Lok Sabha Question No. 620 (UNSTARRED), answered on 2022-12-09
Subject: AB-PMJAY
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sunil Baburao Mendhe, Ratansinh Magansinh Rathod, Mahabali Singh, Hasmukhbhai Somabhai Patel, DNV Senthilkumar. S., Chunni Lal Sahu, Shiromani Ram

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

## LOK SABHA UNSTARRED QUESTION NO. 620 TO BE ANSWERED ON 09 TH  DECEMBER, 2022

## AB-PMJAY

## 620. SHRI SUNIL BABURAO MENDHE:

SHRI RATANSINH MAGANSINH RATHOD:

SHRI MAHABALI SINGH:

SHRI PATEL HASMUKHBHAI SOMABHAI:

DR. DNV SENTHILKUMAR S.:

SHRI CHUNNI LAL SAHU:

SHRI RAMSHIROMANI VERMA:

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

- (a)  the salient features of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) along with the total number of beneficiaries in the country during last three years, State/UTwise;
- (b)    the  details  of  the  eligibility  criteria  and  process  fixed  to  provide  medical  facility  related benefits to the patients under the said Scheme;
- (c)    the  details  of  the  steps  being  taken  by  the  Government  to  cover  all  eligible  beneficiaries deprived of the benefits of the said Scheme and to promote/ expand the Scheme in the remote areas of the country;
- (d)  the  details  of  the  funds  sanctioned,  allocated,  utilized  along  with  the  number  of  hospitals empanelled  under  the  Yojana,  State/UT-wise  during  each  of  the  last  three  years  and  the current year;
- (e)  the details of the number of Ayushman Bharat Cards issued so far along with the number of applications approved and rejected in the country during each of the last three years and the current year, State/UT-wise; and
- (f)  the details of the diseases covered under the Scheme?

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

(a)  to  (f):  The  salient  features,  eligibility  criteria  and  the  process  fixed  to  provide  medical facility related benefits to the patients under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) are at Annexure-I.  State/UT-wise details of the number of authorized hospital admissions during last three years are at Annexure-II.

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. Government of India shall, however, provide its share of funding for all such beneficiaries limited to the number of eligible households as per SECC 2011 database.

State/UT-wise  and  Financial  Year-wise  details  of  Central  share  of  funds  released  and  the number of hospitals empanelled under the scheme are at Annexure-III. Funds are released to States/UTs only after utilization certificate is submitted by them.

State/UT-wise  and  Financial  Year-wise  details  of  Ayushman  cards  issued/applications approved  in  the  country  during  each  of  the  last  three  years  and  the  current  year  are  at Annexure-IV. Total number of applications rejected State/UT-wise during the said period is 41,309.

The details of the diseases covered under the Scheme are available at the following link: https://pmjay.gov.in/sites/default/files/2022-04/HBP%202022%20..pdf

*****

1. Ayushman Bharat, a flagship scheme of Government of India, was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to "leave no one behind."
2. AB-PMJAY is the world's largest Government funded health assurance scheme.
3. AB-PMJAY provides health assurance of up to Rs.5 Lakh per family per year for secondary and tertiary healthcare hospitalizations.
4. AB-PMJAY is a completely cashless and paperless scheme.
5. The benefits under AB-PMJAY are portable across the country.
6. There is no cap on family size, or age or gender.
7. The  beneficiary  families  under  Ayushman  Bharat  -  Pradhan  Mantri  Jan  Arogya  Yojana  (ABPMJAY) have been identified  from  the  Socio-Economic  Caste  Census  (SECC)  of  2011  on  the basis  of  select  deprivation  and  occupational  criteria  across  rural  and  urban  areas.  Details  are  as below:

## Detailed list of criteria for eligibility under AB-PMJAY as per SECC 2011

Automatically included:

1. Households without shelter
2. Destitute/ living on alms
3. Manual scavenger families
4. Primitive tribal groups
5. Legally released bonded labour

Deprivation criteria in rural area:

- D1: Only one room with kutcha walls and kutcha roof
- D2: No adult member between age 16 to 59
- D3: Female headed households with no adult male member between age 16 to 59
- D4: Disabled member and no able-bodied adult member
- D5: SC/ST households
- D7: Landless households deriving major part of their income from manual casual labour

Occupational criteria in urban area:

