Ayushman Bharat Yojana Benefits

Under PM-JAY, eligible beneficiaries can access medical services across empaneled hospitals, and the scheme covers a wide range of treatments, including surgeries, diagnostics, and medications. The eligibility criteria are based on socio-economic factors, and the scheme prioritizes those in need.

Highlights of Ayushman Bharat Yojana

Here is an overview of the Ayushman Bharat Yojana:

Benefits of Ayushman Bharat Yojana

The Ayushman Bharat Yojana offers a lifeline for low-income families in India, providing them with access to quality healthcare through a range of significant benefits:

• Financial Security: A major advantage of this scheme is financial protection for low-income families. It offers a cover of ₹5 lakh per family per year for hospitalization expenses, acting as a lifesaver for those who might otherwise struggle to afford critical medical care.
• Comprehensive Coverage: The scheme goes beyond just hospitalization. It covers a wide range of medical treatments, including surgeries, diagnostics, pre-hospitalization expenses for up to 3 days, and post-hospitalization expenses for up to 15 days, including medicines and diagnostics.
• Convenience and Transparency: Ayushman Bharat Yojana is designed for ease of use. Beneficiaries can avail of cashless and paperless treatment at any empanelled hospital across India, eliminating the hassle of upfront payments and paperwork.
• Wider Hospital Choice: The program offers beneficiaries a broader choice for treatment. They are not restricted to government hospitals and can choose from public and private hospitals that are part of the Ayushman Bharat network.
• Family-Oriented Care: The scheme covers all the family members included in the beneficiary’s Ayushman Bharat Card, ensuring everyone in the household has access to necessary medical care.
• Portability: This is a unique benefit. Beneficiaries can seek treatment at any empanelled hospital in India, regardless of the state where they are registered. This provides flexibility and avoids limitations based on location.
• Age Inclusiveness: Ayushman Bharat Yojana is open to all age groups, ensuring everyone has a chance to benefit from healthcare coverage, irrespective of age.

Ayushman Bharat Yojana Health Coverage

Under the Ayushman Bharat Yojana scheme, eligible beneficiaries are entitled to receive health coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization. This coverage includes a wide range of medical services and treatments, such as:

• Medical Examination, Consultation, and Treatment: The scheme covers the costs associated with medical examinations, consultations with healthcare professionals, and various medical treatments.
• Pre-Hospitalization and Post-Hospitalization Expenses: The coverage extends to expenses incurred before and after hospitalization, up to 15 days on either side.
• Inpatient Care Services: Both non-intensive and intensive care services provided during the hospital stay are covered under the scheme.
• Medicines, Medical Consumables, and Diagnostics: The costs of medicines, medical consumables, and diagnostic tests performed during the hospital stay are included in the coverage.
• Accommodation and Food Services: The scheme covers the expenses related to the beneficiary’s stay in the hospital, including accommodation and food services.
• Medical Implants: If required, the costs of medical implants, such as prosthetics, are also covered under the scheme.
• Complications and COVID-19 Treatment: The scheme provides coverage for any complications that may arise during the treatment, as well as for COVID-19 (Coronavirus) treatment.

Ayushman Bharat Yojana Eligibility Criteria

The eligibility criteria for the Ayushman Bharat Yojana are established with specific requirements to ensure that only the underprivileged individuals in society can avail the benefits of the program.

PMJAY Rural

Covers beneficiaries under at least one of six deprivation categories:

• Destitute, manual scavenger families
• Households living through alms
• Primitive tribal groups
• Bonded laborers

Includes households with:

• Destitute, manual scavenger families
• Only one room with Kucha walls and roof
• No adult member between 16-59 years
• No adult male member between 16-59 years
• Disabled member and no able-bodied member
• Scheduled Caste (SC) and Scheduled Tribe (ST) households
• Landless households with manual casual labor as a major income source

PMJAY Urban

Covers 11 occupational categories of workers:

• Beggars
• Domestic workers
• Ragpickers
• Street vendors, hawkers, and other service providers
• Construction workers, laborers, welders
• Sweepers, gardeners, sanitation workers
• Artisans, handicraft workers, tailors, home-based workers
• Drivers, transport workers, rickshaw pullers
• Shop workers, peons, assistants, waiters
• Mechanics, electricians, repair workers
• Security guards, watchmen

Documents Required For Ayushman Bharat Yojana

Documents required to apply for the Ayushman Bharat Yojana Scheme include:

• Eligibility Check: Help beneficiaries understand how to check their eligibility for the Ayushman Bharat PM-JAY Scheme.
• Identity and age proof (Aadhaar Card/PAN Card)
• Mobile number
• Email address
• Residential address
• Caste certificate
• Income certificate
• Documents stating your current family status.

Check more on the Ayushman Bharat Scheme from the links below: