New Delhi: Prime Minister chaired a Union Cabinet meeting here on Wednesday which approved the launch of Ayushman Bharat – National Health Protection Mission (AB-NHPM). The scheme promises health coverage for upto 10 crore poor families without underlining an age restriction and family size. It will bring much relief to the poor people who are not able to support themselves for medical care.
“To ensure that nobody is left out (especially women, children and elderly) 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 hospitalization will also be paid to the beneficiary,” according to an official statement.
The scheme, Ayushman Bharat, popularly called as Modicare and termed as world’s largest programme to be funded by government for public health will help provide Rs. 5 lakh medical coverage per family per year to the deserving poor families. The scheme is based on Socio Economic and Caste Census (SECC). Apart from that, the scheme proposes to strengthen primary healthcare in the whole country with atleast 150,000 health and wellness centres.
AB-NHPM, which will bring other on-going centrally sponsored schemes like Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS) under its umbrella, will also be responsible for other all secondary care and most of tertiary care procedures.
“Benefits of the scheme are portable across the country and a beneficiary covered under the scheme will be allowed to take cashless benefits from any public or private empanelled hospitals across the country,” said the official statement.
AB-NHPM is set to be an entitlement based scheme with entitlement decided based upon the deprivation criteria in the SECC database, the statement said.
To bring the costs under control, package rate basis payments will be done for the treatment. The package rates will also include other costs which are associated with treatment and will be completely cashless transaction for the beneficiaries. States shall have the power to design the flexibility to be able to modify all these rates under a limited bandwidth.
“One of the core principles of AB-NHPM is to co-operative federalism and flexibility to states,” said the statement. The states will have the permission to expand AB-NHPM both horizontally and vertically ways and they can also implement through insurance company or Trust-Society or a mixed model.
To foster coordination between Centre and states and also to give policy directions, a proposal is being mooted to set up Ayushman Bharat National Health Protection Mission Council (AB-NHPMC) at apex level. Along with that Ayushman Bharat National Health Protection Mission Governing Board (AB-NHPMGB) and an Ayushman Bharat – National Health Protection Mission Agency (AB-NHPMA) are also slated to be set up.
“At the national level to manage, AB-NHPMA would be put in place. States/UTs would be advised to implement the scheme by a dedicated entity called State Health Agency,” it said.