This article is about to know how to check Ayushman Bharat pradhan mantri jan arogya yojana Eligibility Criteria and all about this scheme. AB-PMJAY short form of Ayushman Bharat Yojana is a program which aims to provide a service to create a healthy, capable and content new India. Presently it is running as a pilot project in Uttar Pradesh from 4 September 2018.
What is Ayushman Bharat Yojana or PMJAY Scheme?
The primary aim of PMJAY scheme is to provide health coverage to approximately 50 crore citizens of India. Moreover, Ayushman Bharat Scheme offers beneficiaries with an average coverage amount of Rs. 5 Lakh. This covers a majority of diagnostics, medicines, pre-hospitalization costs, and medical treatment expenses.
In addition to this, the cashless, as well as paperless services, work in the favor of the nominees at any given point of time in their lives. PMJAY Scheme makes quality healthcare accessible to the poorest of poor families in India. Hence, the benefits offered by this ayushman bharat yojna health plan are massive.
Also Read- PM Schemes List
How to do Ayushman Bharat Registration ?
One can follow below steps for Ayushman Bharat Registration Online.
- Generate a patient verification card for your beneficiaries. For card generation, the patient is directed to the PMJAY kiosk.
- Inform yourselves about all the valid charges and payments associated with the PMJAY Scheme.
- Confirm any prevailing sickness or diseases from the provided doctors.
- Obtain a medical treatment or a prescription of medication from the doctors in the case of any severity. If hospitalization is recommended, avail medical facility from Empanelled Healthcare Providers (EHCP) or Public Hospitals.
- After the completion of treatments, receive a discharge certificate/bills/invoices from the hospital.
Submission of essential documents plays a vital role. Providing all the necessary paperwork quickens the procedure. Here’s a closer look at all the required documents for availing the Ayushman Bharat Yojana.
What Documents Are Required for Ayushman Bharat Registration
- Age proof
- A valid age proof is required to opt for the Ayushman Bharat Yojana.
- Provide your identification proof like PAN card or Aadhar Card.
Submit your current contact details like your mobile number, email ID, residential address. Contact details should be mentioned accurately as it is the sole source of contacting the policyholder.
One must submit two different certificates while opting for the Ayushman Bharat Yojana. The required certificates are as follows:
- Income certificate
- Caste certificate
- Family Structure
During the Ayushman Bharat registration and application process, one must specify their family structure. For instance, an individual must mention whether he lives in a nuclear family or a joint family.How to Apply for Ayushman Bharat Yojana?
How to Apply for Ayushman Bharat Yojana?
Follow these steps to apply for Ayushman Bharat Yojana-
- Visit the empanelled hospital and look for Ayushman Mitras who will assist you in admission
- They will confirm whether you are eligible under the PMJAY scheme
- Next, they will authenticate your identity (either through Aadhaar card or ration card)
- The hospital that you are seeking treatment in will check the balance
- You will be requested to submit necessary evidence for the treatment
- The claim will be settled post hospitalization, after you submit discharge summary and post treatment evidence
Once the eligibility is confirmed, the beneficiary is directed to the PMJAY Kiosk where the Pradhan Mantri Arogya Mitra (PMAM) will verify the beneficiary’s identity and eligibility using the Beneficiary Identification System (BIS). Once this is cleared, the beneficiaries are issued an e-card.
How to Download Ayushman Bharat Card ?
The PMJAY beneficiaries can avail cashless healthcare services at any of the empanelled hospitals by simply using the Ayushman Bharat Yojana card. The beneficiaries are issued a card at the time of registration. This card contains all your necessary information and is mandatory to provide it when availing the treatments under the scheme.
To get the Ayushman Bharat Card Download, follow the below steps:
- Visit the official PMJAY website
- Do Ayushman bharat login with your registered contact number
- Enter the captcha code and generate the OTP (One-Time-Password)
- Opt for the HHD code
- Provide the correct HHD code to the Common Service Centre (CSC)
- They will check and verify the details provided
- The CSC representative (also known as Ayushman Mitra) will complete the remaining process
- You will have to pay INR 30 to get the Ayushman Bharat Yojana Card
Which are Ayushman Bharat CSC ?
