AB PM-JAY SEHAT
Ayushman Bharat PM-JAY SEHAT in Jammu and Kashmir: In order to provide the benefits of Ayushman Bharat PM- JAY to all residents of UT of Jammu and Kashmir (More than 20 Lakh families) a scheme by the name of AB PM-JAY SEHAT was launched by Hon’ble Prime Minister of India on 26th December 2020 having National Portability.
In Jammu and Kashmir, scheme is implemented through insurance mode and Private Bajaj Allianz GIC is the implementing agency for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) and AB PM-JAY SEHAT in Jammu & Kashmir. This is for the first time that a publicaly funded Health Insurance Scheme meant for the entire population is being implemented in the UT of Jammu and Kashmir. The main features of the scheme are:
- Ayushman Bharat "Pradhan Mantri Jan Arogya Yojana" (PMJAY) - SEHAT primarily focuses Financial Protection from catastrophic health expenditures, which is the pillar of Universal Health Coverage. It is delivered through both public and private health care providers for providing secondary and tertiary care, health services.
- The scheme provides a cover of Rs. 5 lakh per family per year. All Medical and surgical conditions are included with minimal exclusions.
- It covers both Pre and Post hospitalization expenses.
- All pre-existing conditions are covered from day one.
- Socio Economic Caste Census (SECC) 2011 database (rural and urban areas) has been be used for both AB-PMJAY and AB PM-JAY SEHAT.
- There is No family size and age limit.
- Public hospitals are to be deemed empanelled. Private Health care facilities have been empanelled based on defined criteria (including specialty specific criteria).
- National Portability concept has been used.
- All identified beneficiary families to get benefits from day one.
- Aadhaar will be primary mode of personal identification of beneficiaries.