Tuesday, September 27, 2022

Ayushman Bharat PMJAY celebrates 4th anniversary

Today, the 23rd September 2022 marks the 4th Anniversary of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PMJAY), the world’s largest government sponsored health insurance scheme. PMJAY provides Rs. 5 lakhs insurance cover to poor and vulnerable families. The goal of the scheme is to prevent financial hardship and impoverishment due to medical expenditure. Till date, the scheme has provided services for 28,000 hospitalizations amounting to Rs. 45 crores for the beneficiaries in Nagaland. The scheme covers 2.33 lakhs households in Nagaland.
The scheme provides cashless hospitalized care with features such as – no cap on age or family size, no restrictions on pre-existing health conditions, coverage for pre and post hospitalization medical expenses, coverage of over 1500 treatment packages including cancer care and organ transplant, and access to any PMJAY empanelled private or public hospital across the country. The scheme does not cover OPD services, preventive health check-ups, or stand-alone diagnostic services.
The beneficiary families are those families which are listed in the Socio Economic and Caste Census 2022 (SECC 2011) under the ‘deprived’ categories. Also covered are those families possessing RSBY (Rashtriya Swasthya Bima Yojana) cards renewed in 2016 or 2017, and card holders of Building & Other Construction Workers (BoCW) under Nagaland Building and Other Construction Workers Welfare Board, Labour Department.
For a beneficiary family to make a PMJAY card, the family should first search for the members’ names in the beneficiary lists as mentioned above. If found to be eligible, there are two sets of documents which are required: (1) a personal ID document and (2) a family document. For a personal document, Aadhaar card is required.
If Aadhaar card is not available, a government issued photo ID card such as voter card, driving license, PAN card, etc can be used along with a personal passport photo. Additionally, for those families falling under RSBY category, the RSBY card is required; and the BoCW member needs to produce the BoCW card. For family document, a ration card is required. If an eligible family does not have a ration card, there is a form which the family can fill up and have it countersigned by Village/Ward chairman.
This form is available with the card issuing agencies as mentioned below. Beneficiaries must be careful in filling up this form which is a major cause of card rejections.
The family details such as names, relation to the head of household, passport photo of each member countersigned by Village/Ward chairman with seal, also sign and seal of the Chairman with mobile number as indicated in the bottom of the document, must all be completely filled in.
The agencies/venues for making an ecard are all the PMJAY empanelled public hospitals, Common Service Centres, UTI ITSL kiosk, and card vendor agencies notified by the government such as Clairvoyance Technologies Pvt. Ltd., etc.
To find out which hospitals are providing services under AB PM-JAY, you can visit the website pmjay.gov.in and click on ‘Find Hospital’. You can search a hospital by name, location, specialty, or hospital type (public or private).
Today also marks the 1st Anniversary of Ayushman Bharat Digital Mission (ABDM). Under this Mission, Ayushman Bharat Health Account (ABHA) ID is an important component which aims at digitalizing and sharing of health records. ABHA number is a 14-digit unique number which is a hassle-free method of accessing and sharing your health records digitally.
It enables you to interact with your healthcare providers, and allows you to receive your digital lab reports, prescriptions and diagnosis seamlessly from verified healthcare professionals and health service providers. Over 2.7 lakhs ABHA numbers have been generated in Nagaland. You can create your ABHA number by login to healthid.abdm.gov.in/register.
The Government of Nagaland will be launching its own health insurance scheme called the Chief Minister’s Health Insurance Scheme (CMHIS) on 1st October 2022. It is aimed to reduce out-of-pocket expenditure on hospital care to all bona-fide citizens of the state.
The scheme will cover two beneficiary categories: (1) State government employees and pensioners including legislators/ex-legislators and their dependents, and (2) All the Indigenous and/or Permanent residents of the State who are not beneficiary under AB PM-JAY or any public funded insurance scheme. The beneficiary families shall be entitled to free health insurance coverage of up to Rs. 5.00 lakhs per family per year. Additionally, the first category (Government employees, pensioners, legislators/ex-legislators) shall have additional staggered benefits as notified by the Government. Very soon various awareness campaigns about the scheme shall be carried out. For more information, you can visit cmhis.nagaland.gov.in.
State Health Agency (SHA)
Directorate of Health and
Family Welfare
Kohima, Nagaland.