Insurance cover under Ayushman Bharat health scheme likely to be doubled

The increase in coverage to Rs 10 lakh per family per year and increase in beneficiary base to 100 crore individuals will involve an additional allocation of Rs 12,076 crore per annum, sources stated.

New Delhi: The government is working on finalising a proposal to double the insurance cover under its flagship Ayushman Bharat health scheme to Rs 10 lakh to ensure that serious diseases like cancer and transplants that entail more expenditure are supported by it, official sources said on Wednesday.

An announcement to this effect is likely to be made in the interim Union Budget on February 1, the sources told PTI.

The Union health ministry is also planning to double the beneficiaries to 100 crore under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to include Kisan Samman Nidhi recipients, construction workers, non-coal mine workers and ASHA workers in the next three years.

"In order to ensure that serious illnesses requiring expenditure of more than Rs 5 lakh such as transplants and high-cost cancer treatments etc. are also covered under AB PMJAY, the ministry is working on finalising a proposal to increase the cover amount from Rs 5 lakh per family per year to Rs 10 lakh per family per year from 2024-25 onwards," the sources said.

The increase in coverage to Rs 10 lakh per family per year and increase in beneficiary base to 100 crore individuals will involve an additional allocation of Rs 12,076 crore per annum, the sources stated.

The scheme has successfully catered to 6.2 crore hospital admissions amounting to more than Rs 79,157 crore till now since its launch in 2018.

If the beneficiary had availed the same treatment on his own outside the ambit of AB PM-JAY, the total cost of the treatment would have gone up nearly two times, the official said.

The budget allocated for Ayushman Bharat PM-JAY for the financial year 2023-24 is Rs 7,200 crore, which is likely to more than double to around Rs 15,000 crore in the financial year 2025.

The AB PMJAY crossed the milestone of generating 30 crore Ayushman cards on January 12.

With 4.83 crore cards, Uttar Pradesh tops the list of states having the maximum Ayushman cards. Madhya Pradesh and Maharashtra stand at number two and three positions with 3.78 crore and 2.39 crore Ayushman cards respectively, they said.

Eleven states have more than one crore Ayushman card holders.

The flagship scheme being implemented by the National Health Authority (NHA) aims to provide health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to 12 crore beneficiary families.

Ayushman card creation is the most fundamental activity under the Ayushman Bharat PM-JAY and concerted efforts are being made to ensure that every beneficiary under the scheme has an Ayushman card, the ministry said.

Ayushman card creation has been included in the on-spot services being offered during the Viksit Bharat Sankalp Yatra launched on November 15, 2023 with the intent to ensure saturation of different schemes of the government.

"The scheme is striving to achieve gender parity along with regional parity and income parity in access to healthcare services with 49 per cent Ayushman cards issued to female beneficiaries. Also, 48 per cent of treatment provided under the scheme has been availed by females," the official said, adding gender equity is part of core design of the scheme.