With the Centre’s flagship health insurance scheme has been irregularities exposed by the Comptroller and Auditor-General this week, the Health Ministry defended the scheme, saying that mobile numbers did not play any role in the verification of its beneficiaries.

The CAG’s performance audit report, tabled in the Lok Sabha on Monday, noted multiple cases of the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY) providing treatment for patients With the Centre’s flagship health insurance scheme has been irregularities exposed by the Comptroller and Auditor-General this week, the Health Ministry defended the scheme, saying that mobile numbers did not play any role in the verification of its beneficiaries.

who had been declared dead, as well as for thousands of people using the same Aadhaar or invalid mobile phone number.

Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a flagship health insurance scheme launched by the Government of India.

It is also known as the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

The scheme was announced in September 2018 and officially launched on September 23, 2018.

PM-JAY aims to provide health insurance coverage to economically vulnerable families in India to help them access quality medical care without facing financial hardships.

Coverage: PM-JAY provides health insurance coverage of up to INR 5 lakh per family per year for secondary and tertiary care hospitalization. Beneficiary families are identified based on the Socio-Economic Caste Census (SECC) database.

Cashless Treatment: Beneficiaries can avail of cashless medical treatment in empanelled public and private hospitals across India. This includes a wide range of medical and surgical procedures, including diagnostics, consultations, surgeries, and medications.

Beneficiaries: PM-JAY covers over 10 crore vulnerable and economically disadvantaged families, which roughly translates to around 50 crore individuals. This includes both rural and urban populations.

Portability: Beneficiaries can avail of the scheme's benefits across the country, irrespective of their place of origin. This is particularly beneficial for individuals who need medical care while away from their hometowns.

Empanelled Hospitals: The scheme has a network of empanelled hospitals, both public and private, where beneficiaries can receive treatment. These hospitals are required to meet certain quality standards to participate in the scheme.

Digital Platform: PM-JAY has a digital platform that allows beneficiaries to verify their eligibility, access information about the scheme, and track their medical treatment and claims.

No Cap on Family Size: Unlike some other health insurance schemes, PM-JAY does not impose any restrictions on the family size that can be covered under the policy.

PM-JAY is a significant step towards making healthcare services more accessible to the economically vulnerable population in India. It aims to alleviate the financial burden on families by providing them with health insurance coverage for major medical expenses. The scheme also has the potential to improve health outcomes and reduce the overall out-of-pocket expenditure on healthcare.