Ayushman Bharat Health Insurance

Ayushman Bharat (AB) is an attempt to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. Ayushman Bharat aims to undertake path breaking interventions to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level. Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components.
The first Health and Wellness Centre was launched by the Hon’ble Prime Minister at Jangla, Bijapur, Chhatisgarh on 14 April 2018. The second component is the National Health Protection Mission (NHPM) which provides health protection cover to poor and vulnerable families. The Health and Wellness Centres will play a critical role in creating awareness about AB-NHPM, screening for non-communicable diseases, follow-up of hospitalisation cases among others.
These two far-reaching initiatives under Ayushman Bharat will build a New India 2022. This path-breaking initiative, which will be implemented at an unprecedented scale will bring a paradigm shift in India’s health sector.
Ayushman Bharat – National Health Protection Mission (AB-NHPM) will provide financial protection (Swasthya Suraksha) to 10.74 crore poor, deprived rural families and identified occupational categories of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data (approx. 50 crore beneficiaries). It will have offer a benefit cover of Rs. 500,000 per family per year (on a family floater basis).
AB-NHPM will cover medical and hospitalization expenses for almost all secondary care and most of tertiary care procedures. AB-NHPM has defined 1,350 medical packages covering surgery, medical and day care treatments including medicines, diagnostics and transport.
Beneficiary Level
Government provides health insurance cover of up to Rs. 5,00,000 per family per year.
More than 10.74 crore poor and vulnerable families (approximately 50 crore beneficiaries) covered across the country.
All families listed in the SECC database as per defined criteria will be covered. No cap on family size and age of members.
Priority to girl child, women and and senior citizens.
Free treatment available at all public and empaneled private hospitals in times of need.
Covers secondary and tertiary care hospitalization.
1,350 medical packages covering surgery, medical and day care treatments, cost of medicines and diagnostics.
All pre-existing diseases covered. Hospitals cannot deny treatment.
Cashless and paperless access to quality health care services.
Hospitals will not be allowed to charge any additional money from beneficiaries for the treatment.
Eligible beneficiaries can avail services across India, offering benefit of national portability. Can reach out for information, assistance,
complaints and grievances to a 24X7 helpline number - 14555