Universal Health Coverage: What is It and Why is It Important?

Universal Health Coverage (UHC) is based on the WHO Constitution, 1948 [1]. It aims to ensure that everyone receives proper health care without financial burden. This will protect people from worrying about of paying for health services. It will also reduce the risk of people driven to poverty because of unexpected medical bills.

To achieve its commitment of Sustainable Development Goals, India aims to achieve universal health care by 2030. Taking a step towards this, the launch of Ayushman Bharat (PMJAY) took place. It was to ensure that all people have access to quality health services. This initiative secures 40% of the poorest population of India, roughly 5 crores [2]. It offers an insurance cover of Rs.5 lakh per family. PMJAY provides comprehensive cover for tertiary and secondary care. 

Read to know why universal health coverage is important, and what the different schemes launched as a part of it in India are all about.

Understanding why universal health coverage is important

Principles that guide UHC in India

Following are the main principles that guide universal health coverage in India.

• Equity and universality
• Non-discrimination and non-exclusive
• Financial protection
• Rational and good quality comprehensive care
• Transparency and accountability
• Patient’s rights protection
• Community participation
• Strengthened and consolidated provisioning of public health
• Putting health in the hands of people

Ayushman Bharat (Pradhan Mantri Jan Arogya Yojana)

The launch of PMJAY was a step towards achieving universal health coverage. Providing financial protection during hospitalization is the driving force of PMJAY. On average, the cost of a hospitalization is Rs.20,000. This is higher than the average consumer expenses of half of the nation's population [3]. To avert this, PMJAY aims to provide cover to the vulnerable people of the nation. Now it caters to a large part of the nation’s population and gives them healthcare coverage. PMJAY also aims to transform health centers into health and wellness centers. This is to offer comprehensive and quality care. PMJAY has laid the foundation for modern IT platform in health sector. The other beneficial factors of PMJAY include the following.

• Prioritizing senior citizens and women of the nation
• Availability of medical treatment from all secondary and tertiary hospitals
• Cover for pre-existing diseases, and other health conditions
• A wide range of medical and surgical packages

Ayushman Bharat aims at providing cover to 10 crore families that are in low middle-income group. The scheme, however, has pre-conditions which decide the eligibility of the proposer. It will provide support depending on the data in Socio Economic Caste Census of 2011.

You can check your eligibility for PMJAY by visiting the official website. After clicking the ‘Am I Eligible’ option, you will have to put in the required details. After this, you will receive an OTP. After submitting the OTP, you will have to put in your state of residence and search. You will receive a list of names that fall under this category. If you are eligible for this, your name will appear in the list. If it does not, it means you are not eligible for the benefits of PMJAY.

Universal health insurance scheme

Universal health insurance scheme came into place for improved access to health care. It offers to reimburse medical expenses of up to Rs.30,000 for the entire family. It also offers death cover of up to Rs.25,000 if caused by an accident. Apart from this it provides cover of Rs. 50 per day for 15 days in case the earning member faces a loss of earning. Earlier, UHIS was available to both, people below poverty line and people above poverty line. It is now available to only those people that are below poverty line. There is also an increase in the premium subsidy to Rs.200 for individual, Rs.300 for family of 5, and Rs.400 for family of 7. 

For eligibility under universal health insurance scheme, talk to your insurance provider. You can apply for this scheme by providing a BPL certificate.

Now that you understand what is universal health coverage and insurance schemes launched for universal health cover in India, make sure that you have covered your healthcare expenses with a health policy. Check out the Aarogya Care plans available on Bajaj Finserv Health. These plans offer a comprehensive cover at affordable premiums. With some of these plans you can cover up to 6 members of your family. You also get other benefits such as doctor consultations and preventive health check-ups. Secure your and your loved ones’ health with premiums that don’t strain your finances!