Why is it in the news?
NITI Aayog study revealed high out-of-pocket expenditure despite coverage.
It highlights gaps in financial protection under the scheme.
Category: Social Issues
Important Points:
● Average OOPE in private hospitals is ₹53,965 per hospitalization
● In public hospitals OOPE is ₹21,827
● Around 65% beneficiaries still incur expenses
● Major costs include medicines, diagnostics and transport
● Provides ₹5 lakh health cover per family annually
● Covers only secondary and tertiary hospitalization
● Implemented by National Health Authority
● Based on SECC 2011 data for beneficiary identification
● Expanded to cover all citizens aged 70+ years