There are so many Common Service Center for this scheme. The ayushman bharat CSC are the same, you used to visit for other services. You can get yourself registered at any CSC near you.
Ayushman Bharat Hospital List
These are the hospital where you can get benefits of Pradhan Mantri Jan Arogya Ayushman Bharat Scheme. The complete Ayushman Bharat Hospital List can be checked on official website. Since the implementation of the Ayushman Bharat Yojana scheme, a whopping number of hospitals have been empaneled.
Current estimates say that over 15,000 hospitals are currently part of this scheme. 50% of the empaneled hospitals are estimated to be private hospitals. The complete list of hospitals can be found on the government’s official PMJAY website. Here’s how you can find a hospital in your jurisdiction.
Step 1: Visit the following link https://hospitals.pmjay.gov.in/Search/empnlWorkFlow.htm?actionFlag=ViewRegisteredHosptlsNew
Step 2: Select your state and your district
Step 3: Select the type of hospital you’re looking for (public, private and for profit, private and not for profit)
Step 4: Select the medical specialty you need. For example, general, pediatric, neurosurgery, cancer, gynecology, etc.
Step 5: A captcha will appear. Type it in the box below.
Step 6: Click on search.
Also Read- Pradhan Mantri Kisan Samman Nidhi
Ayushman Bharat States List
We have given list of all states with other important data. Note: Data updated as on 13-07-2020
|State/UT Name||Name of Scheme in the State/UT||Name of the State Health Agency||Mode of Implementation||Date of Roll-Out||Name of Insurance Company||Name of ISA/TPA||Insurance Premium Discovered||Total Number of Households||Source of Data for ‘Total Number of Households’||Number of Eligible Families under PM-JAY||Non PM-JAY Families (Covered under the State Scheme beyond 5 Lakhs)||Number of Hospitals Empaneled (NABH Accredited)||Health Benefit Packages 1.0||Health Benefit Packages 2.0|
|As per SECC/RSBY database||Additional Families (Covered by State upto 5 Lakh)||Total||Public||Private||Total||Total Packages||Reserved for Public Hospitals||Total Packages||Reserved for Public Hospitals|
|Andaman and Nicobar Islands||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY);|
Andaman and Nicobar Islands Scheme for health Insurance (ANISHI)
|State Health Agency, Andaman and Nicobar Islands||Trust||23/9/2018||Good Health TPA Services Ltd.||92,717||SECC 2011||21,398||21,398||56,322||3(0)||0(0)||3(0)||1,393||19|
|Andhra Pradesh||Ayushman Bharat-Dr. YSR Arogyasri Healthcare Scheme||Dr. YSR Arogyashri Healthcare Trust (Dr YSRAHCT)||Trust||01/01/2019||1,63,06,552||Current Civil Supplies Department||54,67,515||88,76,285||1,43,43,800||253(9)||928(39)||1,181(48)||1,864||133|
|Arunachal Pradesh||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY);|
Chief Minister Arogya Arunachal Yojna
|Chief Minister’s Arogya Arunachal Society||Trust||23/9/2018||MD India Healthcare Service (TPA) Pvt. Ltd.||2,60,217||SECC 2011||88,611||1,82,000||2,60,217*||20(0)||1(0)||21(0)||1,394||19|
|Assam||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY);|
Atal Amrit Abhiyan
|Atal Amrit Abhiyan Society||Trust||23/9/2018||Family Health Plan Insurance TPA Limited||64,27,614||SECC 2011||26,96,996||26,96,996||33,26,531||211(0)||182(12)||393(12)||1,393||19|
|Bihar||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||Bihar Swasthaya Suraksha Samiti||Trust||23/9/2018||Med Save Health Insurance TPA Ltd.||2,00,74,242||SECC 2011||1,08,11,015||1,08,11,015||607(1)||264(5)||871(6)||1,393||19|
