Prime Minister Narendra Modi announced his flagship project, Ayushman Bharat or National Health Protection Scheme on Independence Day. The project will be launched on September 25, on the birth annivarsary of Deen Dayal Upadhyay. Dubbed by ministers and BJP leaders as ‘Modicare’, the full roll-out of the scheme is expected to be announced from September 25 onwards. The policy was initially announced by the then finance minister Arun Jaitley in February this year during the presentation of last full budget of the NDA government.
What is Ayushman Bharat or National Health Protection Scheme?
The ambitious Ayushman Bharat or National Health Protection Scheme aims to cover over 10 crore vulnerable families (approximately 50 crore beneficiaries) and provide health cover up to Rs 5 lakh per family per year. The programme is being touted as the world’s largest health protection scheme. The 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.
Who are covered under Ayushman Bharat or NHPS?
The scheme will aim to target over 10 crore families based on SECC (Socio-Economic Caste Census) database. To ensure that nobody from the vulnerable group is left out of the benefit cover, there will be no cap on family size and age in ‘Ayushman Bharat’ scheme. The insurance scheme will cover pre and post-hospitalisation expenses.
How will the finances of Ayushman Bharat be covered?
The expenditure incurred in premium payment will be shared between Central and State Governments in a specified ratio. The funding for the scheme will be shared – 60:40 for all states and UTs with their own legislature, 90:10 in Northeast states and the three Himalayan states of Jammu and Kashmir, Himachal and Uttarakhand and 100% Central funding for UTs without legislature. The states are also free to continue with their own health programmes.
So far, 14 states have finalised their memoranda of understanding with the Centre. Of these Andhra Pradesh, Telangana, Madhya Pradesh, Assam, Sikkim and Chandigarh are the states that will use a trust model for the mission. In a trust model, bills are reimbursed directly by the government. Gujarat and Tamil Nadu have opted for mixed mode implementation. In an insurance model, the government pays a fixed premium to an insurance company, which pays the hospitals.
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