AB-PMJAY will be integrated with Rajasthan government’s existing health scheme — Bhamashah Swasthya Bima Yojana (BSBY).
“The National Health Authority has been constantly working closely with the Rajasthan government in finding ways to seamlessly integrate BSBY with AB-PMJAY. Rohit Singh, Additional Chief Secretary, Health, Rajasthan informed us about the approval for implementation of AB-PMJAY in the state," Indu Bhushan, CEO AB-PMJAY and National Health Authority (NHA) said. “The Centre will provide all policy related and technical support to the state."
Currently, Rajasthan provides benefits to 97 lakh families under the BSBY scheme, and many of the eligible families under AB-PMJAY plan are already covered under BSBY. All eligible families under BSBY and AB-PMJAY will be eligible to avail health benefits up to ₹5 lakh per year under the scheme.
As far as the technology-related aspects in rolling out the scheme are concerned, Rajasthan will continue the current software implementation, and systemic API-based integration with solution suite of NHA for benefits to be delivered under AB-PMJAY.
Rajasthan will run a package mapping exercise to ensure all packages specified under PM-JAY are mapped with those in BSBY. However, Rajasthan has complete flexibility to expand beyond the AB-PMJAY packages. NHA team will provide support for this activity to the state team, wherever required. For all hospitals registered under BSBY in Rajasthan, NHA would see that no duplicate process of re-registration is required.
AB-PMJAY provides a cover of up to ₹5 lakhs per family per year, for secondary and tertiary care hospitalisation to over 10.74 crore vulnerable entitled families (approximately 50 crore beneficiaries). PM-JAY provides cashless and paperless access to services for the beneficiary at the point of service. Under this scheme there are 1,393 health benefit packages with defined rates. Over 15,000 hospitals and health care providers have been empanelled across the country to provide healthcare services as per these packages.
Union minister of health and family welfare Harsh Vardhan recently wrote to the chief ministers of Delhi, Odisha, Telangana and West Bengal, urging them to join the AB-PMJAY. These states had, after major deliberations, refused to adopt the scheme under the previous central government.