Pradhan Mantri Jan Arogya Yojana (PM-JAY)
|State Health Agency, Chandigarh||Trust||23/9/2018||Good Health TPA Services Ltd.||3,00,000||Census Department of UT, Statistical Department||69,282||69,282||8(0)||14(3)||22(3)||872||30|
|Chhattisgarh||Ayushman Bharat PM-JAY Dr. Khubchand Baghel Swasthya Bima Yojana||State Health Agency||Trust||15/9/2018||MediAssist – Claim Processing MD India – Medical Audit Vidal Health TPA – Medical Audit||65,20,725||Food, Civil Supplies & Consumer Protection Department (As on 05-03-2020)||36,50,475||19,20,555||55,71,030||8,71,143||714(5)||348(10)||1062(15)||1,730||191|
|DNH and DD||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||State Health Agency, Dadra and Nagar Haveli and Daman and Diu||Insurance||23/9/2018||The Oriental Insurance Company Ltd.||Health India Insurance TPA Service Pvt. Ltd.||Rs. 1712.13 Per SECC Beneficiary Family||1,82,586||General Survey RGI (Registrar General of India) – 2019||42,805||35,608||78,413||7(0)||0(0)||7(0)||1,409||3|
|Goa||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) Deen Dayal Swasthaya Seva Yojana||State Health Agency, Goa||Trust||23/9/2018||MD India Healthcare Service (TPA) Pvt. Ltd.||2,62,459||AB PM-JAY and DDSSY families||36,431||–||36,431||2,25,485||12(0)||13(7)||25(7)||1,634||1,064|
|Gujarat||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY); Mukhyamantri Amrutam & Mukhyamantri Vatsalya||Gujarat State Health Protection Society||Hybrid||23/9/2018||The Oriental Insurance Company Ltd.||MD India Healthcare Service (TPA) Pvt. Ltd.||Rs. 361 Per Family||1,22,48,428||Census 2011||43,83,948||32,04,589||75,88,537||1837(2)||870(49)||2707(51)||1,912||561|
|Haryana||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY); Haryana Health Protection Mission||Haryana Health Protection Authority||Trust||15/8/2018||–||–||–||46,30,959||SECC 2011||15,46,003||15,46,003||168(1)||371(115)||539(116)||1,394||146|
|Himachal Pradesh||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||Himachal Pradesh Swasthya Bima Yojana Society||Trust||23/9/2018||Med Save Health Insurance TPA Ltd.||14,83,280||Statistical Outline Report of HP 2017-2018||4,78,985||4,78,985||5,50,000||152(5)||62(1)||214(7)||872||21|
|Jammu And Kashmir||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||State Health Agency Jammu and Kashmir||Insurance||01/12/2018||Bajaj Allianz General Insurance Company Limited||MD India Healthcare Service (TPA) Pvt. Ltd.||Rs. 720 Per SECC Beneficiary Family||20,94,081||SECC 2011||5,97,801||5,97,801||197(1)||34(1)||231(2)||872||21|
|Jharkhand||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) Mukhyamantri Swasthya Bima Yojana(MSBY)||Jharkhand State Arogya Society||Hybrid||23/9/2018||National Insurance Company||MD India, Medi Assist and Safe way||Rs. 900 Per Family||57,10,933||PDS database||27,79,867||29,05,180||56,85,047||200(1)||482(6)||682(7)||1,393||19|
|Karnataka||AB-ArK (Ayushman Bharat-Arogya Karnataka)||Suvarna Arogya Suraksha Trust (SAST)||Trust||31/10/2018||1,73,86,486||Census 2011||61,83,502||52,90,927||1,14,74,429||2876(3)||533(20)||3409(23)||1,650||443|
|Kerala||Pradhan Mantri Jan Arogya Yojana – Karunya Arogya Suraksha Paddhati (PMJAY-KASP)||State Health Agency, Kerala||Trust||01/04/2019||Health India TPA||87,06,546||Current Civil Supplies Department||21,49,019||19,40,393||40,89,412||188(19)||218(37)||406(56)||1635||421|
