Eligible Ayushman Bharat-PMJAY beneficiaries can now get financial assistance up to Rs 15 lakh at government-run super speciality hospitals, as per the Ministry of Health and Family Welfare, the National Health Authority NHA said today. The financial assistance up to Rs 15 lakh will be available under the umbrella scheme of Rashtriya Aarogya Nidhi (RAN) for treatment of certain rare diseases not covered under AB-PMJAY.
RAN has been set up by the government to provide assistance to poor patients living below the threshold poverty line and suffering from life-threatening diseases relating to the heart, kidney, liver etc. for their treatment at Government hospitals/institutes having super speciality facilities.
In an Office Memorandum dated January 31, the Department of Health and Family Welfare said, "If as per the medical advice, the suggested treatment is not covered under any of the approved listed packages of AB-PMJAY, financial assistance up to Rs 15 lakh can be provided to AB-PMJAY beneficiaries, out of Umbrella Scheme of RAN."
"In such a situation beneficiary will get certified from the respective Government hospital that the condition is not covered under AB-PMJAY, which may be attached with the RAN application," it added.
As per the OM, the financial assistance under the Umbrella scheme of RAN will be subject to the "usual conditions" of the RAN scheme. These include:
- Financial assistance will be provided to poor patients living below State/UT-wise threshold poverty line notified from time to time. Financial Assistance shall be admissible for treatment of diseases covered under the Umbrella Scheme of RAN.
- Patients will be provided financial assistance for their treatment at Government hospitals having super speciality facilities. Those having treatment in private hospitals will not be eligible for financial assistance under the scheme.
- The financial assistance to eligible patients will be in the form of ‘one-time grant’.
- Government servants and their families will not be eligible.
- There will be no reimbursement of the expenditure already incurred.
- The request for financial assistance will have to be submitted in a prescribed format.
Submission of application
The application shall have to be submitted along with:
– Income certificate (in original) of the patient/parents/other major earning members of the family, indicating income from all sources, duly certified by the Block/Mandal Development Officer/Tehsildar/SDB/Administration/Special Officer of Municipal Boards/District Officer.
A copy of the entire ration card along with its cover page, with details of all the family members, issued by the Food and Civil Supplies Department of the State/UT Government duly self-attested.
The financial assistance under RAN will not be an entitlement and it will be subject to a ceiling of budgetary allocation.
Hospitals to which funds will be released will have to submit utilization certificate for the same.
Diseases for which Rs 15 lakh assistance can be sought
The patients suffering from following rare diseases and eligible for AB-PMJAY will be eligible for financial assistance under the Umbrella Scheme of RAN for packages not covered under AB-PMJAY.