The Union Cabinet has approved the launch of Ayushman Bharat – National Health Protection Mission ((AB-NHPM), popularly known as ‘Modicare’ announced in the budget 2018-19.
“The scheme has the benefit cover of Rs 5 lakh per family per year. The target beneficiaries of the proposed scheme will be more than 10 crore families belonging to poor and vulnerable population,” a PIB statement read.
AB-NHPM will subsume the existing healthcare schemes, Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
Union cabinet chaired by Prime Minister Narendra Modi on Wednesday gave its nod to AB-NHPM which has been touted as one of the world’s largest Government funded scheme.
The AB-NHPM scheme will take care of almost all secondary care and most of tertiary care procedures. There will be no cap on family size and age in the scheme. “The benefit cover will also include pre and post-hospitalisation expenses. All pre-existing conditions will be covered from day one of the policy. A defined transport allowance per hospitalisation will also be paid to the beneficiary,” the Statement said.
An official statement further said the beneficiaries can avail benefits in both public and empanelled private facilities. “All public hospitals in the States implementing AB-NHPM, will be deemed empanelled for the Scheme. Hospitals belonging to Employee State Insurance Corporation (ESIC) may also be empanelled based on the bed occupancy ratio parameter. As for private hospitals, they will be empanelled online based on defined criteria,” the Statement further said.
According to an official data, in-patient hospitalisation expenditure in India has increased nearly 300 per cent in last 10 years. More than 80 per cent of the expenditure are met by out of pocket (OOP). AB-NHPM will play a pivotal role on reduction of Out Of Pocket (OOP) expenditure and will facilitate quality and accessible healthcare delivery to the poor, deprived rural families.