|Ladakh||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||State Health Society (NHM)||Insurance||01/12/2018||Bajaj Allianz General Insurance Company Limited||MD India Healthcare Service (TPA) Pvt. Ltd.||Rs. 720 Per SECC Beneficiary Family||39,615||SECC 2011||10,924||10,924||9(0)||0(0)||9(0)||872||21|
|Lakshadweep||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||State Health Agency, Lakshadweep||Trust||Good Health Insurance TPA services Ltd.||17,908||Ministry of Food & Civil Supplies 2019||1,465||1,465||11,784||1(0)||0(0)||1(0)||1,393||30|
|Madhya Pradesh||Ayushman Bharat-Madhya Pradesh ‘Niramayam’ Yojana||Deen Dayal Swasthya Suraksha Parishad||Trust||23/9/2018||Vidal Health Insurance TPA Pvt. Ltd.||1,47,23,864||SECC 2011||83,57,257||33,18,218||1,16,75,475||422(13)||157(147)||579(160)||1,631||–||875|
|Maharashtra||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY); Mahatma Jyotiba Phule Jan Arogya Yojana (MPJAY)||State Health Assurance Agency||Hybrid||23/9/2018||United India Insurance Company Limited||MD India, Medi Assist and Paramount Health Services and Insurance TPA Pvt. Ltd.||Rs. 797 Per Family||2,69,36,170||Census 2011||82,57,913||82,57,913||1,39,17,739||159(0)||651(54)||810(54)||1,913||460|
|Manipur||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||State Health Agency (SHA), Manipur||Trust||23/9/2018||Medi Assist India TPA Pvt. Ltd.||5,78,939||SECC 2011||2,73,250||–||2,73,250||60,000||50(0)||8(1)||58(1)||2,734||37||21||2,214|
|Meghalaya||Megha Health Insurance Scheme (MHIS) Pradhan Mantri Jan Arogya Yojana (PM-JAY)||State Nodal Agency Meghalaya||Insurance||23/9/2018||Reliance General Insurance Company Ltd.||Paramount Health Services & Insurance TPA Pvt. Ltd.||Rs. 1630 SECC Per Family||5,54,131||SECC 2011||3,47,013||4,41,243||554,131*||163(0)||16(3)||179(3)||2,886||–|
|Mizoram||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||Mizoram State Health Care Society||Trust||23/9/2018||Medi Assist India TPA Pvt. Ltd.||2,26,147||SECC 2011||1,94,859||1,94,859||88(0)||13(0)||101(0)||1,611||46|
|Nagaland||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||SHA (AB-PMJAY), Nagaland||Insurance||23/9/2018||The Oriental Insurance Company Ltd.||Raksha TPA Pvt. Ltd.||Rs. 669.53 per SECC Family||3,79,164||SECC 2011||2,33,328||2,33,328||84(0)||17(1)||101(1)||872||21|
|Puducherry||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||State Health Agency, Puducherry||Insurance||23/9/2018||Star Health and Allied Insurance||Star Health and Allied Insurance||Rs. 432 per SECC Beneficiary Family||2,79,857||SECC 2011||1,03,434||1,03,434||74,621||12(0)||12(8)||24(8)||1,393||30|
|Punjab||Ayushman Bharat Sarbat Sehat Bima Yojana||State Health Agency Punjab||Insurance||20/8/2019||IFFKO Tokyo||Family Health Plan Insurance TPA Limited & Vidal Health Insurance TPA Services Limited||Rs. 597 Per Family||55,13,071||SECC 2011, NFSA, Traders, J Farmers, BOCW, Journalist.||14,76,924||30,98,873||45,75,797||241 (1)||527 (133)||768(134)||1,392||115|
|Rajasthan||Ayushman Bharat-Mahatma Gandhi Rajasthan Swasthya Bima Yojana||Rajasthan State Health Assurance Agency||Trust||01/09/2019||Health India Insurance TPA Services Pvt. Lmt.||1,80,70,963||Census 2011||58,95,363||50,28,504||1,09,23,867||596(0)||1498(25)||2094(25)||2,077||34|
|Sikkim||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||State Health Agency ,Sikkim||Trust||23/9/2018||Good Health Insurance TPA services Ltd.||1,20,014||SECC 2011||39,738||39,738||11(0)||1(0)||12(0)||1,393||19||21||872|
