Only 25% Beneficiaries Enrolled in Ayushman Bharat Yojana: Report

Lack of Awareness Responsible for Low Penetration of Health Insurance in India

According to the report titled ‘Health Insurance Vision 2025’, about two-thirds of the households eligible under the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY) have not enrolled under the health insurance scheme. Households whose names are listed in the Socio-Economic Caste Census 2011 and who have an active Rashtriya Swasthiya Bima Yojana (RSBY) card are eligible to enrol for the scheme.

The report has also stated that about 59% of the households in India are without any health insurance coverage. In the case of less than Rs 5 lakh segment, about 74% of the people do not have health insurance.

Low awareness of health insurance among people is cited as one of the biggest reasons for low takers of health insurance plans in India, including Ayushman Bharat Yojana. A major section of people staying in tier 2 and tier 3 cities are not aware of health insurance. About 66% of the respondents in the survey conducted by CII and BCG, who were eligible for the PMJAY scheme, were unaware of health insurance.

The penetration of health insurance in tier 3 cities are lower as compared to tier 2 cities, the report said. Fewer branches of health insurance companies and a weaker presence of insurance agents in these cities are the major reasons for low health insurance penetration. Besides, most insurance companies do not provide coverage for all medical expenses, such as OPD expenses that account for 45% of the total healthcare expenses incurred.

The CEO of the National Health Authority (NHA), Dr RS Sharma, said that they are currently working towards creating awareness among the beneficiaries of Ayushman Bharat Yojana and ensuring consistency between the rates offered by the private sector and the market rate. They have also been working to ensure quick turnaround time and timely payment to the hospitals.

The NHA implements Ayushman Bharat Yojana in the country.