Source: TOI
Context: At the National Health Authority (NHA) Conclave 2025 held in Bhopal, Chhattisgarh was awarded as the best-performing state in implementing the Pradhan Mantri Jan Arogya Yojana (PM-JAY) for achieving near-zero claim pendency.
About Pradhan Mantri Jan Arogya Yojana (PM-JAY):
- What it is?
- PM-JAY, a component of Ayushman Bharat, is the world’s largest government-funded health assurance scheme, providing free secondary and tertiary healthcare to India’s poorest families.
- Launch: Launched on 23rd September 2018 in Ranchi, Jharkhand.
- 2025 Best State Implementation: Chhattisgarh topped national rankings with 97% empanelled hospitals active, 32,000+ audits for fraud control.
- Aim:
- To provide cashless and paperless access to quality healthcare for 12 crore vulnerable families (≈55 crore people) covering the bottom 40% of the Indian population, and to prevent catastrophic medical expenditure that pushes millions into poverty annually.
- Key Features:
- ₹5 lakh annual health cover per family on a family floater basis (no limit on family size, age, or gender).
- Cashless treatment across public and private empanelled hospitals nationwide.
- Covers 1,929 medical procedures, including diagnostics, surgery, implants, ICU, and medicines.
- Includes 3 days of pre-hospitalisation and 15 days of post-hospitalisation care.
- Portability: Benefits can be availed in any empanelled hospital across India.
- Pre-existing diseases covered from day one.
- Fully funded by Government — cost shared between Centre and States.
- PM-JAY Beneficiaries:
- Eligibility under PM-JAY is primarily based on SECC-2011 data, expanded to include senior citizens aged 70+ years.