- 1) Rag picker
- 2) Beggar
- 3) Domestic worker
- 4) Street vendor/ Cobbler/hawker / Other service provider working on streets
- 5) Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard/ Coolie and other head-load worker
- 6) Sweeper/ Sanitation worker / Mali
- 7) Home-based worker/ Artisan/ Handicrafts worker / Tailor
- 8) Transport  worker/  Driver/ Conductor/  Helper  to  drivers  and conductors/  Cart puller/ Rickshaw puller
- 9) Shop worker/ Assistant/ Peon in small establishment/ Helper/ Delivery assistant / Attendant/ Waiter
- 10) Electrician/ Mechanic/ Assembler/ Repair worker/Washer-man/ Chowkidar
8. The  number  of  eligible  beneficiaries  under  SECC  2011  is  10.74  crore  (50  crore  people).  33 States/UTs  implementing  AB-PMJAY  have  further  expanded  the  coverage  of  the  scheme  to include 14.77 crore families.
9. AB-PMJAY is implemented in all States and UTs barring West Bengal, NCT of Delhi and Odisha.
10. The  scheme  is  implemented  across  the  country  through  a  three-tier  model.  National  Health Authority, an attached office of the Ministry of Health and Family Welfare with full functional autonomy,  is  the  apex  body  implementing  AB-PMJAY  across  the  country.  For  effective implementation  of  AB-PMJAY  at  States/UTs  level,  State  Health  Agencies  (SHAs)  have  been established.  District  Implementation  Units  (DIUs)  have  been  set  up  for  ensuring  on-ground coordination between scheme stakeholders and for smooth implementation.
11. AB-PMJAY is completely funded by the Government and costs are shared between Central and State Governments in the ratio as per the extant directives issued by Ministry of Finance.

## State/UT-wise details of number of authorized hospital admissions during last three years

| State/UT                    | Number of authorized hospital admissions during last three years (2019-20 to 2021-22)   |
|-----------------------------|-----------------------------------------------------------------------------------------|
| Andaman And Nicobar Islands | 1,822                                                                                   |
| Andhra Pradesh              | 2,765,894                                                                               |
| Arunachal Pradesh           | 2,904                                                                                   |
| Assam                       | 548,744                                                                                 |
| Bihar                       | 498,772                                                                                 |
| Chandigarh                  | 23,541                                                                                  |
| Chhattisgarh                | 3,130,538                                                                               |
| DNH&DD                      | 93,191                                                                                  |
| Goa                         | 10,675                                                                                  |
| Gujarat                     | 3,426,496                                                                               |
| Haryana                     | 582,977                                                                                 |
| Himachal Pradesh            | 174,161                                                                                 |
| Jammu And Kashmir           | 652,428                                                                                 |
| Jharkhand                   | 1,398,502                                                                               |
| Karnataka                   | 3,526,985                                                                               |
| Kerala                      | 4,579,831                                                                               |
| Ladakh                      | 5,595                                                                                   |
| Lakshadweep                 | 297                                                                                     |
| Madhya Pradesh              | 2,218,822                                                                               |
| Maharashtra                 | 698,432                                                                                 |
| Manipur                     | 80,663                                                                                  |
| Meghalaya                   | 528,311                                                                                 |
| Mizoram                     | 81,209                                                                                  |
| Nagaland                    | 31,066                                                                                  |
| Puducherry                  | 31,048                                                                                  |
| Punjab                      | 1,349,173                                                                               |
| Rajasthan                   | 3,929,711                                                                               |
| Sikkim                      | 9,017                                                                                   |
| Tamil Nadu                  | 8,394,153                                                                               |
| Telangana                   | 576,304                                                                                 |
| Tripura                     | 187,341                                                                                 |
| Uttar Pradesh               | 1,678,491                                                                               |
| Uttarakhand                 | 620,734                                                                                 |

