No panel formed to cover 70 plus citizens under Ayushman Bharat: Govt

No expert committee has been set up for extending health benefits to cover citizens aged 70 and above under Ayushman Bharat, Union Minister of State for Health Prataprao Jadhav told the Lok Sabha on Friday.

He was responding to a question on whether the government proposed to cover citizens aged 70 and above by expanding Ayushman Bharat through the launch of a national health claims exchange and if an expert panel had been set up to strengthen the format of the scheme for the planned expansion.

Jadhav, in a written reply, said all members of eligible families, irrespective of age, were covered under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana.

 

The scheme provides health insurance cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to 55 crore individuals, corresponding to 12.34 crore families, he said.

"No expert committee has been set up for extending the health benefits to cover senior citizens aged 70 and above," he stated.

Responding to another question, Jadhav said 34 insurers and third-party administrators were live and approximately 300 hospitals ramping up to start sending their claims on the National Health Claims Exchange (NHCX), which aims to streamline and fasten health insurance claim processing, as on July 21.

Jadhav said the government built the NHCX gateway under the Ayushman Bharat Digital Mission.

It aims to streamline and standardise health insurance claim processing, enhance efficiency in the insurance industry and improve patient experience.

It serves as a gateway for exchanging health claim information among insurers, third party audit, healthcare providers, beneficiaries and other relevant entities and ensures interoperability, machine-readability, auditability and verifiability, making the information exchange accurate and trustworthy, the minister said.

This system will enhance efficiency and transparency in the insurance industry, benefiting policyholders and patients, he added.

Supported by the Insurance Regulatory and Development Authority of India and the General Insurance Council, the NHCX will enable standardised and faster health insurance claim processing, Jadhav said.