The Context

India's Health Assurance Scheme, popularly known as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY), is the world’s largest health assurance initiative, designed to provide comprehensive health coverage for secondary and tertiary care hospitalization to poor and vulnerable families. It targets the bottom 40% of the Indian population, offering cashless and paperless healthcare services directly at the point of delivery. Ayushman Bharat comprises two key components: Health and Wellness Centres (HWCs) and the Pradhan Mantri Jan Arogya Yojana (PM-JAY). HWCs serve as primary healthcare hubs, focusing on preventive, promotive, curative, and rehabilitative care, while PM-JAY provides secondary and tertiary care services across public and private empanelled hospitals in India. Together, these components aim to enhance healthcare accessibility, affordability, and quality for the most underserved communities.

  Objectives

• To provide cashless access to healthcare services for beneficiaries at the point of service.
• To mitigate catastrophic expenditure on medical treatment for poor and vulnerable families.
• To improve the quality and timeliness of medical care.

Activities

• Provision of secondary and tertiary care hospitalization across public and private empanelled hospitals.
• Coverage of pre-hospitalization and post-hospitalization expenses, including diagnostics and medicines.
• Coverage of all costs related to treatment, such as drugs, supplies, diagnostic services, physician fees, room charges, surgeon fees, operation theatre (OT) and intensive care unit (ICU) charges.
• Establishment of Health and Wellness Centres (HWCs) to deliver primary healthcare services with a focus on maternal and child health, non-communicable diseases, and essential drugs and diagnostics.

Prerequisites for Implementing Ayushman Bharat in Global South Countries

For Global South countries to successfully implement a program similar to Ayushman Bharat, several prerequisites must be addressed: 

• Adequate Funding and Resources
• Robust Healthcare Infrastructure
• Effective Health Information Systems
• Capacity Building and Training
• Public Awareness and Engagement
• Partnerships and Collaboration

Case Study

 

"I am happy with the Ayushman Bharat Yojana because it has provided significant help. Without it, we would have been unable to afford expensive treatment. When two square meals are a big deal for the poor, from where can we afford costly medical treatment? The good thing is that along with treatment, medicines are also provided for free." said Vinita from Vaishali, Bihar, who came to Delhi for her mother’s treatment.

Schemes