|Tamil Nadu||Pradhan Mantri Jan Arogya Yojana-Chief Minister’s Comprehensive Health Insurance Scheme (PMJAY-CMCHIS)||Tamil Nadu Health System Project (TNHSP)||Hybrid||23/9/2018||United India Insurance Ltd.||MD India, Medi Assist and Vidal Health TPA Ltd.||Rs. 699 Per Family||2,06,53,494||Civil Supplies Corporation||74,89,381||69,29,072||1,44,18,453||1220(0)||1112(28)||2332(28)||3,707||681|
|Tripura||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)||State Health Agency Tripura||Trust||23/9/2018||Heritage Health Insurance TPA Pvt. Ltd.||8,75,621||SECC 2011||4,79,371||4,79,371||102(0)||2(0)||104(0)||872||21|
|Uttar Pradesh||Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) and Mukhiya Mantri Jan Arogya Abhiyan (MMJAA)||State Agency for Comprehensive Health and Integrated Services (SACHIS)||Trust||23/9/2018||Health India Ltd., Heritage Health Ltd., MD India and Vidal health India Ltd.||3,24,75,784||SECC 2011||1,16,84,453||8,43,876||1,25,28,329||–||1103(31)||1572(104)||2675(135)||872||39|
|Uttarakhand||Atal Ayushman Uttarakhand Yojana||Atal Ayushman Uttarakhand Yojana Society||Trust||23/9/2018||Family Health Plan Insurance TPA limited||25,39,653||NFSA+SECC 2011||5,23,536||10,45,932||15,69,468||125(0)||73(4)||198(4)||872||13|
Ayushman Bharat health and Wellness Center
Ayushman Bharat (AB) is an attempt to move from a selective approach to health care to deliver comprehensive range of services spanning preventive, promotive, curative, rehabilitative and palliative care. It has two components which are complementary to each other.
Under its first component, 1,50,000 Health & Wellness Centres (HWCs) will be created to deliver Comprehensive Primary Health Care, that is universal and free to users, with a focus on wellness and the delivery of an expanded range of services closer to the community.
The second component is the Pradhan Mantri Jan Arogya Yojana (PM-JAY) which provides health insurance cover of Rs. 5 lakhs per year to over 10 crore poor and vulnerable families for seeking secondary and tertiary care.
What are the Ayushman Bharat eligibility?
We have listed all the eligibility requirement criteria for all Rural and Urban peoples. You can check it below.
Eligibility Criteria for Rural and Urban People under PMJAY Scheme
Like we know, over 10 crore families across the country will be provided basic health care under the PMJAY scheme. This facility is mainly for the poor and the families with lower middle income. The health coverage provided is of INR 5 lakh per family.
Among the 10 crore families, almost 8 crore families belong to the rural areas while the remaining are from the urban areas. If we break the statistics even further, the scheme will be beneficial to over 50 crore individuals.
Now, just like any other health plan, PMJAY scheme too has certain pre-conditions. Depending on these pre-conditions, it picks who can avail the health coverage benefits. When it comes to rural areas, the eligibility criteria mainly depends on the individuals’ living conditions, income, and other deprivations. Whereas for the urban areas, it is based on each individual’s occupation.
According to the 71st round of the National Sample Survey Organisation, over 85.9% of people in rural areas do not have access to basic healthcare plans. Moreover, 24% of the rural population seeks healthcare facilities by borrowing money.
This is where PMJAY scheme comes in handy. It helps these people avoid getting into a debt trap and avail health facilities. This scheme is economically beneficial to underprivileged households. Also, the families enrolled under the Rashtriya Swasthya Bima Yojana (RSBY) will be covered under the PMJAY scheme.
