Lok Sabha Question No. 1927 (UNSTARRED), answered on 2024-08-02
Subject: Beneficiaries of PMJAY in Chennai
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Dr. Kalanidhi Veeraswamy

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1927 TO BE ANSWERED ON 02 ND AUGUST, 2024

## BENEFICIARIES OFPMJAY IN CHENNAI

## 1927. DR. KALANIDHI VEERASWAMY:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

- (a) whether the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme has achieved its target of providing health cover upto 5 lakh for over 10 crore people since its inception, year-wise;
- (b) if so, the details thereof and if not, the reasons therefor;
- (c) the total number of beneficiaries of PMJAY in the last four years particularly in North Chennai Constituency, State/district-wise;
- (d) the total amount of fund allocated under the said scheme during the last four years, State-wise and year-wise;
- (e) whether the Government has made the AB-PMJAY Scheme available for the migrant workers;
- (f) if so, the details along with number of beneficiaries among the migrant workers under the said scheme; and
- (g) the details of the various healthcare services under the PMJAY scheme that has been claimed during the last four years, year-wise?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI PRATAPRAO JADHAV)

(a) and (b): Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is the largest publicly funded health assurance scheme in the world, which provides health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to approximately 55 crore beneficiaries corresponding to 12.34 crore families, constituting the bottom 40% of India ' s population. States/UTs implementing AB-PMJAY have further expanded the beneficiary base at their own cost.

As on 30.06.2024, more than 34.7 crore Ayushman cards have been created under the scheme and a total number of 7.37 crore hospital admissions worth Rs. One lakh crore have been authorized under the scheme. The utilization of the scheme is driven by the demand of services by the eligible beneficiaries.

(c): In the State of Tamil Nadu, AB-PMJAY is implemented in convergence with the State scheme Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS). In the last four years, a total number of 88.59 lakh hospital admissions have been authorized under the converged scheme in the State of Tamil Nadu. Under the scheme, data is captured and stored district-wise. Accordingly, 12.64 lakh hospitalizations have been authorized in Chennai district in the last four years.

State/UT-wise details of total number of authorized hospital admissions under the scheme in the last four years are at Annexure-I . District-wise details of total number of authorized hospital admissions in the State of Tamil Nadu in the last four years are at Annexure-II .

(d): Under AB-PMJAY, Central share of Grant-in-aid for implementation is released to the States/UTs on the basis of actual utilization under the scheme subject to a maximum of 60%/ 90%/ 100% of the ceiling amount which is currently Rs. 1052/- per family per year. Further, funds are released to States/UTs under Grant-in-aid for administration. There is no State specific allocation as such under the scheme. State/UT-wise details of funds released under the scheme during the last four years are at Annexure-III .

(e) and (f): Beneficiaries under the scheme have been identified from SECC database and other Aadhaar-seeded databases listing beneficiaries with similar socio-economic status. Further, beneficiaries under the scheme are not flagged as migrant workers. In order to facilitate free treatment to the migrant workers under AB-PMJAY, the scheme offers portability feature, wherein eligible beneficiaries can avail treatment across any empanelled hospital in the country, irrespective of the State to which the beneficiary belongs. The total number of hospital adm authorization under portability feature, a total number of 13.5 lakh hospital admissions have been authorized worth Rs. 3495 crore across the country.

(g): The Financial Year-wise details of number of hospital admissions authorized under the scheme during the last four years are as under:

|   Sr. No. | Financial Year   |   No. of hospital admissions authorized (In crore) | Amount of hospital admissions authorized (in crore of Rupees)   |
|-----------|------------------|----------------------------------------------------|-----------------------------------------------------------------|
|         1 | 2023-24          |                                               1.98 | 30,059                                                          |

|   2 | 2022-23   |   1.60 | 22,920   |
|-----|-----------|--------|----------|
|   3 | 2021-22   |   1.44 | 16,607   |
|   4 | 2020-21   |   0.75 | 8,758    |

In the latest national master of the Health Benefit Package (HBP), the scheme provides cashless healthcare services related to 1949 procedures across 27 medical specialties including General Medicine, Surgery, Cardiology, Oncology etc. States have been provided flexibility to further customise the Health Benefit Packages as per local requirement.

*****

## State/UT-wise details of total number of authorized hospital admissions under the scheme in the last four years (FY 2020-21 to FY 2023-24)

| State/UT                    |   Number of authorized hospital admissions (in lakh) |
|-----------------------------|------------------------------------------------------|
| Andaman And Nicobar Islands |                                                 0.03 |
| Andhra Pradesh              |                                                52.18 |
| Arunachal Pradesh           |                                                 0.02 |
| Assam                       |                                                10.01 |
| Bihar                       |                                                 7.68 |
| Chandigarh                  |                                                 0.41 |
| Chhattisgarh                |                                                43.5  |
| DNH&DD                      |                                                 0.79 |
| Goa                         |                                                 0.05 |
| Gujarat                     |                                                30.74 |
| Haryana                     |                                                12.31 |
| Himachal Pradesh            |                                                 2.05 |
| Jammu And Kashmir           |                                                11.3  |
| Jharkhand                   |                                                14.61 |
| Karnataka                   |                                                70.74 |
| Kerala                      |                                                50.41 |
| Ladakh                      |                                                 0.12 |
| Lakshadweep                 |                                                 0.01 |
| Madhya Pradesh              |                                                35.42 |
| Maharashtra                 |                                                12.91 |
| Manipur                     |                                                 1.3  |
| Meghalaya                   |                                                 6.42 |
| Mizoram                     |                                                 0.86 |
| Nagaland                    |                                                 0.55 |
| Puducherry                  |                                                 0.78 |
| Punjab                      |                                                17.9  |
| Rajasthan                   |                                                44.9  |
| Sikkim                      |                                                 0.17 |
| Tamil Nadu                  |                                                88.63 |
| Telangana                   |                                                14.95 |
| Tripura                     |                                                 2.51 |
| Uttar Pradesh               |                                                33.63 |
| Uttarakhand                 |                                                 9.37 |