## State/UT-wise details of fund released & hospitals empanelled under AB-PMJAY

|                   | FY 2019-20                         | FY 2019-20                  | FY 2020-21                         | FY 2020-21                  | FY 2021-22                         | FY 2021-22                  | FY 2022-23                         | FY 2022-23                  |
|-------------------|------------------------------------|-----------------------------|------------------------------------|-----------------------------|------------------------------------|-----------------------------|------------------------------------|-----------------------------|
| State/UT          | Fund released (in crore of Rupees) | No. of Hospitals empanelled | Fund released (in crore of Rupees) | No. of Hospitals empanelled | Fund released (in crore of Rupees) | No. of Hospitals empanelled | Fund released (in crore of Rupees) | No. of Hospitals empanelled |
| A and N Islands   | 0.41                               | -                           | 0.27                               | -                           | 0.76                               | -                           | 1.0                                | 7                           |
| Andhra Pradesh    | 374.07                             | 818                         | 261.23                             | 70                          | 223.95                             | 576                         | 456.27                             | 1,011                       |
| Arunachal Pradesh | -                                  | 17                          | 0.67                               | 16                          | 0.00                               | 18                          | 1.76                               | 11                          |
| Assam             | 133.23                             | 151                         | 12.10                              | 49                          | 87.91                              | 16                          | 110.94                             | 212                         |
| Bihar             | 82.49                              | 200                         | -                                  | 44                          | 59.77                              | 45                          | 115.76                             | 699                         |
| Chandigarh        | 3.82                               | 7                           | 1.84                               | 4                           | 2.49                               | 7                           | 3.78                               | 15                          |
| Chhattisgarh      | 280.37                             | 632                         | 112.62                             | 720                         | 66.00                              | 151                         | 263.73                             | 104                         |
| DNH and DD        | 2.02                               | 0                           | 4.24                               | 0                           | 1.76                               | 0                           | 2.49                               | 7                           |
| Delhi             | -                                  | 35                          | -                                  | 20                          |                                    | 28                          | -                                  | 26                          |
| Goa               | 0.06                               | 16                          | 0.49                               | 3                           | 0.60                               | 8                           | 0.53                               | 9                           |
| Gujarat           | 212.33                             | 105                         | 99.84                              | 104                         | 330.55                             | 168                         | 477.81                             | 2,496                       |
| Haryana           | 58.69                              | 151                         | 71.92                              | 49                          | 89.95                              | 64                          | 94.71                              | 465                         |
| Himachal Pradesh  | 19.12                              | 22                          | 32.93                              | 13                          | 33.71                              | 35                          | 30.18                              | 200                         |
| Jammu and Kashmir | 33.44                              | 82                          | 22.70                              | 2                           | 75.12                              | 39                          | 42.15                              | 172                         |
| Jharkhand         | 126.50                             | 138                         | 100.32                             | 50                          | 7.98                               | 53                          | -                                  | 611                         |
| Karnataka         | 254.13                             | 2356                        | 160.85                             | 241                         | 414.11                             | 102                         | 333.7                              | 1040                        |
| Kerala            | 97.56                              | 130                         | 145.61                             | 179                         | 138.90                             | 160                         | 138.89                             | 282                         |
| Ladakh            | -                                  | 1                           | 1.62                               | -                           | 0.51                               | -                           | 1.92                               | 9                           |
| Lakshadweep       | -                                  | -                           | -                                  | 5                           | 0.31                               | -                           | 0.15                               | 1                           |
| Madhya Pradesh    | 118.46                             | 318                         | 164.80                             | 209                         | 355.25                             | 206                         | 480.9                              | 278                         |
| Maharashtra       | 241.88                             | 185                         | 376.65                             | 333                         | 324.75                             | 93                          | 316.58                             | 489                         |
| Manipur           | 17.10                              | 42                          | 11.45                              | 8                           | 22.50                              | 15                          | 26.63                              | 28                          |
| Meghalaya         | 18.07                              | 21                          | 49.52                              | 6                           | 22.28                              | 1                           | 19.75                              | 155                         |
| Mizoram           | 12.41                              | 16                          | 14.97                              | 4                           | 16.58                              | -                           | 14.55                              | 76                          |
| Nagaland          | 10.89                              | 29                          | 12.27                              | 9                           | 14.09                              | 4                           | 10.27                              | 99                          |
| Odisha            | -                                  | 24                          | -                                  | 2                           | -                                  | 1                           | -                                  | 1                           |
| Puducherry        | -                                  | 19                          | 1.23                               | 2                           | 0.11                               | 6                           | 5.5                                | 5                           |
| Punjab            | 55.55                              | 674                         | 46.85                              | 156                         | 80.50                              | 94                          | -                                  | 0                           |
| Rajasthan         | 200.07                             | 974                         | 258.31                             | 21                          | 96.39                              | 12                          | 348.92                             | 91                          |
| Sikkim            | 0.09                               | 5                           | 1.85                               | -                           | 1.04                               | 6                           | 1.83                               | 6                           |
| Tamil Nadu        | 441.77                             | 88                          | 359.81                             | 44                          | 75.14                              | 623                         | 330.96                             | 1,022                       |
| Telangana         | -                                  | 20                          | -                                  | 16                          | 150.26                             | 394                         | 43.03                              | 306                         |
| Tripura           | 20.18                              | 15                          | 8.98                               |                             |                                    | 2                           |                                    | 92                          |
|                   |                                    |                             |                                    | 36                          | 35.60                              |                             | 32.41                              |                             |
| Uttar Pradesh     | 147.49                             | 961                         | 167.63                             | 104                         | 157.56                             | 313                         | 269.17                             | 1,906                       |
| West Bengal       | -                                  | 52                          | -                                  | 6                           | -                                  | 4                           | -                                  | 9                           |

Note: State/UT of Odisha, West Bengal and Delhi are not implementing AB-PMJAY. Hospitals are empanelled in these States/UT to facilitate beneficiaries of implementing States/UTs to avail treatment under the portability feature of the scheme.

