Jammu & Kashmir first in India to cover all residents with free health insurance

Jammu and Kashmir has become the first among Indian states and UTs to offer free health insurance to all its residents.

The universal health coverage plan rolls out today with Prime Minister Narendra Modi launching it in a virtual event.

The scheme called Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (AB-PMJAY) SEHAT will cover 21 lakh families of the UT providing universal health coverage to all. It will also cover government employees.

“The scheme will provide free of cost insurance cover to all the residents of the UT of Jammu and Kashmir. A financial cover up to Rs five lakh per family will be offered to all residents. The plan envisages extension of the already operational PM Jan Arogya Yojna to 15 lakh additional families to provide full financial protection,” JK administration officials said to media persons. The new scheme will operate on insurance mode in convergence with the already operational PM-JAY.

“The most important feature of the scheme is it would be portable across the country which means JK residents can avail of the free health insurance cover in any hospital empanelled under the National PMJAY scheme anywhere in India,” government sources said. There are at present 24,148 empanelled hospitals under PM JAY.

JK’s new expanded health protection scheme will ensure that all beneficiary families can avail of any of the 1,592 procedures offered by PMJAY. At least 219 hospitals, including 34 private hospitals, have been empanelled under AB-PMJAY for providing health services to the residents of Jammu and Kashmir. Medical procedures such as oncology, cardiology, nephrology, etc., will be included in the scheme. 

Sources said the registration for generation of golden cards for all the residents of JK UT under the new scheme had started on September 21 and 14 lakh beneficiaries have already been registered on the Beneficiary Identification System as of today.

JK’s Journey So Far

• 835 sub centres out of the targeted 1089 operationalized as health and wellness centres under the first component of Ayushman Bharat PMJAY

• Insurance coverage cards given to at least one member of 3.60 lakh families (60.30 pc of all beneficiary families) under the second component of PMJAY which gives Rs 5 lakh free hospitalization cover to poor families listed in the socio economic caste census

• 229 hospitals empanelled in JK under PM-JAY

• 12.54 lakh beneficiaries have been registered and 11.07 lakh given golden cards under PMJAY.

• Pre-authorization claims amounting to Rs 53.91 crore raised in respect of 97078 persons who availed of free hospital cover. Of these, 87,365 claims settled amounting to Rs 43.87 crore.

As far as the portability feature of AB-PMJAY is concerned, beneficiaries can avail the services from any of the 24,148 empanelled hospitals across India. 

AB-PMJAY is a flagship healthcare programme of the central government that provides a cover of up to Rs 5 lakh per family per year for secondary and tertiary care hospitalisation. It covers 10.74 crore poor and vulnerable families (roughly 53 crore beneficiaries). Launched in 2018, more than 1.5 crore beneficiaries have received medical treatment under the scheme so far.