AB-PMJAY Records Over 6 Cr Hospital Admissions & Expenditure of INR 77,298 Cr

The AB-PMJAY, designed to offer health coverage to the bottom 40% of the population, has a budget allocation of INR 7,200 Cr for the financial year 2023-24.

In a significant update on the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), Union health minister Mansukh Mandaviya informed the Lok Sabha that approximately six crore hospital admissions, involving a substantial expenditure of INR 77,298 Cr, have been authorised under the scheme as of November 30.

The AB-PMJAY, recognised as the world's largest publicly funded health assurance initiative, aims to provide health coverage of INR 5 Lakh per family annually for secondary and tertiary care hospitalisation to 12 Cr families.

The minister shared that 26,774 hospitals, including 11,733 private facilities, have been empanelled nationwide as of December 2, 2023, to deliver healthcare services to scheme beneficiaries.

Notably, 4.98 Cr claims have been submitted between the financial years 2020-21 and 2023-24, illustrating the extensive reach and utilisation of the program.

The AB-PMJAY, designed to offer health coverage to the bottom 40% of the population, has a budget allocation of INR 7,200 Cr for the financial year 2023-24.

Mandaviya emphasised that the scheme's unique features include being completely cashless and paperless, with no concept of reimbursement. Beneficiaries can avail themselves of treatment under defined packages, and empanelled healthcare providers are reimbursed based on specified health benefit packages with standardised rates.

Highlighting the range of services, he stated that, as per the latest health benefit packages in 2022, a total of 1,949 procedures across 27 specialities are available for AB-PMJAY beneficiaries. States and Union Territories have the flexibility to add state-specific packages, and the cost of the package can be adjusted as per local requirements.

While leprosy is not included as a package under PM-JAY, the scheme covers 26 procedures related to skin diseases and 549 procedures related to cancer. To ensure comprehensive care, an unspecified package has been included for treatments or procedures not featured in the health benefit packages.

In a move to address specific health concerns, the scheme provides treatment corresponding to a total of 1,949 procedures under 27 different specialities, encompassing critical areas such as cancer, diabetes, and heart ailments.

As of December 2, 2023, approximately 34.92 Lakh hospital admissions worth INR 6,537 Cr have been authorised under AB-PMJAY for cancer-related treatment. Additionally, 1.68 Lakh hospital admissions, amounting to INR 254 Cr, have been approved for skin-related treatments.

The update underscores the substantial impact of the AB-PMJAY, contributing to the healthcare needs of millions of families nationwide and marking a significant milestone in India's public health initiatives.