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The government has approved the launch of a new Centrally Sponsored Ayushman Bharat -National Health Protection Mission (AB-NHPM) under Ayushman Bharat Mission anchored in the MoHFW.
1) The scheme will have a defined benefit cover of Rs. 5 lakh per family per year, to cover almost all secondary care and most of tertiary care procedures.
2) Pre and post Hospitalization expenses and transport allowance per hospitalization is also covered under the scheme.
3) A beneficiary, covered under the scheme can take cashless benefits from any public and empanelled private hospital across the country.
4) The scheme will be an entitlement based scheme with entitlement decided on the basis of deprivation criteria in the SECC database. For urban areas, 11 defined occupational categories are entitled under the scheme.
5) States will be free to choose the modalities for implementation. They can implement through insurance company or directly through Trust/ Society or a mixed model.
6) The scheme also proposes "Ayushman Bharat National Health Protection Mission Council" (AB-NHPMC) at apex level Chaired by Union Health and Family Welfare Minister, to fooster coordination between center and states.
7) The scheme also proposes to have an "Ayushman Bharat National Health Protection Mission Governing Board (AB-NHPMGB)" which will be jointly chaired by Secretary (HFW) and Member (Health), NITI Aayog.
8) The scheme also proposes to establish an "Ayushman Bharat - National Health Protection Mission Agency (AB-NHPMA)" to manage the AB-NHPM at the operational level in the form of a Society. AB-NHPMA will be headed by a full time CEO of the level of Secretary/ Additional Secretary to the Government of India.
9) States needs to choose from existing "Trust / Society / Not for Profit Company/ State Nodal Agency" or create a new one to act as "State Health Agency (SHA)" to implement the scheme.