Benefits of Ayushman Bharat Yojna
16 June, 2023
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Launched in 2018, the Ayushman Bharat Yojana - Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme has become an integral part of the healthcare sector. It has become an essential ingredient for leading health insurance providers like Niva Bupa.
What is Ayushman Bharat Yojana Scheme?
Ayushman Bharat Yojana scheme or PMJAY is a part of the national health policy of the Indian government. The scheme provides free access and health insurance benefits to lower-income groups. It enables the economically underprivileged sections of the society to obtain cashless facilities for tertiary and secondary healthcare services and treatments. More than 50 million individuals are supposed to benefit from Ayushman Bharat Yojana - PMJAY. This initiative is set to cover both urban and rural areas while establishing the importance of health insurance in India.
Features of Ayushman Bharat Yojana Scheme
- Ayushman Bharat Yojana offers a family floater policy for medical treatments with a coverage of Rs. 5 lakh.
- The beneficiaries are identified based on the Socio-Economic Caste Census (SECC) of 2011.
- The cashless treatment, maintenance and administration of records is available at empanelled hospitals.
- The Ayushaman Bharat Yojana has defined 1350 medical packages and 25 special category treatments like surgeries and chemotherapy.
- This scheme chooses families below the poverty line to ensure they do not burden themselves with financial debts for availing of medical facilities.
Benefits Under the Ayushman Bharat Yojana
- More than the bottom 40% of the population qualifies for the scheme that changes the notion that insurance is for the rich only.
- The scheme is available free of cost across India.
- The medical expenses on treatments are capped with specified package rates pre-determined by the government so that the hospitals cannot over-charge.
- The scheme covers three days of pre-hospitalisation and 15 days of post-hospitalisation expenses.
- The scheme covers ICU expenses, specified pre-existing diseases and day-care expenses, and transportation costs incurred during the pre & post-hospitalisation period.
- There is no restriction on the size of the family for coverage, with priority to women, children and senior citizens.
- 7It also provides cover for the treatment of Covid-19 patients.
How to Generate Patient Cards?
The prospective beneficiaries need to check their eligibility on the PMJAY website. You need to submit your Aadhaar details and generate OTP for registration.
If you are eligible, approach a PMJAY kiosk for identity verification based on your Aadhaar card or Ration card. Post-verification of documents, a patient e-card and Ayushman Bharat ID will be generated. This e-card displays all the information of the beneficiary and is applicable at all the empanelled hospitals across India.
In case of queries, you can call Ayushman Bharat Yojana call centre numbers for assistance.
Are COVID-19 Treatments Covered Under Ayushman Bharat Yojana Scheme?
Yes. As per the Ministry of Health and Family Welfare, testing and treatment of Covid-19 at private hospitals will be covered under the Ayushman Bharat Yojana. Testing and treatment of Covid-19 were already available free of cost at public medical facilities. All the empanelled hospitals shall provide bundled treatment to Covid-19 patients up to the sum assured of Rs. 5 Lakh.
Niva Bupa provides a Corona Kavach Family Floater plan with affordable health insurance premiums and extensive coverage for Covid-related treatments. Features like hospitalisation coverage, coverage of pre-existing diseases, homecare treatment expenses, and AYUSH treatment coverage imbibe the attributes with Ayushman Bharat Yojana. Hassle-free claims and relatively affordable plans offer a chance to secure the health of your family with lesser financial stress!
Frequently Asked Questions
What are the main benefits of Ayushman Bharat Yojana?
The scheme provides free healthcare coverage of up to ₹5 lakh per family annually for secondary and tertiary care hospitalisation. It offers cashless and paperless treatment at over 27,000 empanelled hospitals across India. The scheme covers pre-existing conditions from day one and includes transportation allowances for patients travelling for treatment.
How does Ayushman Bharat reduce healthcare costs for families?
Ayushman Bharat eliminates out-of-pocket expenses for eligible families by providing completely free treatment at empanelled hospitals. The scheme covers all medical procedures, medicines, diagnostic tests, and even follow-up care without any co-payment. This protection prevents families from falling into medical debt and ensures access to quality healthcare regardless of financial status.
What medical treatments are covered under Ayushman Bharat benefits?
The scheme covers over 1,350 medical packages including surgeries, cancer treatments, cardiac procedures, and organ transplants. It includes both planned and emergency treatments, diagnostic services, medicines, and medical consumables during hospitalisation. Maternity care, neonatal services, and follow-up consultations are also covered under the comprehensive benefit package.
Can Ayushman Bharat cardholders access treatment anywhere in India?
Ayushman Bharat provides pan-India portability, allowing beneficiaries to access treatment at any empanelled hospital across the country. This benefit is particularly valuable for migrant workers and families who travel for better healthcare facilities. The digital infrastructure ensures seamless treatment access regardless of the patient's location within India.
How does Ayushman Bharat improve healthcare access for rural populations?
The scheme prioritises rural healthcare by empanelling hospitals in smaller towns and district headquarters, bringing quality care closer to rural communities. It eliminates the need for families to arrange funds before treatment, removing financial barriers to healthcare access. The scheme also covers transportation costs, making specialist care more accessible for remote populations.
What additional benefits does Ayushman Bharat provide beyond hospitalisation coverage?
Beyond the ₹5 lakh coverage, the scheme includes benefits like free health check-ups, wellness programmes, and preventive care initiatives. Pregnant women receive maternity benefits, whilst the scheme also covers mental health treatments and rehabilitation services.
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