Gujarat leads in timely claim settlement under Ayushman Bharat scheme

Gandhinagar, Dec 18 (LatestNewsX) Gujarat has emerged as the top-performing state in the country in terms of claim payments to beneficiaries under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana-Mukhyamantri Amrutum (AB PMJAY–MA), reinforcing its position as a leader in public healthcare delivery.

The state government said the achievement reflects its focus on ensuring timely, cashless and inclusive access to medical treatment for citizens across income groups.

The AB PMJAY–MA scheme, which integrates the Centre’s flagship Ayushman Bharat programme with the state-run Mukhyamantri Amrutum Yojana, currently covers around 1.20 crore families in Gujarat.

In July 2023, under the leadership of Chief Minister Bhupendra Patel, the annual health insurance cover per family was enhanced from Rs 5 lakh to Rs 10 lakh, significantly expanding financial protection against major illnesses.

Chief Minister Patel said the scheme was guided by Prime Minister Narendra Modi’s vision of “Swasth Gujarat, Samruddh Gujarat”, aimed at strengthening health security for the poor and middle class.

He noted that the issuance of Ayushman cards and the enhanced coverage have ensured that even people in remote and economically weaker regions are able to access free treatment for serious diseases, while government hospitals are also delivering high-quality healthcare services.

With the increase in insurance coverage, the premium structure under the scheme has also seen changes.

When the coverage was capped at Rs 5 lakh, the premium per family stood at Rs 2,177.10 during the period from July 2021 to July 2022, with total expenditure of Rs 1,681.20 crore.

The premium was reduced to Rs 1,492 between July 2022 and July 2023, with expenditure of Rs 1,363.52 crore. Following the enhancement of coverage to Rs 10 lakh from July 10, 2023, the premium rose to Rs 3,708 per family.

The state’s expenditure under the scheme stood at Rs 2,676.26 crore during 2023–24 and increased to Rs 3,210.03 crore in 2024–25.

At present, 2,090 hospitals have been empanelled under AB PMJAY-MA in Gujarat, including 1,132 government hospitals and 958 private hospitals. As of November 2025, beneficiaries can avail treatment for 2,299 medical procedures, along with 50 Specialised Referral Services (SRS).

Officials said Gujarat’s first-place ranking in claim settlements highlights the efficiency of its implementation mechanism. The state has also expanded the ambit of the scheme to cover government personnel.

In May 2025, the Gujarat government launched the Karmayogi Swasth Suraksha Yojana for all state government officers, employees and pensioners.

Under this initiative, cashless treatment benefits are provided through AB PMJAY–MA to All India Services officers, state government staff, fixed-pay employees and pensioners, along with their dependent family members.

Approximately 6.40 lakh beneficiaries have been registered under the “G” category and issued AB PMJAY-MA cards. The impact of the scheme is evident in individual cases such as that of 66-year-old Faruk Khimani, a small shopkeeper from Ahmedabad.

Diagnosed with coronary artery disease, Khimani underwent coronary angiography and coronary artery bypass grafting surgery at the U.N. Mehta Institute of Cardiology and Research Centre in May 2025, with Rs 5.24 lakh in financial assistance provided under AB PMJAY-MA.

He was later readmitted in December 2025 for a CRT-P implant procedure due to breathing complications.

His condition has since stabilised, and he has credited the scheme for saving him from crippling medical expenses. State officials said the scheme continues to play a crucial role in providing financial security and access to advanced medical care, underlining Gujarat’s commitment to building an inclusive and resilient healthcare system.

janvi/dan