- PM-JAY is the world’s largest health insurance scheme fully financed by the government.
- Launched in 2018, it offers a sum insured of Rs.5 lakh per family for secondary care and tertiary care.
- Health Benefit Packages covers surgery, medical and day care treatments, cost of medicines and diagnostics.
Beneficiaries
- It is an entitlement-based scheme that targets the beneficiaries as identified by latest Socio-Economic Caste Census (SECC) data.
- The National Health Authority (NHA) has provided flexibility to States/UTs to use non- Socio-Economic Caste Census (SECC) beneficiary family databases with similar socio-economic profiles for tagging against the leftover (unauthenticated) SECC families.
Funding
- The funding for the scheme is shared – 60:40 for all states and UTs with their own legislature.
- 90:10 in Northeast states and Jammu and Kashmir, Himachal and Uttarakhand and 100% Central funding for UTs without legislature.
Nodal Agency
- The National Health Authority (NHA) has been constituted as an autonomous entity under the Society Registration Act, 1860 for effective implementation of PM-JAY in alliance with state governments.
- The State Health Agency (SHA) is the apex body of the State Government responsible for the implementation of AB PM-JAY in the State.