In what could be the game changer for the development of health care services in the Union territory of Jammu and Kashmir, more than 22000 free and cashless treatments have been provided to eligible beneficiaries under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) SEHAT scheme in the first two months.

The scheme was launched by Prime Minister on December 26, 2020 and it aims to provide Universal Health Insurance Coverage of Rs. 5 lakh per family on a floater basis in convergence with central government’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

Since the launch of the scheme, more than 30 Lakh residents of Jammu and Kashmir have already registered under the scheme, covering about 56% of the families. Under the scheme, in the first two months, 22.05 Lakh Golden cards have been issued to eligible beneficiaries in addition to 13.28 Lakh Golden Cards already issued under AB PM-JAY. Under AB PM-JAY, about 70% of the eligible families have been registered.

For the ease of the beneficiaries, government has started registrations for the scheme in all empanelled hospitals besides a network of more than 5000 Common Service Centres (CSCs) has been established for this purpose.

Speaking regarding the scheme, Financial Commissioner, Health & Medical Education Department, Atal Dulloo said, “AB PM-JAY SEHAT Scheme is one of the most ambitious schemes of Government of Jammu & Kashmir and it is heartening to see residents availing free and cashless benefits from reputed empanelled hospitals of Jammu & Kashmir under this scheme.” He added that the residents of Jammu and Kashmir have already started availing benefits under the scheme from reputed hospitals from outside also.

Giving details about the benefits availed by the beneficiaries under the scheme, Atal Dulloo said that since the launch of the scheme, more than 450 patients have already availed benefits in empanelled hospitals from outside J&K using portability feature of AB PM-JAY scheme.

Ankita (name changed), 67 years old from a remote village of Baramulla was admitted in American Oncology Centre, a Private Empanelled Hospital in Jammu for cancer treatment. She was provided with free and cashless treatment under AB PM-JAY SEHAT. Another patient, Neelam (name changed) was treated at Khyber Medical Institute Srinagar and was operated upon at the facility for treatment of heart disorder and was provided free treatment worth Rs. 3.00 Lakhs.

Similarly, another person Mandeep (name changed), 56 years old, from District Kathua received free and cashless services worth Rs. 3.40 lakhs at Indus International Hospital Punjab under AB PMJAY SEHAT. The patient was suffering from a heart disease. Another patient Rashid (name changed), 67 years old from Srinagar underwent Coronary Artery Bypass Grafting from All India Institute of Medical Sciences, New Delhi free of cost.

Apart from benefits availed in private empanelled hospitals, utilization of benefits under this scheme in Government Empanelled Hospitals is also encouraging. A patient, Waseem (name changed), from Ganderbal received treatment worth Rs. 2.09 Lakhs free of cost from SKIMS Soura.  Similarly, one more patient, Atul (name changed), suffering from heart disease received treatment worth 2.80 Lakhs free of cost from Narayana Hospital, Katra.

This ambitious health insurance scheme is going to be the game changer as far as provision of health-care services is concerned. It will on one hand help residents of J&K to avail quality health care services and on the other hand will strengthen and streamline the supply-side in health service delivery paradigm.

Pertinently, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) SEHAT in convergence with PM-JAY aims to provide Universal Health Insurance Coverage of Rs. 5.00 lakh per family on a floater basis. AB PM-JAY SEHAT has the same benefits as available under AB-PMJAY. This scheme covers all residents of Jammu and Kashmir including employees/pensioners of the Government of Jammu and Kashmir and their families. AB PM-JAY-SEHAT in convergence with PM-JAY provides cashless access to health care services for the beneficiary at the point of service.

AB PM-JAY SEHAT in convergence with PM-JAY envisions to mitigate expenditure on medical treatment to all the residents of Jammu & Kashmir. It covers up to 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines. There is no restriction on the family size, age or gender. All pre-existing conditions are covered from day one. Benefits of the scheme are portable across the country as such beneficiaries can visit any of the 24000 empanelled public or private hospitals (including 229 hospitals empanelled within Union Territory of Jammu & Kashmir) under AB PM-JAY in India to avail cashless treatment.

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