## Annexure-III

## State/UT-wise details of Ayushman cards issued/applications approved and applications rejected

| State/UT                              | Financial Year-wise Ayushman Card generated   | Financial Year-wise Ayushman Card generated   | Financial Year-wise Ayushman Card generated   | Financial Year-wise Ayushman Card generated   | Applications Rejected   |
|---------------------------------------|-----------------------------------------------|-----------------------------------------------|-----------------------------------------------|-----------------------------------------------|-------------------------|
| State/UT                              | FY 2019- 2020                                 | FY 2020- 2021                                 | FY 2021- 2022                                 | FY 2022- 2023                                 | Applications Rejected   |
| Andaman And Nicobar Islands           | 11,520                                        | 18,802                                        | 6,107                                         | 453                                           | 0                       |
| Andhra Pradesh                        | 5                                             | 14                                            | 49                                            | 6,336,211                                     | 0                       |
| Arunachal Pradesh                     | 1,494                                         | 13,603                                        | 32,166                                        | 28,560                                        | 3                       |
| Assam                                 | 908                                           | 145,776                                       | 218,005                                       | 517,396                                       | 10086                   |
| Bihar                                 | 4,142,913                                     | 1,466,970                                     | 723,114                                       | 216,675                                       | 44                      |
| Chandigarh                            | 24,814                                        | 11,894                                        | 7,402                                         | 25,214                                        | 21                      |
| Chhattisgarh                          | 2,118,892                                     | 8,893,021                                     | 3,736,808                                     | 618,906                                       | 0                       |
| Dadra And Nagar Haveli &Daman And Diu | 84,293                                        | 13,577                                        | 11,682                                        | 402                                           | 25                      |
| Goa                                   | 13,965                                        | 317                                           | 263                                           | 4,271                                         | 0                       |
| Gujarat                               | 2,837,932                                     | 245,274                                       | 4,964,420                                     | 3,902,801                                     | 16557                   |
| Haryana                               | 1,298,886                                     | 337,478                                       | 301,961                                       | 2,847,630                                     | 5                       |
| Himachal Pradesh                      | 319,764                                       | 214,649                                       | 69,791                                        | 14,039                                        | 2                       |
| Jammu And Kashmir                     | 50,337                                        | 3,408,585                                     | 2,114,246                                     | 1,364,070                                     | 11117                   |
| Jharkhand                             | 5,636,939                                     | 235,264                                       | 408,275                                       | 247,136                                       | 23                      |
| Karnataka                             | 336                                           | 79                                            | 48                                            | 11,952,403                                    | 2                       |
| Kerala                                | 6,373,978                                     | 176,502                                       | 280,986                                       | 230,211                                       | 5                       |
| Ladakh                                | 514                                           | 58,254                                        | 16,676                                        | 30,344                                        | 71                      |
| Lakshadweep                           | 1,559                                         | 93                                            | 16,593                                        | 7,457                                         | 33                      |
| Madhya Pradesh                        | 4,869,858                                     | 9,137,725                                     | 3,717,286                                     | 6,424,880                                     | 418                     |
| Maharashtra                           | 6,298,349                                     | 270,809                                       | 372,042                                       | 622,893                                       | 2117                    |
| Manipur                               | 145,769                                       | 70,155                                        | 102,677                                       | 71,280                                        | 682                     |
| Meghalaya                             | 1,283,970                                     | 41,424                                        | 145,387                                       | 56,541                                        | 15                      |
| Mizoram                               | 210,100                                       | 11,035                                        | 3,940                                         | 68,607                                        | 4                       |
| Nagaland                              | 207,056                                       | 16,672                                        | 21,709                                        | 33,415                                        | 0                       |
| Puducherry                            | 114,006                                       | 15,793                                        | 256,564                                       | 13,352                                        | 3                       |
| Punjab                                | 3,836,218                                     | 2,331,067                                     | 1,647,287                                     | 151,296                                       | 35                      |
| Sikkim                                | 27,218                                        | 2,702                                         | 10,797                                        | 6,812                                         | 5                       |
| Tamil Nadu                            | 188                                           | 179                                           | 373                                           | 869,429                                       | 4                       |
| Tripura                               | 768,415                                       | 117,895                                       | 37,531                                        | 29,124                                        | 0                       |
| Uttar Pradesh                         | 6,530,324                                     | 4,406,775                                     | 4,154,358                                     | 5,382,279                                     | 16                      |
| Uttarakhand                           | 860,813                                       | 573,729                                       | 355,719                                       | 243,484                                       | 16                      |

Note:  In  Rajasthan,  AB-PMJAY  is  implemented  in  convergence  with  the  States'  health  insurance  scheme.  To  avail  benefits under the converged scheme, eligible beneficiary families can use their existing Jan Aadhaar cards.

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