Which Diseases Are Covered Under PMJAY?

Ayushman Bharat, popularly known as PMJAY (Pradhan Mantri Jan Arogya Yojana),  is a healthcare insurance programme designed to provide you with financial security and high-quality medical services. The Ayushman Bharat scheme is a gem for the public health care system in India as it is highly beneficial to individuals from economically disadvantaged backgrounds. This scheme aims that qualified beneficiaries can get cashless treatment and reimbursement for medical fees incurred during any medical treatment for the covered diseases.

The list of diseases covered under Ayushman Bharat includes many medical procedures and treatments that cater to different diseases.

Let us understand if the medical treatment you require for your condition falls within the coverage of this scheme.

What Conditions are Covered Under the Ayushman Card Disease List?

The Ayushman Bharat Yojana was launched with one aim in the mind of policymakers and that is to offer free medical treatment to economically disadvantaged people. To complete this aim, it was carefully observed that the public health system in India is diverse. There are people with different monetary backgrounds as well as some who suffer from conditions that are not common. This observation led to an important inclusion in the policy which was the incorporation of a diverse range of illnesses and Best Mediclaim Policy conditions that they may not be able to afford otherwise.

Ayushman Bharat Yojana list includes many medical treatments and it is regularly updated by NHA (National Health Authority) so that any medical condition is not spared from being included under this health scheme. It has over 1,500 medical procedures and treatments available that includes both inpatient and outpatient treatment.

As per the latest information, approximately 25 medical specialities are covered by Ayushman Bharat Yojana.

What are the Key Medical Specialities Covered by Ayushman Bharat Yojana?

It is important that you have the knowledge of the medical specialities that are covered under this scheme:

How has the Scheme Improved Healthcare in India?

With the coming of the Ayushman Bharat Yojana the public health care system in India has seen a great improvement in terms of patient admission as well as in terms of health upliftment. There are many other fronts where this scheme has helped the people: 

• Increased Access to Healthcare Services: With the Ayushman Bharat scheme the number of people taking healthcare services has increased incredibly. Beneficiaries now have access to high-quality healthcare services. This scheme ensures that they can receive the necessary medical treatments without burning a hole in their pockets.
• Comprehensive Coverage: The list covers over 1,500 medical procedures and treatments across various medical specialities. People who are enrolled under this scheme can take advantage of medical conditions like cardiology, neurosurgery, oncology, and many more.
• Inclusive for All Family Sizes: One of the features that has greatly benefited people by opting for this scheme is the coverage to families of all sizes. It provides medical assistance to all the members of the family. This ensures that comprehensive healthcare benefits can be extended to every eligible individual health insurance and family health insurance.
• Cashless Treatment: Treatment without cash is also one compelling benefit offered by Ayushman Bharat Yojana. People can have the convenience of availing cashless treatment at network hospitals throughout the country. This simplifies the process of healthcare and reduces the need for immediate out-of-pocket expenditures.

Summing Up

Ayushman Bharat, or Pradhan Mantri Jan Arogya Yojana has turned out to be one of the best government sponsored schemes. It offers holistic medical support to the underprivileged population of the country and has managed to cover major medical conditions under it.

The Ayushman Bharat covered diseases list under the scheme is long and this Yojana plays a crucial role in granting access to quality healthcare for those who are economically disadvantaged. This initiative reflects the government of India's dedication to fortifying the healthcare ecosystem in the country and addressing the healthcare needs of marginalised communities.

FAQs

1. Who can apply for PMJAY?

To apply for PMJAY, you have to fulfill the eligibility criteria of: belonging to the SC/ST category, families with no earning member older than 16, those with incomes under ₹2.5 lakhs, and those on the PMJAY beneficiary list.

2. What are the advantages of PMJAY?

Advantages of PMJAY include free health insurance coverage of up to five lakhs and health coverage to senior citizens of 70 years and above, regardless of their economic status. 

3. Are Ayushman Bharat and PMJAY the same?

Yes, Ayushman Bharat and PMJAY are the same. Ayushman Bharat is a larger umbrella scheme that includes various health initiatives. One of its key parts is the Pradhan Mantri Jan Arogya Yojana (PMJAY), which is a government-sponsored health insurance scheme.

4. What is the limit for income to Benefit from a PM Ayushman card?

As per the latest policy updates, people with certificates of a maximum annual income of up to ₹5 lakhs can benefit from a PM Ayushman card.

5. What are the critical diseases covered by PMJAY?

PMJAY covers a wide range of critical illnesses and complex treatments. Some of the major critical diseases covered include:

• Cancer treatments (such as chemotherapy, radiotherapy, and surgical oncology)
• Kidney-related diseases including dialysis
• Cardiac surgeries and procedures (e.g., bypass surgery, angioplasty)
• Neurological conditions (e.g., brain tumour surgeries, stroke management)
• Burns and polytrauma care
• Severe infections and sepsis
• Organ failures and transplants (limited to select procedures)

These treatments are provided under a pre-defined package and available at empanelled public and private hospitals across India.

6. Which treatment is not covered under Ayushman card?

While PMJAY offers extensive health coverage, there are certain exclusions. Treatments not covered under the Ayushman Bharat scheme include:

• Cosmetic procedures and plastic surgeries (unless medically necessary due to trauma or burns)
• Organ transplant surgeries (only a limited range covered)
• OPD consultations and medications (unless tied to a hospitalisation package)
• Fertility treatments and IVF
• Drug rehabilitation and de-addiction therapies
• Experimental or unproven treatments
• Vaccinations (except when part of a hospital package)

7. Are pre-existing diseases covered under PMJAY from day one?

Yes, pre-existing diseases are covered from day one under PMJAY. This is one of the key benefits of the Ayushman Bharat scheme. Beneficiaries do not have to undergo a waiting period, and treatments for chronic conditions such as diabetes, hypertension, heart diseases, or cancer are included from the start, provided the treatment falls within the listed packages and is delivered at an empanelled hospital.