What is Ayushman Bharat Scheme? Benefits, Features, Eligibility & Online Registration Process

Ayushman Bharat Yojana is an initiative by the central government to help weaker sections with medical aids and facilities. The paperless scheme provides cashless medical cover of a maximum 5 lacs.

What is Ayushman Bharat Sceme?

Every year, April 30 is observed as Ayushman Bharat Diwas. Ayushman Bharat, or Pradhan Mantri Jan Arogya Yojana is a government initiative to provide medical aid to marginalized sections. Launched by PM Narendra Modi in 2018, this flagship National Health Protection Scheme is funded by GOI. The Senior Citizen Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojana (RSBY) cater both poor and rurally destitute households.

The scheme providing coverage to almost 50 crore Indians aims at making secondary and tertiary healthcare completely cashless for underprivileged sections. The PMJAY e-card holders can retain insurance coverage of a maximum INR 5 lakh for each family at an empaneled public or private health center anywhere within the boundary.

What is Ayushman Bharat Yojana or PMJAY Scheme?

PMJAY, also known as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Scheme, is one of the biggest healthcare paperless scheme which offers cashless medical coverage. Sponsored by the Government of India, this initiative provides financial help to underprivileged families without any limitations pertaining to family size, gender or age at public hospitals and network private hospitals.

Ayushman Bharat Health insurance covers the cost of hospitalization, pre-hospitalization, treatment, and post-hospitalization expenses. Below is the list of treatment or components covered under Ayushman Yojana:

• Medical examination, treatment and consultation fee
• Pre-hospitalization expenses
• 15 days Post-hospitalization expenses
• Medicine and medical consumables
• Hospital admission and accommodation charges
• Non-intensive and ICU facilities
• Diagnostic procedures
• Medical implantation services
• Food services

The new drafts or package of PMJAY also includes Sex Reassignment Surgery to benefit Transgenders and and third gender. Although Ayushman Bharat benefits come with certain limitations. Know about the components not included:

• Out-Patient Department (OPD) expenses.
• Drug rehabilitation.
• Cosmetic surgeries.
• Fertility treatments.
• Individual diagnostics.
• Organ transplant.

Ayushman Bharat Eligibility Criteria for Rural vs Urban Individuals

The Union Government initiative provides medical coverage to individuals listed in Socio-Economic Caste Census-2011 data. However, the eligibility criteria for people living in the rural areas and urban areas are different. Such as:

Eligibility for Rural citizens

• Families with no adult/male/ earning member of age between 16-59 years
• One living in a one room Kaccha house(roof and walls)
• One is eligible for benefits in the absence of a healthy adult.
• Manual scavenger families
• Landless manual labours and their families
• Families with Divyaang(disabled) head members.

Eligibility for Urban State citizens

• Domestic worker
• Beggar
• Ragpicker
• Home-based Artisans/ Tailor Sweeper/ Handicrafts worker/ Sanitation worker/ Mali
• Construction worker/ Labour/ Painter/ Welder/ Security guard/ Coolie
• Washer-man/ Plumber/ Mason
• Electrician/ Mechanic/ Assembler/ Repair worker
• Transport worker/ Rickshaw puller/ Conductor/ Cart puller/
• Waiter/Shop worker/ Assistant/ Peon/Delivery assistant
• Street vendors/ hawker / Cobbler

Who all are not entitled to benefits of Ayushman Yojana?

The list of categories who cannot apply for Ayushman Bharat coverage are as follows:

• People who own a vehicle like a two-wheeler, three-wheeler, or a car
• Government employees
• People whose monthly income is more than Rs 10,000
• Those who have farming machinery and equipments
• Those who live in properly build houses
• Those who hold a Kisan card
• Those owing a motorized fishing boat
• Those owing an agriculture land of more than 5 acres
• People employed in government-run non-agricultural enterprises
• People who have refrigerators and landline phones in their houses

Features of Ayushman Bharat Yojana Scheme

• Ayushman Bharat Yojana scheme covers the complete family with a sum assured of Rs. 5 lakh.
• This flagship of National Health Authority is exclusively designed for people who do have access to internet or online health plans
• It is a paperless and cashless scheme.
• Ayushman Bharat Yojana also recompends the transportation costof pre and post-hospitalization period.
• Along with medical treatment expenses, the scheme package includes day-care expenses.
• The payment for medical expenses is paid according to the already curated package.
• The treatment is usually done at health and wellness centres established as per the Socio-Economic Caste Census data.

What are the Benefits of Ayushman Bharat Yojana Scheme?

• PMJAY assures treatment and healthcare facilities for registered individuals and their families at zero cost.
• The packages included in the scheme offer 25 specialty categories which covers 1,354 medical and surgical treatments.
• In case of multiple surgeries, the cost of the highest package is covered by the government. And for followed surgeries the amount covered is 50% an 25% respectively.
• This scheme also covers the treatment cost of oncology with chemotherapy for 50 different types of Cancer.
• The beneficiaries under PMJAY scheme can also opt for follow-up treatment coverage.

How to Register for Ayushman Bharat Scheme Online?

Any eligible individual can apply for Ayushman Bharat Scheme in two ways. Look for the nearest CSC or empanelled hospital. Carry all the required documents and do the needful to get registered for Ayushman Bharat Scheme.

• Visit the official government website for PMJAY scheme.
• You will find the ‘Am I Eligible tab’, simply click on it.
• Submit your mobile number, CAPTCHA code, and click on ‘Generate OTP’ button.
• Now enter your State and your name, ration card number, household number, or mobile number.
• If your family is covered under Ayushman Bharat Yojana, then you name will be displayed in the results

List of documents Required for Ayushman Bharat Registration

• Age & Identity Proof (Aadhaar Card/PAN Card)
• Contact details (mobile, address, email)
• Caste certificate
• Income certificate (maximum annual income to be only up to Rs. 5 lakh a year)
• Document proof the current status of the family to be covered (Joint or nuclear)

What are the steps to download Ayushman Bharat Card?

• Firstly, visit Ayushman Bharat Yojana official website
• Now login with your email id and generate password
• Enter your Aadhaar number to proceed further
• Click on the approved beneficiary option.
• It will be redirected to their help centre now
• Now enter your password in CSC and the pin number
• It will be redirected to the home page
• Click on the download option to receive your golden Ayushman card.

What is the latest update about the Ayushman Bharat Scheme?

Central government is planning to include the missing middle class families neither rich nor poor under the Ayushman Bharat Scheme. At present the healthcare scheme for the economically weaker section of the society at present provides a cover of 5 lakh to 10.74 million families.

“We are in the process of further strengthening the scheme to be able to benefit all those who are in need of it. It is being strongly considered whether to extend the facility at a nominal premium to those who can pay, which would be over and above the current list of identified beneficiaries,” as mentioned by a Union Government official.

The amendment in the scheme will help individuals who cannot afford all medical expenses with a revised limitation on annual income. And to execute this new plan, the government has already begun culling private and public hospitals to provide cashless treatment.

On the other hand National Health Authority is working hard to draft new packages on the basis of latest demands and increasing cost of healthcare delivery.

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