The Odisha government on Monday signed a memorandum of understanding (MoU) with the National Health Authority (NHA) to implement Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in the state.
The Centre’s flagship health scheme will run in convergence with the state's Gopabandhu Jan Arogya Yojana (GJAY).
The combined initiative will provide healthcare coverage of Rs 5 lakh per family per annum, with additional Rs 5 lakh for women members.
The AB-PMJAY, launched in 2018, provides health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to around 550 million individuals, corresponding to 123.4 million families.
Whether households are covered or not depends on the deprivation and occupational criteria of the Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas, respectively.
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“In Odisha, the converged scheme is expected to cover around 10.3 million families, with 6.78 million of them being supported by the central government,” a senior official said.
Odisha Chief Minister Mohan Charan Majhi said people from the state, who were previously receiving treatment in around 900 empanelled hospitals under GJAY, will now have access to cashless and quality treatment in over 29,000 government and private-empanelled hospitals.
“The converged schemes will cumulatively benefit around 45 million people of Odisha with the help of a single card,” he added.
The scheme would also cover families of accredited social health activists (ASHA) and anganwadi workers in the state.
Implementation of the converged scheme will be looked after by the NHA and Odisha’s State Health Assurance Society (SHAS).
While the NHA’s remit includes providing operational guidelines, technical support and facilitating capacity building, SHAS’s work will revolve around card printing, distribution and empanelment of healthcare providers and hospitals.
The financing mix will remain in the existing sharing ratio of 60:40, as is there for states and union territories (UT) with legislature.
The signing of the MoU also makes Odisha the 34th state or UT to implement the health insurance scheme, with only West Bengal and Delhi not having come on board the PMJAY.
“The government is working with the remaining states and UTs to get them to join the scheme,” said a senior official from the health ministry.
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