Who is eligible for the Ayushman Bharat scheme in Delhi? Check out the criteria

Eventually, 6.54 lakh of the poorest families in Delhi can avail of annual health coverage of up to Rs 10 lakh — Rs 5 lakh from the Centre and a top-up of the same amount from the Delhi government. There is no restriction on family size, age or gender and all pre-existing conditions are covered from day one.

The criteria:

There are two categories: urban and rural beneficiaries.

In urban areas, 11 occupational categories of workers are eligible for the scheme: These include ragpickers, beggars, domestic workers, street vendors, construction workers, sanitation workers, and security guards, among others.

Rural beneficiaries, on the other hand, have to meet one of seven deprivation criteria. These include households with no adult male member between ages 16 to 59 as well as SC/ST households. They should be living in one room with kucha walls and kucha roof.

Families with no able-bodied adult members are also eligible. The list automatically includes destitutes living on alms and manual scavenger households.

Once they sign up, families can avail free and cashless treatment for 1,961 medical procedures across 27 specialities, covering the costs of medicines, diagnostic services, hospitalisation, ICU care, and surgeries, among other related expenses.

The scheme will also cover three days of pre-hospitalisation and 15 days of post-hospitalisation expenses, such as diagnostics and medicines.
Services can be availed across the Capital — at 46 private, 34 Delhi government, and 11 central government hospitals. These have been empanelled under the state health authority to provide the medical insurance coverage.

Number crunching

Beneficiaries, said officials, will be identified based on the Socio-Economic and Caste Census data of 2011. “Beneficiaries will also be ascertained through ration cards made under the National Food Security Act,” said an official.

The beneficiary family count as per data of Food Security Act in Delhi includes three categories:

-66,281 families under Antyodaya Anna Yojana with a total of 2.72 lakh beneficiaries

-1.68 lakh families under priority households with a total of 7.63 lakh beneficiaries who get sugar, wheat and rice.

-15.05 lakh families with a total of 62.33 lakh beneficiaries who get only wheat and rice

The state health authority has also identified 28,294 families of ASHA and anganwadi workers and helpers.

The scheme’s implementation was a major promise of the BJP leading up to the Delhi Assembly elections in February. The previous AAP government had refused to adopt AB-PMJAY and had proposed its own scheme.