- erstwhile National Health Protection Scheme
- largest health assurance scheme in world
- beneficiaries:
- identified thru SECC 2011
- families covered under Rashtriya Swasthya Bima Yojna
- all snr citizen > 70 age
- Ayushman Bhava Campaign: saturate coverage of health services thru 3 components
Why important
- financial protection, OOPE, insurance
- helps the poorest segment of society
- digital, transparency
- boost to economy & employment
- improved access to healthcare
Challenges
- limited coverage: high cost procedures, non hospitalization needs
- insufficient hospital participation due to low reimbursement rates
- fraud & misuse: ghost beneficiaries, fake claims
- awareness & implementation gaps
- financial sustainability
- poor quality of care
- delays in reimbursement & claim settlement