SRINAGAR: The SEHAT cardholders in Jammu and Kashmir have availed medical benefits worth Rs 86 crore in the first six months of the launch of the scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). It is the world’s largest health insurance scheme fully financed by the government, an official spokesman said.
So far, the cashless treatment has been availed by 86000 cardholders. Chief Executive Officer, State Health Agency (SHA) J&K, Dr. Doifode Sagar Dattatray informed that out of 70000 claims worth Rs 75 crore submitted by empanelled hospitals, 50000 claims worth Rs 40 crore have been paid to date.
“We are introducing several innovations in the ecosystem of the scheme like the implementation of Standard Treatment Guidelines, Establishment of District Implementation Units (DIUs), reforms in the functioning of Pradhan Mantri Arogya Mitras, a real time-based monitoring system for Insurance Company and Empanelled Hospitals, strengthening of supply-side and introduction of smart Ayushman Cards to further streamline these schemes so that residents may avail free, cashless and hassle-free benefits from reputed empanelled hospitals across the country”, Dattatray was quoted saying.
The scheme was launched on December 26, 2020, aims to provide Universal Health Insurance Coverage of Rs 5.00 lakh per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India on a floater basis. AB PM-JAY SEHAT has the same benefits as available under AB-PMJAY. This scheme covers all residents of Jammu and Kashmir including employees and pensioners of the Government of Jammu and Kashmir and their families.
The scheme covers up to three days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines. Benefits of the scheme are portable across the country i.e. a beneficiary can visit any of the more than 24000 empanelled public or private hospitals including 218 hospitals empanelled within Jammu and Kashmir under AB PM-JAY in India to avail cashless treatment.