Health policy

Introduced by the Prime Minister Narendra Modi, the health insurance scheme with a grand vision, named as Ayushman Bharat providing the subscribers a medical expenses cover of up to Rs 5 lakh. Here is what you must know about the scheme and the eligibility criteria that will help you benefit from the scheme.
Called by other names such as the National Health Protection Mission (AB-NHPM) or Modicare, this government-sponsored health insurance scheme offers free coverage of up to Rs 5 lakh per family per year for medical care availed of at any government hospital or an empanelled medical care facility in India.

The scheme is meant only for poor families and the economically deprived segments of the society. The scheme aims to cover about 10.74 crore beneficiary families and around 50 crore Indian citizens.

Key aspects of Ayushman Bharat scheme

The medical insurance cover will provide a maximum of about Rs 5 lakhs per family per year; on secondary; as well as tertiary medical care availed of from medical facilities. Eligibility is strictly based on the Socio-Economic Caste Census (SECC) database; and the program automatically will cover those that are eligible without having to register for it.

If a person from an eligible family is hospitalized; the family need not spend on the treatment when they visit a government or an empanelled private hospital for treatment. The policy covers all kinds of diseases and the benefit offers coverage both for pre and post hospitalization expenses. Unlike other kinds of medical insurance schemes; there is no waiting period for pre-existing ailments.

Though Aadhaar card is not a mandated requirement for availing of the medical care under the Ayushman Bharat scheme; the beneficiaries will have to produce a prescribed ID at the hospital to receive free treatment.

Ayushman Bharat scheme

Families inhabiting a single room or a domicile with “kuchcha walls and kuchcha roof”; families in which there is no adult member in the age group 16 and 59 3. Family headed by a female with no adult male member belonging to the 16-59 age group, etc.
As per the guidelines issues as part of the Ayushman Bharat scheme; the following 11 occupational categories of workers, included in the list automatically. Such as, domestic worker, street vendor, cobbler, hawker, and; other service providers working on the streets, construction worker, plumber, mason, labour, painter, welder, security guard, coolie and other head-load workers, etc.