Hospital
46. Primus Super Speciality Hospital
47. Makkar Multispeciality Hospital
48. I-Create Hospital
49. Anant Jyoti Eye Hospital
50. Delhi Heart Hospital
51. Sir Ganga Ram Hospital
52. Samar Hospital
53. Indus Valley Hospitals
54. Metro Hospital and Cancer Institute
55. Irene Hospital
56. Ardent Ganpati Hospital
57. Brahm Shakti Hospital
58. Aakash Healthcare Super Speciality Hospital
59. Divya Prastha Hospital
60. National Heart Institute
61. Institute of Brain and Spine
62. Sri Balaji Action Medical Institute
63. Jeewan Mala Hospital Pvt. Ltd.
64. Mata Roop Rani Maggo Hospital
65. Garg Hospital
66. Ayushman Hospital and Health Services
67. Composite Hospital CRPF
68. RS Grover Memorial Hospital

The scheme is available for beneficiaries in both rural and urban areas. The Ayushman Bharat beneficiary list is based on the Socio-Economic Caste Census (SECC) database. Read on to find out the Ayushman Bharat Yojana eligibility for India’s rural and urban populations.

Eligibility of Ayushman Bharat Yojana

The scheme is available for beneficiaries in both rural and urban areas. The Ayushman Bharat beneficiary list is based on the Socio-Economic Caste Census (SECC) database. Read on to find out the Ayushman Bharat Yojana eligibility for India’s rural and urban populations.

Eligibility of Ayushman Bharat Yojana for Rural Areas

The following families can access PMJAY health cover in rural areas:-

1. Households without shelter
2. Scheduled Cast (SC)/ Scheduled Tribe (ST) households
3. Particularly vulnerable tribal groups
4. Legally released bonded labourers
5. Families working as manual scavengers
6. Beggars or people living on alms
7. Families without adults between 16 to 59 years
8. Families without an adult male between 16 to 59 years
9. Households with at least one disabled family member and no non-disabled adult member
10. Landless households that earn a major part of their income working as casual manual labourers
11. Families living in one-room houses with kutcha roofs and walls

According to the National Sample Survey Organisation, before PMJAY, 80.9% of urban Indians had no healthcare insurance. Furthermore, approximately 9% of the urban population borrowed money to pay for healthcare expenditures. In urban areas, families eligible to receive annual funding of up to Rs 5 lakh include:-

1. Ragpickers
2. Domestic workers
3. Beggars
4. Washerman, chowkidar, mechanic, electrician, repair worker, assembler
5. Sweeper, sanitation workers, gardener
6. Cobblers, hawkers, street vendors, and other service providers on the streets
7. Tailors, handicraft workers, artisans, home-based workers
8. Plumbers, masons, porters, weldors, construction workers, painters, security guards, coolies, and other head-load workers
9. Peons in small establishments, shop workers, helpers, assistants, delivery assistants, waiters, attendants
10. Drivers, conductors, transport workers, cart pullers, rickshaw pullers

The Ayushman Bharat Yojana eligibility list does not include those:-

1. With a decent solid house
2. With agricultural land of five acres or more
3. Who are government employed
4. Who works in government-managed non-agricultural enterprise
5. With a two, three, or four-wheeler or a motorised fishing boat
6. With merchandised farming equipment
7. Who have refrigerators and landlines
8. Who have Kisan cards with Rs 50000 credit limit
9. With a monthly income above Rs 10000

A total of 33 states/UTs in India have implemented the PMJAY scheme. The scheme is completely government-funded, and the costs are shared among the Central and State governments as per the ratio decided by the Ministry of Finance. Furthermore, the states and UTs have the flexibility to implement the scheme as best suited for their local situation. Thus, the states can implement the Ayushman Bharat scheme in insurance, trust, and hybrid mode. 

1. Insurance Mode: Under the insurance model, the state government pays a premium to the insurance companies that administer and pay the claim. 
2. Trust Mode: Under the trust model, every state forms its own trust that not only manages and administers the scheme but also pays the claims. 
3. Hybrid Mode: Under the hybrid or mixed model, a part of the premium is paid to the insurance company, and the balance gets pooled into a trust.

Additionally, the State government can alter the scheme specific to their state/UTs. For instance, earlier, the Ayushman Bharat Yojana in Rajasthan provided a cover of Rs 20,000 for general illness and Rs 3 lakh for serious diseases. Now, the cover has increased to Rs 50,000 for general illness and Rs 4.5 lakh for serious diseases.  

Summing it Up

To conclude, the National Health Protection Scheme, commonly known as the Ayushman Bharat Yojana, is a well-implemented government program that aims at benefitting the poor all across the country. With this scheme, the Indian government can successfully improve the healthcare sector in India. Stay tuned for more updates on the Ayushman Bharat Yojana. Or, you can consult an expert at HexaHealth for your concerns.

Contact our specialists at HexaHealth for queries on surgery, and our experts will answer with pleasure.

Q. Who is the CEO of Ayushman Bharat?
A. Dr Indu Bhushan is the CEO of Ayushman Bharat.

Q. Why was Ayushman Bharat launched?
A. Ayushman Bharat (AB) was launched to provide a complete range of services such as preventive, curative/medicinal, promotive, rehabilitative, and palliative care. It also gives health insurance to vulnerable and low-income families looking for secondary and tertiary care.

Q. What is the National Health Protection Mission?
A. National Health Protection Mission is Ayushman Bharat, which provides insurance up to five lakh rupees per family per year to the poor and vulnerable families for secondary and tertiary hospital services.

Q. What has been the experience with Ayushman Bharat health insurance schemes?
A. A study conducted from January 2020 to March 2020 concluded that the financial burden for healthcare expenses was lower in families under the Health Insurance scheme. Due to improper awareness, many people could not avail or use the scheme properly. Therefore, creating awareness among people regarding the PM-JAY scheme is very important.

Q. Who is eligible to apply for Ayushman Bharat health insurance?
A. Poor, vulnerable rural families and identified occupational categories of urban workers’ families identified by the Socio-Economic Caste Census (SECC) are eligible to apply for Ayushman Bharat health insurance.