BHUBANESWAR: Amid challenges for smooth integration of state-funded Gopabandhu Jan Arogya Yojana (GJAY) with the national health scheme, the Odisha government is gearing up to roll out Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) next week.
The much-awaited national health coverage scheme, initially planned to be launched in the state on the occasion of Odisha Divas, has been rescheduled owing to the proposed visit of Union minister of Health and Family Welfare JP Nadda to the state on April 11 and 12. Odisha will be 34th state to implement the scheme.
As many as 3.52 crore people from 1.08 crore families will be covered under the combined schemes, likely to be named as AB-GJAY. As per the eligibility criteria, around 67.8 lakh families will be covered under AB-PMJAY and the state government will cover the remaining beneficiaries under GJAY.
While the GJAY is a trust-based health assurance scheme with additional coverage of Rs 5 lakh for women beneficiaries, the other is an insurance model having equal annual coverage limit of Rs 5 lakh for both men and women.
The process for integration of both the schemes is in the final stages. TCS, the software developing agency, has been asked to tweak its previously made interfaces in the billing and claims sections for easier accessibility by both the hospitals and monitoring agencies.
A major hurdle in the seamless integration of the two schemes was identifying and categorising beneficiaries between AB-PMJAY and GJAY without duplication or omission, and finalising healthcare packages besides issuing a single health card to beneficiaries of two schemes having different eligibility criteria and coverage limits.
As per the finalised modalities, the state would pay for the beneficiaries and packages of those are not covered under AB-PMJAY. Unlike the previously-run Biju Swasthya Kalyan Yojana (BSKY), now renamed as GJAY, the state government would provide a health card to every individual covered under the combined schemes for better functionality. Elderly persons above 70 years will also get a separate card under Ayushman Vay Vandana scheme.
“Earlier each family had received two cards - one for men and another for women. Now, all 3.52 crore beneficiaries will get a card each. So far 1.5 crore cards have been kept ready for distribution and every day one lakh cards are being prepared. The government is spending more than `350 crore for the cards,” said the sources.
Health officials said beneficiaries will not be deprived of health coverage due to delay in distribution of cards. Their Aadhaar numbers have been linked to the scheme and they will get the coverage once they produce their Aadhaar card at the empanelled hospital after the rollout. A team of IT professionals has been engaged to resolve the issues, if any, they said.