In the rural areas, the PMJAY health facility is available to –
- People belonging to scheduled caste and scheduled tribe families
- Households with no male member between the age of 16 years and 59 years
- Beggars and those surviving on alms
- Families with no individual between the age of 16 years and 59 years
- Households with at least one physically challenged member and no healthy adult individual
- Landless families who make a living by working as casual manual labourers
- Primitive tribal communities
- Legally released bonded labourers
- People living in one-room makeshift houses with no proper walls or roof
- Manual scavenger families
Much like the rural areas and as per the 71st round of the National Sample Survey Organisation, over 82% of urban families do not have access to adequate healthcare insurance. Furthermore, over 18% of the urban population avails health facilities by borrowing money in one form or another.
With the PMJAY scheme, these people can avail healthcare services, as the funding provided is of INR 5 lakh per family. According to the Socio-Economic Caste Census 2011, PMJAY in the urban areas is beneficial to workers’ families. Also, the families enrolled under the Rashtriya Swasthya Bima Yojana (RSBY) will be covered under the PMJAY scheme.
In the urban areas, PMJAY scheme can be availed mainly by –
- Washerman/ Chowkidars
- Rag Pickers
- Mechanics, electricians, and repair workers
- Domestic help
- Sanitation workers, gardeners, and sweepers
- Home-based artisans and handicraft workers
- Cobblers, hawkers, and people providing services by working on streets or pavements
- Plumbers, masons, construction workers, porters, welders, painters, and security guards
- Transport workers such as drivers, conductors, helpers, cart, or rickshaw pullers
- Assistants, peons of a small organization, delivery men, shopkeepers and waiters
How to Check Ayushman Bharat Yojana Eligibility?
1) On the landing page of AM I Eligible Portal, the user has to enter an active mobile number (to receive an OTP) and enter the Captcha letters displaying on the screen and click on the “Generate OTP” button. After this, the user will receive an OTP as a text message on the mobile number entered. The user has to enter this OTP and click on “Verify OTP” which directs to a page to enter the details for search.
2) An individual can search whether he/she is an eligible beneficiary for Pradhan Mantri Jan Arogya Yojna (PMJAY) using a) Mobile number/Ration Card Number (collected during ADCD drive), b) SECC Name or c) RSBY URN.
a) Mobile number/Ration Card Number: An Additional Data Collection Drive (ADCD) was conducted on 30th April 2018 at Gram Sabha’s across India to capture active mobile number and ration card number of a family of the Socio-Economic Caste Census (SECC) database. If the individual got his/her Mobile number or Ration card number captured during this drive, only then it will show results on the portal. If the individual got his details captured during the ADCD drive and still no results are displayed, then the “SECC Name” option should be used for searching.
b) SECC Name: An individual can search if he/she is eligible for PMJAY using his details as per the SECC database such as Name, Father’s Name, Gender, State etc. Even now, if no results are displayed, then the user should contact a nearby Ayushmaan Mitra.
c) RSBY URN : Additionally, all active families that are enrolled under RSBY (till 31st March, 2018) that do not feature in the targeted groups as per SECC data will be included as well and can identify if they are eligible for PMJAY using RSBY URN.
3) If the search is successful, the individual has an option to receive a text message with the HHID number/RSBY URN for future purposes on his/her phone by clicking the “Get SMS” button and entering the mobile number. Note: This mobile number can be different from the mobile number used in the first step for OTP Generation.
What is Covered Under Ayushman Bharat Yojana Scheme?
With the intention to provide accessible healthcare to the poor and needy, the Ayushman Bharat Yojana Scheme offers coverage of up to Rs.5 lakh per family per year for secondary and tertiary hospitalisation care.
The health insurance under AB-PMJAY includes hospitalization costs of beneficiaries and includes the below components:
- Medical examination, consultation and treatment.
- Non-intensive and intensive care services.
- Medicine and medical consumables.
- Diagnostic and laboratory services.
- Medical implant services, wherever possible.
- Food services.
- Complication arising during treatment.
- Post-hospitalisation expenses for up to 15 days.
- COVID-19 (Coronavirus) treatment.
What is Not Covered Under Ayushman Bharat Yojana Scheme?
