Lok Sabha Question No. 1466 (UNSTARRED), answered on 2023-02-10
Subject: Enrollment under AB-PMJAY
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Balashowry Vallabbhaneni, Kaushalendra Kumar, Lavu Sri Krishna Devarayalu

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

## LOK SABHA UNSTARRED QUESTION NO. 1466 TO BE ANSWERED ON 10 TH  FEBRUARY, 2023

## ENROLLMENT UNDER AB-PMJAY

## 1466.  SHRI BALASHOWRY VALLABHANENI: SHRI KAUSHALENDRA KUMAR: SHRI LAVU SRI KRISHNA DEVARAYALU:

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

(a) whether it is true that many households particularly in rural areas of the country have not been enrolled under the Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and are deprived of the benefits under this Yojana and if so, the details thereof, State/UT-wise;

- (b) whether there are nearly two crore eligible AB-PMJAY individuals and only 72.4 lakhs i.e., 36  per  cent  individuals  have  been  issued  AB-PMJAY  cards  in  Andhra  Pradesh  and  if  so,  the details thereof and the reasons therefor;
- (c) the necessary efforts being made to cover left out individuals by re-conducting survey in the country; and
- (d) the details of average payment made to each beneficiary during the last three years and the current year, year-wise?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

- (a)  to  (d):  Ayushman  Bharat-Pradhan  Mantri  Jan  Arogya  Yojana  (AB-PMJAY)  is  an entitlement-based  scheme.  No  enrolment  or  registration  of  beneficiary  is  required  to  avail benefits under the scheme. The beneficiary may directly visit any empanelled hospital (public or  private)  across  the  country  to  avail  cashless  treatment  benefits.  Eligible  beneficiaries cannot be denied treatment in absence of Ayushman Card.

As of 02 nd February 2023, 1.07 crore beneficiaries have been verified under the scheme in Andhra Pradesh. Aapke Dwar Ayushman, a door-to-door campaign has been taken to verify and  create  Ayushman  Cards.  NHA  has  launched  mobile  application-based  verification process. State has deployed the services of field level workers to ensure issuance of cards to all eligible beneficiaries.

As  per  instructions  issued  by  Ministry  of  Health  &  Family  Welfare  to  States/UTs  on 23.06.2022, States/UTs may use their own datasets for identification of beneficiaries under AB-PMJAY.  For  this  purpose,  only  poor,  deprived  and  marginalized  families  may  be enrolled, keeping the overall design and intent of the scheme intact.

Government of India releases funds to the States/UTs. Respective State Government makes payments  to  the  hospitals  against  the  claims  submitted  by  them.  Payment  is  not  made  to beneficiaries. Year-wise details of average per hospital admission cost are as under:

| Financial Year                      | 2019-20    | 2020-21    | 2021-22    | 2022-23    |
|-------------------------------------|------------|------------|------------|------------|
| Average per hospital admission cost | Rs. 12,271 | Rs. 11,008 | Rs. 10,507 | Rs. 13,703 |

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