• Transgender persons will now get composite health care services under the Ayushman Bharat-PMJAY with a MoU being signed between the National Health Authority and the Department of Social Justice and Empowerment.

• The MoU will extend all healthcare benefits to transgender persons (holding a transgender certificate issued by the national portal for transgender persons) across the country.

• The ministry of social justice and empowerment (MOSJE) will fund Rs 5 lakh insurance cover per transgender beneficiary per annum. 

• A comprehensive package is being prepared for transgender category including the existing AB-PMJAY packages and specific packages like Sex Reassignment Surgery (SRS) and treatment for transgenders.

• They will be eligible to seek treatment in any of the AB-PMJAY empanelled hospitals across the country, where specific packages are available. The scheme would cover all transgender persons not receiving such benefits from other centre/state sponsored schemes.

Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)

• Over the past few decades there has been improvement in various health indicators of lndia. However, the out-of-pocket expenditure, which pushes millions of people into poverty every year. 

• In order to address this and provide health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to poor and vulnerable section of the population, Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) was launched, subsuming the erstwhile Rashtriya Swasthya Bima Yojana, on September 23, 2018. 

• The scheme aims to improve affordability, accessibility, and quality of care for the poor and vulnerable section of the population.

• Around 10.74 crore poor and vulnerable families (approximately 50 crore individuals) are entitled under AB-PMJAY for cashless and paperless access to services at the point of service — empanelled hospitals. 

• This health cover includes three days of pre-hospitalisation and 15 days of post hospitalisation expenses. There is no cap on family size, age or gender to ensure that all members of the beneficiary families are covered. Also, benefits are portable across the country.

• The funding of the scheme is shared between central and state governments. The ratio of central share to state share for all states except northeast states and Himalayan states and Union Territories with legislature, is 60:40. For northeast states and Himalayan states, the ratio is 90:10. In the case of Union Territories without legislatures, the central contribution of premium is 100 per cent.

Manorama Yearbook app is now available on Google Play Store and iOS App Store