Similar to other types of health insurance policies, the Ayushman Bharat Yojana Scheme has some exclusions. Below components are not covered under the scheme:
- Out-Patient Department (OPD) expenses.
- Drug rehabilitation.
- Cosmetic surgeries.
- Fertility treatments.
- Individual diagnostics.
- Organ transplant.
Features of Ayushman Bharat Yojana Scheme:
Below are some of the key features of the PMJAY scheme:
- It is one of the world’s largest health insurance schemes financed by the government of India.
- Coverage of Rs.5 lakh per family per annum for secondary and tertiary care across public and private hospitals.
- Approximately 50 crore beneficiaries (over 10 crore poor and vulnerable entitled families) are eligible for the scheme.
- Cashless hospitalisation.
- Covers up to 3 days of pre-hospitalisation expenses such as medicines and diagnostics.
- Covers up to 15 days of post-hospitalisation expenses which include medicines and diagnostics.
- No restriction on the family size, gender or age.
- Can avail services across the country at any of the empanelled public and private hospitals.
- All pre-existing conditions covered from day one.
- The scheme includes 1,393 medical procedures.
- Includes costs for diagnostic services, drugs, room charges, physician’s fees, surgeon charges, supplies, ICU and OT charges.
- Public hospitals are reimbursed at par with private hospitals.
Benefits of Ayushman Bharat Yojana Scheme:
The scheme is targeted at the vulnerable and underprivileged sections of the society. To cater to them, below are the benefits of the PMJAY:
- It covers all hospitalisation expenses with cashless transactions to beneficiaries.
- Accommodation during hospitalisation.
- Pre and post-hospitalisation costs.
- Any complications arising during the treatment.
- Can be used by all family members.
- No cap on family size, age or gender.
- Pre-existing conditions are included from day one.
List of Critical Diseases or Illnesses Covered Under Ayushman Bharat Yojana Scheme:
The medical care scheme extended coverage for more than 1300 medical packages at empanelled public and private hospitals in the country. Below are some of the critical illnesses covered under the Ayushman Bharat Yojana:
- Prostate cancer.
- Double valve replacement.
- Coronary artery bypass graft.
- Pulmonary valve replacement.
- Skull base surgery.
- Anterior spine fixation.
- Laryngopharyngectomy with gastric pull-up
- Tissue expander for disfigurement following burns.
- Carotid angioplasty with stent.
Ayushman Bharat Scheme FAQs
What is the aim of Ayushman Bharat Yojana ?
It has two goals, one, creating a network of health and wellness infrastructure across the nation to deliver comprehensive primary healthcare services, and another is to provide insurance cover to at least 40 per cent of India’s population which is majorly deprived of secondary and tertiary care services.
Who is the CEO of Ayushman Bharat Yojana | AB-PMJAY ?
Indu Bhushan appointed as a Chief Executive Officer (CEO)
When Ayushman Bharat Yojana | AB-PMJAY was launched ?
Ayushman Bharat Yojana will be launched on 25 September 2018.
What are the Features of Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana ?
Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana has mainly two features:
- National Health Protection Scheme – to provide cashless treatment to patients
- Health and Wellness centres (HWC) – to provide primary care to the patients
What are the Benefits under Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana ?
- Cashless Treatment at Public/Private Healthcare Providers
- Secondary and Tertiary care hospitalization treatments coverage
- 5 Lakhs cover per family
- No cap on size of family or age of family members
- Pre-existing diseases covered from Day 1 of enrollment of the scheme
- Portable across India at all em-paneled healthcare Providers
- Fixed Transportation Allowance payable from place of residence to hospital
- AYUSH (Alternative Medicine Systems other than Allopathic ) covered
Ayushman Bharat Scheme Package List
1,350 packages under 23 medical specialties will be provided under the Ayushman Bharat scheme. 253 packages offered under general surgery while 161 packages offered under Urology. The Package cost includes Room and bed charges, nursing care, procedure cost and physician fee, consultation and diagnostics pre-hospitalization, two-week medicine, stitch removal and follow-up consultancy for two weeks after discharge.
Where was Ayushman Bharat Yojana is not launched ?
- Kerala and
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