PM- Jan Arogya Yojana

Contact Counsellor

Last Updated07/01/2022

Pradhan Mantri Jan Arogya Yojana (PM-JAY) provided cushion to only 14.25% of people hospitalised for COVID-19

The report was released by the Public Health Foundation of India and Duke Global Health Institute, United States
Their report, released in July this year, showed that the Pradhan Mantri Jan Arogya Yojana (PM-JAY), launched in 2018 with a promise to provide annual insurance coverage of Rs 5 lakh per family to the poorest 40 per cent of the population, provided cushion to only 14.25 per cent of people hospitalised for the novel coronavirus disease (COVID-19), between April 2020 and June 2021.

The scheme was launched in September 2018 and recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC).
It is a Centrally Sponsored Scheme
It was earlier known as the National Health Protection Scheme (NHPS) before being revamped.
It subsumed the Rashtriya Swasthya Bima Yojana (RSBY) launched in 2008.

It is the world’s largest health insurance/ assurance scheme fully financed by the government and the cost of implementation is shared between the Central and State Governments.
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.
It covers up to 3 days of pre-hospitalization and 15 days of post-hospitalization expenses such as diagnostics and medicines.
There is no restriction on the family size, age or gender whereas Rashtriya Swasthya Bima Yojana had a family cap of five members.

The households included are based on the deprivation and occupational criteria of Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas respectively.

It provides cashless access to health care services for the beneficiary at the point of service, that is, the hospital.
It aims to mitigate out of the pocket expenditure on medical treatment which pushes nearly 6 crore Indians into poverty each year.

PM-JAY paid for only 0.52 million COVID-19 hospitalisations across the country.
It does not cover all the target groups and eligible individuals
Under PM-JAY, beneficiaries can go to only a list of empanelled private hospitals. This has remained a major problem, particularly in smaller towns and villages, where hospitals are few and far between.