Seeking to address the growing concerns of island residents over medical accessibility, Member of Parliament Bishnu Pada Ray has urged the Lieutenant Governor of the Andaman and Nicobar Islands to review and amend specific clauses in the existing guidelines governing patient referrals and travel reimbursements under the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
In a formal representation, the MP highlighted that the revised referral guidelines issued by the State Health Agency in June 2023 have caused considerable difficulty for patients who require treatment on the mainland. The issue, he said, stems from the discontinuation of the earlier ANIISHI scheme. This state-run initiative provided comprehensive cashless medical coverage of up to ₹5 lakh per person, covering both treatment and transportation.
According to Ray, after ANIISHI merged with the national Ayushman Bharat scheme, the modified provisions have failed to accommodate the geographical and logistical challenges faced by the island population. With limited and irregular ship connectivity to Chennai, Kolkata, and Visakhapatnam, patients often have to resort to air travel, which remains outside the scope of reimbursement. This, he observed, has placed a financial strain on economically weaker families who depend on timely mainland referrals for serious medical conditions.
The MP has proposed several key amendments to address these constraints. His foremost suggestion is to include both-way air travel as a standard and reimbursable provision for all referred patients. Such a measure, he believes, would ensure that medical access remains equitable and timely, given the unpredictable nature of ship services between the islands and the mainland.
Ray has also called for greater flexibility in purchasing air tickets, recommending that patients be allowed to book through any authorized travel agent of their choice rather than being restricted to specific government-approved agencies such as Balmer Lawrie, Ashok Travels, or IRCTC. These agencies, he noted, are not easily accessible in many island locations, leading to unnecessary delays in ticketing and travel.
Another key point raised was the reintroduction of a credit facility for air ticketing. The MP suggested that ANIIDCO or another designated government agency could provide this facility on a deferred payment basis, similar to the practice under ANIISHI, so that patients do not have to bear the immediate financial burden of travel costs before receiving reimbursement.
In addition, Ray has sought a revision of the income ceiling that determines eligibility for non-SECC beneficiaries. The current limit of ₹3 lakh per annum, fixed nearly a decade ago under the ANIISHI scheme, is no longer adequate, he said, given the steady rise in the cost of living and inflation. An upward revision, he argued, would extend the benefits of the scheme to more deserving households across the islands.
The MP emphasized that these revisions are essential for protecting the interests of economically weaker patients and ensuring that healthcare access in the islands remains equitable with the rest of the country. The representation has also been forwarded to the Prime Minister, Home Minister, and Union Health Minister for their consideration and necessary instructions to the Union Territory Administration.
Residents across the islands have long expressed concern that without adequate provisions for air travel, the existing guidelines under Ayushman Bharat fail to address the realities of living in a remote archipelago. Ray’s recommendations, if adopted, are expected to make the scheme more inclusive and responsive to the unique logistical challenges of the Andaman and Nicobar Islands.
