Odisha all set to join Centre’s Ayushman Bharat health coverage scheme

Odisha to join AB PM-JAY for ₹5 lakh health cover, addressing technical issues before implementation.

Odisha is all set to join the Ayushman Bharat Pradhan Mantri - Jan Arogya Yojana (AB PM-JAY), which aims to provide health cover of ₹5 lakh per family per year for secondary and tertiary care hospitalisation. Confirming this, a senior Health Ministry official on Monday (September 23, 2024) said that “some technical issues are being ironed out with the State” before its implementation.

“Odisha is running its own health scheme which will now run alongside this Central scheme. Under the scheme, the Centre and State share the financial burden and States like Punjab, which haven’t posted their audit report from 2019-2020 onwards are also being engaged with. Bihar has joined recently, and we are seeing many enrolments from the State,” said a senior Health Ministry official on Monday.

He added that while 18 States have converged their State-specific schemes with AB PM-JAY, the four States of Uttar Pradesh, Haryana, Uttarakhand, and Nagaland run their State employee schemes in convergence with AB PM-JAY hospitals and IT platform. The integration of Karnataka’s Karnataka Arogya Sanjeevani Scheme in the National Health Authority’s IT platform is currently in progress.

The official said that as on September 1, 2024, a total of 29,648 hospitals including 12,696 private hospitals have been empanelled under the scheme. It is being implemented in 33 States and Union Territories currently excluding Delhi, Odisha, and West Bengal.

“Forty-nine percent of the Ayushman cards are issued to women and out of 7.79 crore hospital admissions, approximately 3.61 crore are utilised by women. Under the public-private utilisation — 57% is under public healthcare, while the utilised specialties include cancer, nephrology, cardiology, general medicine, gastroenterology, etc,” said a release issued by the Health Ministry.

The scheme, according to the Ministry, provides cashless inpatient services to beneficiaries at empanelled hospitals nationwide, with no restrictions on family size, age, or gender. All pre-existing diseases are covered from day one in the scheme, which offers a comprehensive coverage that includes 1,949 medical procedures across 27 medical specialities, such as general medicine, surgery, oncology, and cardiology.

“Hospital services, including drugs (covering 15 days medication post-discharge), diagnostics (up to three days before admission), food, and lodging, are provided at no cost to the beneficiaries. The scheme operates through a robust IT platform and the services are entirely paperless and cashless,” it added.