Lok Sabha Question No. 1113 (UNSTARRED), answered on 2022-07-22
Subject: Coverage under AB-PMJAY Scheme
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Gopal Jee Thakur

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

## LOK SABHA UNSTARRED QUESTION NO. 1113 TO BE ANSWERED ON 22 ND  JULY, 2022

## COVERAGE UNDER AB-PMJAY SCHEME

## 1113.  SHRI GOPAL JEE THAKUR:

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

- (a) whether the Government has intensified the exercise of registering citizens under Ayushman Bharat Yojana to provide free access to health insurance coverage to low income earners in the country and if so, the details thereof;
- (b)  whether  the  Government  has  taken  note  of  the  fact  that  many  deserving  and  eligible families/persons are deprived of benefits under AB-PMJAY for not being covered thereunder;
- (c) if so, the details thereof along with necessary steps taken in this regard;
- (d)  whether  the  Government  proposes  to  make  necessary  amendments  to  the  Scheme  so  as  to cover each eligible person as per the 2011 Census;
- (e) if so, the details thereof along with necessary steps taken in this regard;
- (f) whether the Government is aware of the fact that a large number of eligible persons have not been included in the scheme due to their names not figuring in the 2011 census; and
- (g) if so, the efforts being made by the Government to include all such persons under the scheme?

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

(a) to (g):  Ayushman  Bharat-Pradhan  Mantri  Jan  Arogya  Yojana  (AB-PMJAY)  is  an entitlement-based  scheme.  Eligible  beneficiaries  can  directly  visit  any  empanelled  public  or private  hospital  to  avail  cashless  treatment.  Ayushman  cards  are  issued  to  the  beneficiaries  to create awareness about the scheme. National Health Authority in association with State Health Agencies has fast-tracked the process of issuance of cards to the beneficiaries across the country.

Healthcare services including primary, secondary and tertiary are provided free to all citizens of the  country  in  Central/State  Government  hospitals.  PMJAY's  beneficiary  database  is  defined.

10.74 crore poor and vulnerable families (bottom 40 percent population) identified on the basis of SECC 2011 data are entitled to receive free treatment under the scheme. Further, States/UTs have the flexibility to run their own health protection schemes in alliance with AB-PMJAY at their  own  cost.  Accordingly,  States/UTs  have  expanded  the  scheme  coverage  to  14.75  crore beneficiary families at their own cost.

To cover each eligible person as per the 2011 Census under the scheme, guidelines are issued to States/UTs to identify beneficiaries as per deprivation/occupational criteria of SECC and to meet the shortfall in terms of number of eligible beneficiary households vis-à-vis those already identified/verified using their own datasets.

Details of steps taken to improve registrations under the scheme are as under:

-  Leveraging  grassroots  network  of  healthcare  workers  (HCWs),  frontline  workers (FLWs),  Panchayati  Raj  institutions  (PRIs),  village  level  entrepreneurs  (VLEs)  / agents  from  CSC and UTIITSL to mobilize and verify beneficiaries under 'Aapke Dwar Ayushman' (ADA) initiative.
-  Leveraging  the  updated  databases  of  welfare  schemes  of  Central  Government Ministries/Departments for better targeting of PMJAY beneficiaries to reach out to eligible individuals from this list to issue Ayushman cards to them.
-  Four additional agencies on-boarded,  along the lines of CSC and UTIITSL for the generation of Ayushman cards across the country.
-  Eight  additional  agencies  on-boarded  to  ensure  immediate  approval  of  Ayushman card requests.
-  An enhanced location  hierarchy  based  search  option  enabled  in  SECC  database  to access village level beneficiary data.
-  A revamped 'Self BIS' system launched for self / assisted verification.
-  Crowd sourced approval functionality enabled for beneficiary record approval.

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