The National Health Protection Mission (AB-NHPM) or Ayushman Bharat is a centrally sponsored health insurance scheme launched by Prime Minister Narendra Modi as part of health policy 2017. The focus of this scheme is to provide access to quality healthcare and free medication and diagnostic services to people of low financial status. Ayushman Bharat or Modi-care provides covers to the poor, deprived rural families and families below the poverty line, from both urban and rural India, defined in line with the latest Socio-Economic Caste Census (SECC) data. The following will help you better understand Ayushman Bharat:

What is Ayushman Bharat Yojana?

There are two facets to the Ayushman Bharat Yojana – National Health Protection Scheme (NHPS) and establishment of health and wellness centres.

NHPS is a comprehensive health insurance programme designed to provide access to quality healthcare to all Indians. It offers insurance cover of Rs 5 lakh per family per year in all public hospitals and empanelled private hospitals across the country. This scheme enables the insured to get cashless treatment at secondary (referral to a physician or surgeon) and tertiary (advanced medical investigations and treatment) healthcare centres.

Health and wellness centres, on the other hand, will provide free diagnostic services and free access to essential drugs. These will also provide treatment for all communicable and non-communicable diseases and maternity and child care.

What are the features of Ayushman Bharat scheme?

The insurance scheme is fully sponsored by the government – the cost shared between the Centre and states. It would provide cover to more than 10 crore families and their beneficiaries. There is no cap on family size and age in this scheme. Benefits will also include pre and post-hospitalisation expenses. All pre-existing conditions will be covered from day one of the policy. Transport allowance, to an extent, will also be paid to the beneficiary.

Will the policy be valid across the country?

Yes. The benefits of the policy, irrespective of the state, are portable across the country and the beneficiary covered under the scheme would be allowed to take cashless services from any public or private empanelled hospitals in the country.

How and when will the scheme be implemented?

It will be implemented through insurance companies or through a society or trust or both. It is expected to be launched on September 25, 2018.

What will happen to the Centre’s existing insurance schemes?

Ayushman Bharat – NHPS will subsume ongoing insurance schemes such as the Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).

Can everyone be a part of Ayushman Bharat?

No. This scheme is applicable to families in the low-income bracket and for families living below the poverty line.

What is the eligibility criteria?

Eligibility is decided based on the latest deprivation criteria in the SECC database. For instance, the different categories in rural areas include families living in houses having only one room with kucha walls and kucha roof, families with no adult member between age 16 and 59 or female headed households with no adult male in the same age group and SC/ST households.

Also, families without household shelter, destitute, living on alms, primitive tribal groups and so on will be automatically included in the scheme. When it comes to urban areas, 11 defined occupational categories are entitled under the scheme including beggars, cobblers, hawkers, plumbers and painters.