Ayushman Bharat: How To Apply? Check Your Eligibility

The landscape of Indian healthcare underwent a significant change in 2018 with the launch of Ayushman Bharat , a scheme designed to achieve the aim of Universal Health Coverage. It was conceived to move away from segmented and sectoral health services towards a comprehensive need based approach.

Dual Pillars of Ayushman Bharat

Ayushman Bharat is made upon two dual distinct yet interconnected pillars which aim to address healthcare both at grassroots and tertiary level:

Health and wellness centres

The government’s aim was to provide comprehensive primary healthcare. For this goal, it converted around 1,50,000 existing sub centers and primary health centers into health and wellness centers . These centers provide a wide range of services like maternal and child healthcare, non communicable diseases treatment and free essential drugs and diagnostics services. They serve as the first point of contact for the community and emphasise prevention and healthcare promotion.

Pradhan Mantri Jan Arogya Yojana (PM-JAY)

The second pillar is the insurance arm of the scheme. Known as Pradhan Mantri Jan Arogya Yojana (PM-JAY), it provides a health coverage of rupees 5 lacs per family per year for secondary and tertiary care hospitalization. This benefit is targeted at the bottom 40% of the Indian households, which is approximately 12 crore poor and vulnerable families as per the Socio Economic Caste Census data.

Key features

It has introduced portability in the healthcare system and now a beneficiary can seek treatment in any equipped hospital across the country regardless of their home state.

This scheme has also ensured that the beneficiary does not have to pay any money upfront for treatment at the hospital, thereby reducing the out of pocket expenditures that pushes Indian families into poverty.

The government has also empanelled thousands of private hospitals which has made better infrastructure available for the poor who could rely before only on overburdened public facilities.

Eligibility criteria

The eligibility criteria is determined based on data from Socio Economic and Caste Census, 2011. The criteria is different for rural and urban households.

For rural areas, households residing in dwellings made of unbaked mud or other non durable material and consisting of only a single room. Those which lack an adult male member within the age of 16 to 59. Families with at least on disabled member and no able bodied adult member for support. Households from Scheduled Castes and Scheduled Tribes communities and landless families primarily depend on manual, casual labour for livelihood.

For urban areas, the coverage extends to individuals who are employed as domestic workers, street vendors, sanitation workers, construction labourers and transport workers.

Senior citizens above the age of 70, irrespective of their social economic status will get coverage up to 5 lac rupees whose cost will be shared by the center as well as the state. Senior citizens above the age of 70 whose households are already covered under this scheme will get an additional top up coverage of 5 lac rupees per year.

How to apply?

Online - visit https://beneficiary.nha.gov.in/. Enter your mobile number and captcha. Use your name, Ration Card, or mobile number to check for inclusion. Complete Aadhaar-based e-KYC (using biometrics or OTP). Once approved, download the Ayushman card.

Offline- Go to the nearest Common Service Centre (CSC) or an empanelled hospital. Bring your Aadhaar Card, Ration Card, and Mobile Number. The operator will verify your eligibility in the database. The card is generated, printed, and provided (often for free or a nominal fee).

Bridging the rural- urban divide

Historically speaking, specialized healthcare was a luxury confined to urban centers only. Ayushman Bharat is trying to bridge the gap by introducing health and wellness centers to rural areas too, thereby strengthening the rural infrastructure. Furthermore, the integration of Digital Health allows for seamless record keeping and tele consultation, bringing expert medical advice to the most remote parts of the world.

Challenges

Despite its success there is still an awareness issue as most beneficiaries are still not aware of their rights and entitlements.

There is also an infrastructure gap as in many regions the public healthcare is still not up to the marks set by their private counterparts.

There have also been doubts in its sustainability and managing the long-term financial burden on the exchequer while maintaining a low rejection rate for claims remains a priority for policymakers .

Ayushman Bharat is not just another healthcare scheme but a movement towards a healthier India and if implemented properly could change the lives of the bottom 40% of Indian society.