Lok Sabha Question No. 982 (UNSTARRED), answered on 2019-11-22
Subject: Reimbursement of Medical Expenses under AB-PMJAY
Ministry: HEALTH AND FAMILY WELFARE
Asked by: M V V Satyanarayana

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUESTION NO. 982 TO BE ANSWERED ON 22 ND NOVEMBER, 2019

## REIMBURSEMENT OF MED ICAL EXPENSES UNDER AB - PMJAY

## 982. SHRI M.V.V. SATYANARAYANA:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) the number of persons benefited under the Ayushman Bharat Yojana in the country inclu the State of Andhra Pradesh and Telangana since its inception, State/UT - wise;
- (b) the details of Government, Private Hospitals empanelled under this scheme in the St Andhra Pradesh and Telangana;
- (c) whether the Government is considering to increase the ceiling limit from Rs. 5.00 la per person to Rs. 10.00 lakhs per person under this scheme, if so, the details thereof;
- (d) the details of diseases covered under the scheme;
- (e) whether the Government is considering to fully reimburse the amount spent by the pat for the critical ailments like kidney transplant, heart transplant, liver transplant, an diseases under this scheme; and
- (f) if so, the details th ereof and if not, the reasons therefor?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

- (a) & (b):      From the inception of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPMJAY) till 20.11.2019, total number of hospital admissions under the scheme is 61.53 Lakh. State/UT - wise details of hospital admissions are at Annexure.

As on 20.11.2019, the total number of hospital admissions in the State of Andhra Prad 5.03 Lakh . 692 Hospitals, including 467 Private and 225 Public Hospitals, are empanelled u AB - PMJAY.

The  State  of  Telangana  has  not  signed  the  Memorandum  of  Understanding  (MoU)  for implementation of the scheme.

(c ): No.

(d) to (f) : As on date, 1392 treatments (packages) across 24 specialities and 1 unspeci package are available under AB - PMJAY  at  the  empanelled hospitals. Details of packages are available at www.pmjay.gov.in . Organ transplant is not included in the health benefit packages under AB- PMJAY.

AB - PMJAY is a cashless scheme and the beneficiary is not required to pay for avai the benefits under the scheme. Therefore, the issue of reimbursement of cost of treatmen beneficiary does not arise.

………………..

** The State of West Bengal has withdrawn from the scheme from January 2019

## Annexure

| State-wise details of Hospital admissions under AB-PMJAY as on 20.11.2019 since inception   | State-wise details of Hospital admissions under AB-PMJAY as on 20.11.2019 since inception   | State-wise details of Hospital admissions under AB-PMJAY as on 20.11.2019 since inception   |
|---------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|
| Sl. No.                                                                                     | Name of State                                                                               | No of Hospital admissions (In lakhs)                                                        |
| 1                                                                                           | Andaman And Nicobar Islands                                                                 | 0.000                                                                                       |
| 2                                                                                           | Andhra Pradesh                                                                              | 5.041                                                                                       |
| 3                                                                                           | Arunachal Pradesh                                                                           | 0.013                                                                                       |
| 4                                                                                           | Assam                                                                                       | 0.943                                                                                       |
| 5                                                                                           | Bihar                                                                                       | 1.219                                                                                       |
| 6                                                                                           | Chandigarh                                                                                  | 0.023                                                                                       |
| 7                                                                                           | Chhattisgarh                                                                                | 6.886                                                                                       |
| 8                                                                                           | Dadra And Nagar Haveli                                                                      | 0.220                                                                                       |
| 9                                                                                           | Daman And Diu                                                                               | 0.082                                                                                       |
| 10                                                                                          | Goa                                                                                         | 0.101                                                                                       |
| 11                                                                                          | Gujarat                                                                                     | 10.199                                                                                      |
| 12                                                                                          | Haryana                                                                                     | 0.646                                                                                       |
| 13                                                                                          | Himachal Pradesh                                                                            | 0.406                                                                                       |
| 14                                                                                          | Jammu And Kashmir                                                                           | 0.419                                                                                       |
| 15                                                                                          | Jharkhand                                                                                   | 3.579                                                                                       |
| 16                                                                                          | Karnataka                                                                                   | 3.997                                                                                       |
| 17                                                                                          | Kerala                                                                                      | 5.981                                                                                       |
| 18                                                                                          | Lakshadweep                                                                                 | 0.000                                                                                       |
| 19                                                                                          | Madhya Pradesh                                                                              | 2.061                                                                                       |
| 20                                                                                          | Maharashtra                                                                                 | 2.425                                                                                       |
| 21                                                                                          | Manipur                                                                                     | 0.086                                                                                       |
| 22                                                                                          | Meghalaya                                                                                   | 0.813                                                                                       |
| 23                                                                                          | Mizoram                                                                                     | 0.263                                                                                       |
| 24                                                                                          | Nagaland                                                                                    | 0.059                                                                                       |
| 25                                                                                          | Puducherry                                                                                  | 0.001                                                                                       |
| 26                                                                                          | Punjab                                                                                      | 0.605                                                                                       |
| 27                                                                                          | Rajasthan                                                                                   | 4.247                                                                                       |
| 28                                                                                          | Sikkim                                                                                      | 0.007                                                                                       |
| 29                                                                                          | Tamil Nadu                                                                                  | 7.217                                                                                       |
| 30                                                                                          | Tripura                                                                                     | 0.424                                                                                       |
| 31                                                                                          | Uttar Pradesh                                                                               | 2.365                                                                                       |
| 32                                                                                          | Uttarakhand                                                                                 | 1.025                                                                                       |
| 33                                                                                          | West Bengal**                                                                               | 0.176                                                                                       |
| GRAND TOTAL                                                                                 | GRAND TOTAL                                                                                 | 61.531                                                                                      |