## District-wise details of total number of authorized hospital admissions in the State of Tamil Nadu in the last four years (FY 2020-21 to FY 2023-24)

| District        |   of authorized hospital admissions (in thousands) |
|-----------------|----------------------------------------------------|
| Ariyalur        |                                              33.3  |
| Chengalpattu    |                                              84.27 |
| Chennai         |                                            1264.1  |
| Coimbatore      |                                             738.9  |
| Cuddalore       |                                             187.93 |
| Dharmapuri      |                                              67.65 |
| Dindigul        |                                             129.26 |
| Erode           |                                             613.88 |
| Kallakurichi    |                                              53.04 |
| Kancheepuram    |                                            1300.24 |
| Kanniyakumari   |                                             150.36 |
| Karur           |                                              48.15 |
| Krishnagiri     |                                              67.32 |
| Madurai         |                                             148.26 |
| Mayiladuthurai  |                                              20.47 |
| Nagapattinam    |                                             130.07 |
| Namakkal        |                                             414.29 |
| Perambalur      |                                              30.52 |
| Pudukkottai     |                                              94.28 |
| Ramanathapuram  |                                              61.9  |
| Ranipet         |                                              41.1  |
| Salem           |                                             194.61 |
| Sivaganga       |                                              83.29 |
| Tenkasi         |                                              44.23 |
| Thanjavur       |                                             115.75 |
| The Nilgiris    |                                             268.46 |
| Theni           |                                              79.16 |
| Thiruvallur     |                                             141.95 |
| Thiruvarur      |                                             146.82 |
| Thoothukkudi    |                                              31.3  |
| Tiruchirappalli |                                             289.77 |
| Tirunelveli     |                                             626.92 |
| Tirupathur      |                                             184.83 |
| Tiruppur        |                                              70.81 |
| Tiruvannamalai  |                                              98.05 |
| Vellore         |                                             208.77 |
| Viluppuram      |                                             340.15 |
| Virudhunagar    |                                             255.04 |

## State/UT-wise details of funds released under the scheme during the last four years

(in crore of Rupees)

| State/UT                 |   FY 2020-21 |   FY 2021-22 |   FY 2022-23 |   FY 2023-24 |
|--------------------------|--------------|--------------|--------------|--------------|
| Andaman &Nicobar Islands |         0.27 |         0.76 |         1    |         0.59 |
| Andhra Pradesh           |       261.23 |       223.95 |       480.89 |       451.45 |
| Arunachal Pradesh        |         0.67 |         0    |         3.8  |         3.47 |
| Assam                    |        12.1  |        87.91 |       209.33 |       292.06 |
| Bihar                    |         0    |        59.77 |       145.51 |       172.5  |
| Chandigarh               |         1.84 |         2.49 |         6.41 |         8.96 |
| Chhattisgarh             |       112.62 |        66    |       352.94 |       195.47 |
| DNH and DD               |         4.24 |         1.76 |         2.93 |         7.79 |
| Goa                      |         0.49 |         0.6  |         0.53 |         1.2  |
| Gujarat                  |        99.84 |       330.55 |       660.15 |       267.48 |
| Haryana                  |        71.92 |        89.95 |       143.5  |        95.17 |
| Himachal Pradesh         |        32.93 |        33.71 |        64.32 |        47.91 |
| Jammu and Kashmir        |        22.7  |        75.12 |        85.62 |        42.22 |
| Jharkhand                |       100.32 |         7.98 |         0    |        83.55 |
| Karnataka                |       160.85 |       414.11 |       647.74 |       320.59 |
| Kerala                   |       145.61 |       138.9  |       151.34 |       155.49 |
| Ladakh                   |         1.62 |         0.51 |         1.92 |         1.93 |
| Lakshadweep              |         0    |         0.31 |         0.15 |         0.07 |
| Madhya Pradesh           |       164.8  |       355.25 |       665.73 |       790.35 |
| Maharashtra              |       376.65 |       324.75 |       388.03 |       548.4  |
| Manipur                  |        11.45 |        22.5  |        38.55 |        29.17 |
| Meghalaya                |        49.52 |        22.28 |        47.31 |        49.74 |
| Mizoram                  |        14.97 |        16.58 |        26.3  |        23.35 |
| Nagaland                 |        12.27 |        14.09 |        21.69 |        28.6  |
| Puducherry               |         1.23 |         0.11 |         7.98 |         5.3  |
| Punjab                   |        46.85 |        80.5  |       111.38 |        57.96 |
| Rajasthan                |       258.31 |        96.39 |       416.96 |       606.04 |
| Sikkim                   |         1.85 |         1.04 |         2.3  |         6.01 |
| Tamil Nadu               |       359.81 |        75.14 |       578.67 |       681.74 |
| Telangana                |         0    |       150.26 |       173.54 |       135.75 |
| Tripura                  |         8.98 |        35.6  |        45.25 |        48.81 |
| Uttar Pradesh            |       167.63 |       157.56 |       501.78 |       841.11 |
| Uttarakhand              |        40.52 |        54.23 |        65.11 |        60.21 |