National Health Protection Scheme (NHPS): A Game Changer for Affordable Healthcare in India

India’s public healthcare landscape took a transformative step with the introduction of the National Health Protection Scheme (NHPS), announced in Budget 2018-19. Now operating as Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY), this scheme is the world’s largest government-funded health insurance program, ensuring financial protection and medical access to millions of Indians.

Scheme Overview

Attribute	Details
Scheme Name	National Health Protection Scheme (NHPS) 2018
Also Known As	Ayushman Bharat PM-JAY
Announced In	Union Budget 2018-19
Launched By	Government of India
Coverage Amount	₹5 Lakh per family per year
Beneficiaries	Over 10 crore poor and vulnerable families
Estimated Beneficiaries	~50 crore individuals
Funding Model	60:40 cost-sharing between Centre and States

What Is the NHPS?

The National Health Protection Scheme (now PM-JAY) is a cashless, paperless health insurance program funded entirely by the government. It covers hospitalization expenses—both secondary and tertiary care—through a network of empanelled public and private hospitals.

Cashless Coverage: Beneficiaries do not need to pay upfront for treatment.

What Treatments Are Covered?

Secondary Care:

Includes outpatient procedures, short hospital stays, and treatments from specialists like:

●       Dermatologists

●       Cardiologists

●       Urologists

Tertiary Care:

Involves advanced and specialized procedures such as:

●       Cardiac surgeries

●       Burn treatment

●       Organ transplants

●       Plastic and reconstructive surgeries

Why NHPS Was Needed

According to NSSO data, over 65% of healthcare expenses in India are paid out-of-pocket, pushing millions into poverty. NHPS was designed to address:

●       Rising medical costs

●       Lack of insurance among the poor

●       Inadequate access to quality healthcare in rural areas

Related Government Health Insurance Schemes

1. Rashtriya Swasthya Bima Yojana (RSBY)

Replaced by PM-JAY; provided ₹30,000 coverage for BPL families.

2. Employees’ State Insurance Scheme (ESIC)

Covers salaried employees with comprehensive medical and cash benefits.

3. Central Government Health Scheme (CGHS)

Health services for central government employees and pensioners via Allopathy, Ayurveda, Homeopathy, and Unani.

4. Aam Aadmi Bima Yojana (AABY)

Covers rural landless households with life and accidental insurance, including education scholarships for children.

5. Universal Health Insurance Scheme (UHIS)

Implemented through public insurers, offering hospitalization coverage to both BPL and APL families.

Benefits of NHPS / Ayushman Bharat PM-JAY

●       ₹5 Lakh annual coverage per family

●       No premium or co-payment required

●       Nationwide portability of benefits

●       Access to over 25,000 empanelled hospitals

●       Digitally verifiable beneficiary identity

●       Enhanced healthcare access in Tier 2 & 3 cities

The National Health Protection Scheme marks a historic step toward universal health coverage in India, bridging the gap between economic vulnerability and access to quality healthcare. For families previously burdened by medical debt, NHPS (PM-JAY) offers hope, dignity, and better health outcomes.