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Transgender persons now covered under Ayushman Bharat's Health Benefit Package

Transgender persons now covered under Ayushman Bharat's Health Benefit Package

The health cover will include medical support and medical intervention for transgender persons.

Pradhan Mantri Jan Arogya Yojana (PM-JAY) gives a medical cover of Rs 5 lakh per family per year for free treatment at all public and empanelled private hospitals for 53 crore beneficiaries. Photo: Reuters Pradhan Mantri Jan Arogya Yojana (PM-JAY) gives a medical cover of Rs 5 lakh per family per year for free treatment at all public and empanelled private hospitals for 53 crore beneficiaries. Photo: Reuters

In a first of its kind move, Ayushman Bharat, the health insurance scheme, will now offer a healthcare cover to transgender people and support sex-change operations. The addition is part of the National Health Authority's (NHA) revised Health Benefits Package, or HBP 2.2.

Under the revised HBP 2.2, rates of health packages have been increased by 20 per cent to 400 per cent. Rates have been revised for radiation oncology procedures, management procedures for dengue, acute febrile illness, black fungus, heart catheterisation, PDA closure, arthrodesis, cholecystectomy, and appendectomy. Rates for ICU with ventilator are revised by 100 per cent, ICU without ventilator by 136 per cent, HDU by 22 per cent while prices for routine ward changed by 17 per cent.  

Pradhan Mantri Jan Arogya Yojana (PM-JAY) gives a medical cover of Rs 5 lakh per family per year for free treatment at all public and empanelled private hospitals for 53 crore beneficiaries. This benefit will now be extended to transgender people under the government's new scheme, Support for Marginalised Individuals for Livelihood and Enterprise (SMILE). The health cover will include medical support and medical intervention for transgender persons.

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"I am glad that the revised version of Health Benefits Packages (HBP 2.2) will strengthen the empanelled hospitals to provide better healthcare services to the beneficiaries under Ayushman Bharat PM-JAY. New packages have been added to cover more disease conditions and regular rates of the packages are being revised to provide better healthcare services. State Health Agencies (SHAs) currently implementing any of the previous versions of HBP can now accept and implement the latest version of HBP 2.2," said Mansukh Mandaviya, Union Minister of Health and Family Welfare.

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HBPs are designed to cover diseases with high incidence/prevalence rates and those that contribute to maximum Out of Pocket (OOP) expenditure. It defines the scope of healthcare services being provided and the extent of financial risk protection to the beneficiaries.

Currently, Ayushman Bharat PM-JAY has 1669 treatment procedures, 1080 are surgical, and 588 medical. In 2018, Ayushman Bharat PM-JAY was launched with HBP 1.0 with a total of 1,393 packages. Since the scheme's inception, more than 2.2 crore eligible AB-PMJAY beneficiaries have been provided with health coverage for secondary, tertiary, and daycare procedures through 24,000 empanelled Health Care Providers (EHCP). The HBP 2.2 is expected to be rolled out from November, 2021.

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