Premium rates for PM-JAY to rise for first time since ’18

The marquee scheme provides a health coverage of ₹5 lakh per beneficiary family per year. Currently, the premium per family is ₹1,052 per year, which is shared between the Centre and state governments in a 60:40 ratio.

As part of the Centre’s share, NHA releases about ₹5,000-6,000 crore to states annually.

“Since the inception of the scheme in 2018, the premium has not been revised. In view of the high inflation during the period, higher scheme utilization and increased expenditure, states are asking NHA to upwardly revise the premium," said a person aware of the matter said.

“In this regard, a committee has been constituted comprising members from NHA and state health authorities to undertake the exercise of calculating per- family expenditure on the basis of a health cover of ₹5 lakh for beneficiary family per year," said the person.

Queries sent to the health ministry remained unanswered at press time.

AB PM-JAY has logged a 50 million hospital admissions so far, involving a financial commitment of ₹61,501 crore, the health ministry said on Wednesday.

The scheme is being implemented in all states and Union territories except Delhi, Odisha and West Bengal. Till date, 233 million beneficiaries have been verified and issued Ayushman cards for availing free treatment under the scheme.

The scheme offers policy holders 1,949 procedures under 27 different specialties.

More than 28,351 hospitals, including 12,824 private ones, have been empaneled under the scheme with most admissions taking place in corporate hospitals.

“During 2022-23, around 56% of the total admissions have been authorized in private hospitals," said the government official.