SEHAT Health Insurance Scheme:  A ray of hope for poor families
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SEHAT Health Insurance Scheme:  A ray of hope for poor families

The main aim behind the scheme is to extend health insurance coverage to all residents of Jammu and Kashmir

Post by MOHAMMAD HANIEF on Monday, October 17, 2022

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With the implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT scheme in union territory of Jammu and Kashmir, the low and middle class families got a ray of hope for free medical treatment to the tune of Rs 5 lacs per person thus bringing a cheer in the families of those patients where the amount of high treatment goes unaffordable.

 

Most of the top surgeries and medical treatments are already going on progressing average for such needy patients in Sher-i-Kashmir Institute of Medical Sciences and other hospitals in Jammu and Kashmir. Before the launch of this scheme, the treatment of high cost surgeries and medical treatment for such patients in rural and urban areas of Jammu and Kashmir and even in Ladakh was almost unaffordable. 

 

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT scheme was launched in the year 2020. The main aim behind the scheme is to extend health insurance coverage to all residents of Jammu and Kashmir. It provides free of cost insurance cover to all residents of Jammu and Kashmir up to Rs.5 Lakh per family on a floater basis to all residents. Prime Minister Narendra Modi launched the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT scheme in December, 2020.  The full form of SEHAT is social, endeavour for health, and telemedicine. The government is going to ensure smooth implementation of the Jammu Kashmir PMJAY SEHAT Health Scheme full in all regions and districts of Jammu and Kashmir.

 

It is the world’s largest health insurance/assurance scheme fully financed by the government, provides a cover of Rs 500,000 per family per year for secondary and tertiary care hospitalisation across public and private empanelled hospitals in India. The benefit of Rs 5,00,000 is on a family floater basis. This means it can be used by one or all members of the family. It covers medical procedures including oncology, cardiology, nephrology etc and up to three days of pre-hospitalisation and 15 days post-hospitalisation expenses like diagnostics and medicines are also included in the scheme.

 

The National Health Policy, 2017 has envisioned Health and Wellness Centres as the foundation of India’s health system. Under this 1.5 lakh centres will bring health care system closer to the homes of people. These centres will provide comprehensive health care, including for non-communicable diseases and maternal and child health services.  These centres will also provide free essential drugs and diagnostic services. The Budget has allocated Rs.1200 crore for this flagship programme. Contribution of private sector through CSR and philanthropic institutions in adopting these centres is also envisaged.

 

 

The State Health Agency has already started the Jammu and Kashmir Gold Card campaign to target registering of 97 lakh souls under the ‘Ayushman Bharat SEHAT Scheme’ launched by the Government of India which has revolutionized the health sector across Jammu and Kashmir. With this scheme, lakhs of poor people who can’t afford treatment at hospitals can now receive advanced treatment for their health conditions at all the empanelled hospitals across the country. According to official figures, more than 76,52,064 persons (78.74%) have been registered under this scheme in union territory of Jammu and Kashmir making them eligible for free and quality treatment in empanelled hospitals of the country and  among the 25,05,626 targeted families, 22,51,116 (89.84%) families with at least one family member are verified.

 

Notably, Shopian, Kulgam and Ganderbal districts have achieved 100 percent saturation under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) SEHAT scheme. These districts achieved the milestone due to continuous efforts by district administration and special registration drives organized by the State Health Agency (SHA) aimed to cover all families under AB-PMJAY SEHAT scheme. The AB PM-JAY SEHAT scheme is the world’s largest health insurance scheme fully financed by the government and provides a cover of Rs five lakh per family per year for secondary and tertiary care hospitalization.

 

Earlier, SHA rolled out ambitious door-to-door exercise to achieve 100 percent saturation under the Ayushman Bharat PMJAY SEHAT scheme. AB-PMJAY SEHAT Scheme has become a ray of hope for poor families who couldn’t afford health treatment at prestigious and well known medical institutes of the country. Under the initiative of ‘Gaon Gaon Ayushman, State Health Agency (SHA) has also started ’ to reach out to last mile villages which remain cut off from the rest of the world due to adverse weather conditions so as to percolate the benefits of the scheme down to every beneficiary.

 

The union territory administration has already directed the State Health Agency to put in extra efforts and ensure mobilization of left-out population within their respective jurisdictions with the assistance of concerned Store keepers/Fair Price Shop owners and Anganwari workers so that people are entitled to get the benefit of having Golden Card in the need of hour that provides free of cost Universal Health Insurance Coverage up to Rs 5 lakh per family on a floater basis in convergence with Central Government’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

 

So far as many as 5, 64,404 Golden Cards have been issued in Srinagar District covering 1, 67,538 families and process of registration under the scheme is going on and remaining beneficiaries shall be brought under the coverage within shortest possible time. Under the initiative of ‘Gaon Gaon Ayushman, State Health Agency (SHA) has also started’ to reach out to even last mile villages which remain cut from the rest of the world due to adverse weather conditions so as to percolate the benefits of the scheme down to every beneficiary.

 

Notably, to ensure hassle-free registration of all eligible beneficiaries under the scheme, the State Health Agency (SHA) has set up a network of more than 8000 Common Service Centres (CSCs) in Jammu and Kashmir. The VLE Centres are also being stationed in villages for ensuring 100 percent registration and awareness activities at the grassroots level in association with PRI representatives and ASHA workers.

 

A constant awareness campaign by the administration through various mediums including TV, radio and print and social media is already ongoing. The accessibility for the golden cards too has been simplified so that everyone gets it in his or her locality. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) SEHAT has crossed a major milestone of providing Rs five lakh free treatments to the citizens of J&K UT recently.

 

(The author is a regular columnist and can be mailed at m.hanief@gmail.com)

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