Context:
The Government of Odisha has recently unveiled a comprehensive health insurance initiative by integrating the Centre’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) with the state-specific Gopabandhu Jan Arogya Yojana (GJAY). This unified scheme is designed to expand access to quality healthcare across the state, addressing long-standing gaps in coverage.
Key features of the scheme:
· The unified health insurance scheme is expected to benefit approximately 3.5 crore residents from over 1.03 crore families in Odisha.
o Each family is entitled to ₹5 lakh in annual health coverage. To address gender disparities in healthcare access, additional ₹5 lakh coverage is provided for women beneficiaries in each family.
· Senior Citizen Provisions: A key feature of the scheme is the Ayushman Vayo-Vandana Card, offering ₹5 lakh in annual coverage to all citizens aged 70 years and above, regardless of income or social status. Families that include at least one senior citizen will be eligible for a total annual health coverage of ₹15 lakh.
· Cashless Treatment Facilities:The unified scheme significantly expands access to medical services. Beneficiaries can now avail of cashless treatment at over 29,000 empanelled hospitals across India, up from only 900 hospitals under the earlier state-only scheme. This enhancement ensures greater geographic coverage and improved service delivery.
· Financial Allocation: To support the implementation and sustainability of the scheme, the Odisha Cabinet has approved a financial outlay of ₹27,019 crore over five years. This budget will fund both the central and state components of the programme, ensuring its long-term viability.
About Ayushman Bharat scheme:
Ayushman Bharat, the Government of India’s flagship health scheme, recently marked 1.5 crore treatments and completed two years of operation. Launched under the National Health Policy 2017, Ayushman Bharat comprises two components:
1. Health and Wellness Centres (HWCs) – aimed at upgrading 1.5 lakh primary health centres to offer comprehensive care, including child and maternal health, NCDs, and diagnostics.
2. Pradhan Mantri Jan Arogya Yojana (PM-JAY) – launched in 2018, offers ₹5 lakh annual health coverage per family, based on SECC 2011 (Socio Economic and Caste Census 2011) data, making it the world’s largest health insurance scheme.
About Gopabandhu Jan Arogya Yojana:
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.
Conclusion
The unified health insurance scheme represents an administrative effort to streamline healthcare coverage and enhance service delivery in Odisha. By integrating state and central schemes, the initiative seeks to provide comprehensive, accessible, and financially supported healthcare for a large section of the population
