Based on the Nationwide Well being Authority (NHA)’s annual report for 2024-25, girls account for 49 per cent of the overall hospitalizations below the federal government’s flagship medical health insurance scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). This exhibits that girls’s entry to institutional care has improved, the report mentioned.
Probably the most utilized remedy was hemodialysis (14%), adopted by a number of packages (7%). Remedy of acute febrile sicknesses (4%); acute gastroenteritis, cataracts and associated procedures (3%).
Launched in 2018, AB-PMJAY is among the largest well being assure schemes on this planet and goals to offer medical cowl of Rs 500,000 per household per yr. Odisha and Delhi lately joined in implementing this scheme.
At present, 35 states and union territories, excluding West Bengal, come below AB-PMJAY. As of March 31, 2025, AB-PMJAY has lined 15.14 billion eligible households, with one other 8.57 billion households below state-specific schemes, the report mentioned.
“Thus far, over Rs 9,193 crore hospitalizations have been facilitated below AB-PMJAY, therapies value Rs 1,29,386 crore have been accomplished, 31,005 hospitals have been strengthened and nationwide entry (55% public and 45% non-public) has been ensured,” the report mentioned.
It added that below the nationwide Ayushman card saturation drive, over 40.45 billion playing cards have been issued overlaying 14.69 billion households. The ‘Aapke Dwar Ayushman’ (ADA 3.0) initiative enabled advocacy via a technology-driven community-based self-registration marketing campaign, empowering residents on the grassroots.
To additional promote inclusivity, the Interim Funds 2023 introduced the inclusion of 37 million frontline employees, together with Accredited Social Well being Activists (ASHA), Anganwadi Staff and Anganwadi Helpers, below AB-PMJAY.
In October 2024, the Union Cupboard permitted the enlargement of AB-PMJAY to cowl all residents aged 70 years and above, regardless of revenue or socio-economic standing.
Whereas public hospitals proceed to play an essential position in rural and low-income areas, non-public amenities dominate costly care in some areas, reminiscent of oncology, cardiology, and orthopedics.
Personal hospital participation continues to extend, with empanelment growing by 12% in 2024-25, in line with the NHA.
The federal government’s efforts to combine healthcare supply via the Ayushman Bharat Digital Mission (ABDM) are additionally altering the way in which hospitals handle affected person information and claims, the report mentioned. By March 2025, over 61.8 million Ayushman Bharat Well being Accounts (ABHA) had been created and 340,000 healthcare amenities and 170,000 professionals have been registered on the platform.
“The combination of AB-PMJAY and ABDM has enabled paperless, cashless and interoperable healthcare supply,” the report mentioned, highlighting that the digital ecosystem is dashing up claims settlement and decreasing fraud.
The NHA warned that the long-term sustainability of the scheme would rely upon common funding, quicker claims decision and constant participation from non-public hospitals in all areas. With a number of state medical health insurance packages being merged into AB-PMJAY, the overall expenditure is anticipated to be over Rs 20,000 billion in FY 2024-25.
issued – October 18, 2025 6:36 PM IST
