ABHA and Ayushman Bharat Yojana

What is ABHA?

Ayushman Bharat Health Accounts (ABHA) is a unique identification number system introduced by the
Indian Government to identify and manage the health records of individuals across multiple healthcare
systems. The ABHA number is a 14-digit number that is linked to the individual’s demographic
information and is used to manage their health records. ABHA aims to create a seamless and secure
digital ecosystem for healthcare delivery in India.

The Need to Link Health Records with ABHA

The recent data breaches and ransomware attacks on hospitals in India have highlighted the need for a
secure and unified digital health record system. In November 2022, one of the highest Health data
breaches occurred at AIIMS New Delhi, where millions of people’s health records were compromised.
Such incidents underscore the importance of implementing a robust system like ABHA to manage health
records and prevent such breaches.

Why did GoI Announce ABHA?

ABHA was introduced in 2020 by the central government in response to the challenges posed by the
COVID-19 pandemic. During the COVID lockdown, it was difficult for healthcare professionals to contact
people and provide them with information about vaccine administration. To address this challenge, the
central government introduced ABHA to ensure that healthcare providers could access health records
and identify individuals who needed vaccines.

What is Ayushman Bharat Digital Mission?

Ayushman Bharat Digital Mission (ABDM) was launched in September 2021 to connect various digital
health solutions used by hospitals across India. ABDM leverages ABHA numbers to create a common
platform that can be accessed by healthcare providers to manage health records.

The objective of ABDM is to simplify hospital-related processes, prevent the loss of medical records, and
increase the efficiency of healthcare services. This initiative aims to create a robust digital healthcare
ecosystem in India, which is accessible to everyone.

Online Registration for the Ayushman Bharat Yojana under the PMJAY Scheme

The eligibility criteria and registration process for Ayushman Bharat Yojana under the PMJAY scheme
can be completed online. In 2018, Our Prime Minister Narendra Modi launched the Pradhan Mantri Jan

Arogya Yojana (PMJAY), which is a National Health Protection Scheme funded by the Indian
Government. The Ayushman Bharat Yojana scheme, also known as AB-PMJAY, is a part of PMJAY and
has replaced the Senior Citizen Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojna
The AB-PMJAY scheme aims to provide healthcare coverage to not only poor but also rural families,
which makes it financially advantageous for disadvantaged households in both urban and rural areas.
The registration process for Ayushman Bharat Yojana under the PMJAY scheme can be completed
online, and there are specific eligibility criteria that need to be fulfilled for availing of the benefits of this

The Ayushman Bharat Yojana or PMJAY Scheme

The Ayushman Bharat Yojana, also known as the PMJAY scheme, is one of the largest healthcare
schemes sponsored by the Government of India. The scheme was launched by Prime Minister Narendra
Modi to provide healthcare coverage to over 50 crore Indian citizens, including nearly 10 crore
underprivileged families, with no restrictions on family size and age.

Coverage and Benefits

Under the Ayushman Bharat Yojana, each family can avail of insurance coverage of up to INR 5 lakh per
year for tertiary and secondary hospitalization expenses. The scheme is paperless and provides cashless
hospitalization cover at both public hospitals and network private hospitals. Additionally, the coverage
includes the cost of hospitalization, pre-hospitalization, medication, and post-hospitalization expenses for
almost all tertiary and secondary care procedures.

Coverage for Expensive Treatments

The Ayushman Bharat Yojana scheme covers nearly 1,400 expensive treatments, including skull surgery,
knee replacements, and other similar procedures. Patients can also follow up on their treatments to
ensure a full recovery.

Features of Ayushman Bharat Yojana Scheme

The Ayushman Bharat Yojana Scheme, also known as Pradhan Mantri Ayushman Bharat Yojana
(PMJAY), has several key features.
● It is a family floater scheme that provides a sum assured of Rs. 5 lakh per enrolled family.
● The scheme is designed for people below the poverty line who do not have access to the internet
or online health plans.
● PMJAY provides cashless healthcare services to its beneficiaries in any public sector or private
network hospital.
● The scheme covers transportation costs incurred by the beneficiary during the pre and post-
hospitalization period, as well as day-care expenses.
● Certain pre-existing diseases are also covered under the PMJAY scheme.
● Payment for medical expenses is based on predetermined package rates set by the government.
● The PMJAY scheme aims to establish numerous health and wellness centers based on the
Socio-Economic Caste Census data.

Benefits of Ayushman Bharat Yojana Scheme

The Ayushman Bharat Yojana Scheme provides significant benefits to almost 40% of vulnerable and
needy families in India. The healthcare services and advantages that they can receive are outlined below:
● The PMJAY treatment and healthcare facilities are available throughout India, and they are
provided free of cost.
● The Ayushman Bharat Scheme offers coverage for 25 specialty categories and encompasses a
broad range of 1,354 medical and surgical packages, such as neurosurgery and cardiology.
● The Ayushman Bharat Yojana scheme covers post-hospitalization expenses.
● If multiple surgeries are required, the cost of the most expensive package will be covered, and
the cost of the second and third surgeries will be covered at 50% and 25%, respectively.
● The scheme also covers the treatment cost of oncology with chemotherapy for 50 different types
of cancer. However, medical and surgical packages cannot be availed of simultaneously.
● The beneficiaries of the PMJAY scheme can also avail follow-up treatment coverage.

Author: Shirley