Odisha to sign MoU with Centre for implementation of Ayushman Bharat, know benefits and key features of PM-JAY
by Subadh Nayak · KalingaTVNew Delhi: The Odisha government is all set to sign a Memorandum of Understanding (MoU) with the National Health Authority (NHA), under the Ministry of Health and Family Welfare (MoHFW) at Vigyan Bhawan in New Delhi at 2 PM tomorrow.
The MoU for implementation of Ayushman Bharat PM-JAY in Odisha will be inked in the presence of the Union Health Minister JP Nadda and Odisha Chief Minister Mohan Charan Majhi. Union Education Minister Dharmendra Pradhan and Union Tribal Affairs Minister Jual Oram also are slated to grace the event.
Key Features of PM-JAY:
- PM-JAY is the world’s largest health insurance/ assurance scheme fully financed by the government.
- It provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India.
- Over 12 crore poor and vulnerable entitled families (approximately 55 crore beneficiaries) are eligible for these benefits.
- PM-JAY provides cashless access to health care services for the beneficiary at the point of service, that is, the hospital.
- PM-JAY envisions to help mitigate catastrophic expenditure on medical treatment which pushes nearly 6 crore Indians into poverty each year.
- It covers up to 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines.
- There is no restriction on the family size, age or gender.
- All pre–existing conditions are covered from day one.
- Benefits of the scheme are portable across the country i.e. a beneficiary can visit any empanelled public or private hospital in India to avail cashless treatment.
- Services include approximately 1,929 procedures covering all the costs related to treatment, including but not limited to drugs, supplies, diagnostic services, physician’s fees, room charges, surgeon charges, OT and ICU charges etc.
- Public hospitals are reimbursed for the healthcare services at par with the private hospitals.
Benefit Cover Under PM-JAY:
- Benefit cover under various Government-funded health insurance schemes in India have always been structured on an upper ceiling limit ranging from an annual cover of Rs 30,000 to Rs 3,00,000 per family across various States which created a fragmented system.
- PM-JAY provides cashless cover of up to Rs 5,00,000 to each eligible family per annum for listed secondary and tertiary care conditions. The cover under the scheme includes all expenses incurred on the following components of the treatment.
- Medical examination, treatment and consultation
- Pre-hospitalization
- Medicine and medical consumables
- Non-intensive and intensive care services
- Diagnostic and laboratory investigations
- Medical implantation services (where necessary)
- Accommodation benefits
- Food services
- Complications arising during treatment
- Post-hospitalization follow-up care up to 15 days