Ayushman Bharat

Ministry of Health and Family Welfare
Year Of Launch: 2018

As part of the Ayushman Bharat Programme, the National Health Protection Scheme aims to provide insurance coverage of up to 5 lakh rupees per family per year for secondary and tertiary care hospitalisation to over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries). This will be the world’s largest government-funded health care programme. Since the launch of the scheme on the 23rd of September, 2018, 32,11,960 beneficiaries have been admitted.

Given the scale of implementation, there are concerns about the amount of investment required and if it is sustainable. It is also crucial to address the fact that certain states are yet to accept the scheme, raising questions about the program‘s nationwide implementation.

Further, successful execution of the scheme depends on the private sector, which has been cautious in its participation owing to the low cost of health packages being offered which does not guarantee profits. In this context, many have argued that the focus of the government should go back to upgrading and expanding the public healthcare infrastructure.

Source: https://www.pmjay.gov.in/

Top 5 beneficiary states (Amount Received INR)

  1. Andhra Pradesh 14,10,84,67,483
  2. Tamil Nadu 14,00,83,74,619
  3. Karnataka 6830002602
  4. Maharashtra 6354890137
  5. Chhattisgarh 5928078227

Health & Wellness Centers (HWCs)

Stated Target 1,50,000
HWCs Empanelled 22,796

Progress

15.19%

15.7%

Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Stated Target 50,00,00,000
Hospital Admissions 1,08,99,888

Progress

2.17%

15.7%

Health Insurance Claim Data

Coverage (Per annum/ Per Family)

Amount Rs.5,00,000
Beneficiaries (Families) 10,74,00,000
Total Amount Promised Rs.5,37,00,00,00,00,000

Claims Paid 65,51,993
Amount Paid Rs.75,64,21,47,554

Total Progress: 0.14%

Claims Paid By Gender

  • Female
  • Male

Coverage Type

  • Medical
  • Surgical
  • Unspecified

Coverage Type

  • 1-12 yrs
  • 12-18 yrs
  • 18-24 yrs
  • 24-44 yrs
  • 44-65 yrs
  • 65+ yrs

Ten Most Claimed Specialities

  1. Multiple Speciality Rs.15179813828
  2. Cardiology Rs.8950427138
  3. General Surgery Rs.8748828582
  4. General Medicine Rs.8621912924
  5. Orthopaedics Rs.6922438356
  6. Cardiothoracic & Vascular surgery Rs.6603079080
  7. Obstetrics & Gynaecology Rs.5392462826
  8. Urology Rs.3719102743
  9. Radiation Oncology Rs.3562767358
  10. Ophthalmology Rs.3191069385