Pradhan Mantri Jan Arogya Yojana has provided over Rs 1.1 crore in free hospitalization benefits to beneficiaries since its launch in September 2018, significantly increasing access to healthcare for India’s most vulnerable populations. According to official data, 79 million people have benefited from the PM-JAY scheme, which provides an annual health cover of Rs 5 lakh. The scheme was made available to 107 million poor households in the country since September 2018, covering the poorest 40% of India’s population.
PM-JAY can help reduce out-of-pocket healthcare expenses, which had previously pushed millions of people into poverty. At the start of the scheme, around 62% of healthcare costs were paid directly by individuals, leaving many people in financial difficulties. The states with the highest number of beneficiaries include Tamil Nadu, Karnataka, Rajasthan, Kerala, Andhra Pradesh and Gujarat.
Under PMJAY, around 2,000 procedures are available for beneficiaries to get cashless treatment, covering all treatment-related costs, medicines, supplies, diagnostic services, doctor fees, room charges, surgeon charges, OT charges and ICU, etc. They are included. The main specialized care treatments received so far by beneficiaries are general medicine, infectious diseases, general surgery, medical oncology, ophthalmology and orthopedics. The procedures people received included hemodialysis, COVID-19 testing, multipacks, and acute febrile illness.
More than 355.40 million Ayushman cards have been issued to eligible people, helping them receive healthcare at 30,672 public and private hospitals. Recognizing the impact of high medical bills on financial stability, the Parliamentary Standing Committee on Finance has recommended extending PM-JAY to cover the “missing middle” in payments. Recently, the plan was expanded to include people over 70, regardless of income.
A NITI Aayog report from October 2021 noted that 30% of India’s population, about 400 million people, still lack health coverage. This class is called the “missing middle class,” which remains vulnerable without financial security for health-related expenses.
