The Lok Sabha recently received updates on the Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), the government’s principal health insurance initiative. As stated by the Health and Family Welfare Minister, Mansukh Mandaviya, the scheme has seen remarkable progress, with nearly six crore hospital admissions funded, costing approximately Rs 77,298 crore.

As of December 2, 2023, the scheme has successfully integrated 26,774 hospitals, including 11,733 private institutions, across India. These empanelled hospitals are dedicated to serving beneficiaries of the scheme, which Prime Minister Narendra Modi launched on September 23, 2018. The AB-PMJAY aims to provide a health cover of Rs 5 lakh annually to each family, focusing on the country’s low-income segment.

Mandaviya highlighted that the scheme targets the poorest 40% of the population, ensuring they have access to quality healthcare. With an allocated budget of Rs 7,200 crore for the fiscal year 2023-24, AB-PMJAY operates on a cashless and paperless basis, eliminating the need for reimbursements. Payments to Empanelled Healthcare Providers (EHCPs) are made based on predefined Health Benefits Packages (HBP) at standardised rates.

The latest HBP version, updated in 2022, covers 1,949 procedures spanning 27 specialities, including cancer, mental health, cardiology, and urology. The current financial year (2023-24) has seen a total of 1,19,00,359 claims as of November 30, with Rajasthan leading in the number of claims at 29,49,063. This data, tabled in the Lok Sabha, underscores the extensive reach and impact of the AB-PMJAY across India.

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