Ayushman Bharat Yojana is a National Health Protection Scheme launched by the Government of India in the year 2018. This scheme is also known as the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Scheme or AB-PMJAY Scheme. This scheme not only caters to the needs of the poor but rural households as well, thus it is financially beneficial for both poor and destitute families in urban and rural areas. Under this scheme, the citizens can avail best healthcare services with an insurance cover of up to Rs. 5 Lakh for each household per annum for secondary and tertiary hospitalization expenses. It is a paperless insurance scheme and provides cashless hospitalization coverage at network private hospitals and public hospitals.

Also, this scheme includes expenses for around 1400 exorbitant treatments such as knee replacement, skull surgery, etc.

Basic Details About Ayushman Bharat Health Insurance-PMJAY

Here you can check basic information about Ayushman Bharat health insurance below:

Salient Features of Ayushman Bharat Health Insurance Yojana

Let us know about the salient features of the Ayushman Bharat Yojana, to understand the Ayushman health insurance scheme better:

• It is a family floater health insurance scheme offering a sum assured of Rs. 5 Lakh per annum for each household enrolled under this scheme.
• It is designed specifically for individuals who are below the poverty line.
• This scheme offers its beneficiaries cashless healthcare services in any of the private network hospitals and public sector hospitals.
• Under this insurance scheme, coverage is also offered for certain pre-existing diseases.
• Also, this scheme offers recompensation for the transportation expenses incurred by the beneficiaries during the pre-hospitalisation and post-hospitalisation expenses.
• Under this health scheme backed by the government, various healthcare and wellness centers would be established according to the socio-economic caste census data.

What Is Covered Under Pradhanmantri Jan Arogya Yojana?

The healthcare coverage offered under Ayushman Bharat Health Insurance Scheme is as follows:

• This scheme offers the beneficiary coverage for medical tests, treatment, and consultation fees.
• Under this scheme, the beneficiary is offered coverage for pre-hospitalisation expenses, and expenses for post-hospitalisation are offered for up to 15 days.
• Also, the Pradhan Mantri health insurance policy offers coverage for medicine consumables, medicine costs, hospitalization accommodation expenses, ICU, and Non-intensive services.
• The beneficiary is also offered coverage for expenses incurred towards diagnostic procedures, complications that arise during treatment, and similar expenses.
• It also offers coverage for medical implantation services wherever needed.

Critical Diseases Covered Under PMJAY Health Insurance

Under this scheme, over 1300 medical packages are provided at any of the listed private hospitals and all the government health centers or hospitals. Some of the critical illnesses covered under PMJAY are as follows:

• Prostate Cancer
• Carotid Angioplasty with stent
• Skull base surgery
• Coronary artery bypass grafting
• Anterior spine fixation
• Pulmonary Valve Surgery
• Surgery for Double valve replacement

Who All Are Not Entitled to Receive Coverage Under PMJAY Scheme?

The following individuals are not offered coverage under the Ayushman Bharat Health Insurance Scheme:

• Individuals, who own vehicles such as three-wheelers, two-wheeler, or car
• Individuals with a monthly income of more than Rs. 10,000
• Government Employees
• People have farming equipment, machinery, motorized fishing boats, and a Kisan card.
• People living in proper houses or having agricultural land of more than 5 acres.
• Individuals employed under non-agricultural enterprises run by the government.

Benefits Offered Under Pradhan Mantri Health Insurance

Around 40% of the vulnerable and destitute households are offered coverage under Ayushman Bharat Yojana Scheme. The benefits offered to them under this health insurance scheme are as follows:

• The healthcare treatment and other health services offered under this insurance scheme are available throughout the nation free of cost.
• This scheme offers the beneficiary coverage for medical tests, treatment, and consultation fees.
• Under this scheme, the beneficiary is offered coverage for pre-hospitalisation expenses, and expenses for post-hospitalisation are offered for up to 15 days.
• Also, the Ayushman Bharat Yojana scheme offers coverage for medicine consumables, medicine costs, hospitalization accommodation expenses, ICU, and Non-intensive services.
• The beneficiary is also offered coverage for expenses incurred towards diagnostic procedures, complications that arise during treatment, and similar expenses.
• It also offers coverage for medical implantation services wherever needed.

How to Apply for Ayushman Bharat Yojana?

It is very easy to register yourself for Ayushman Bharat Yojana. All the beneficiaries who are a part of the RSBY health scheme and are identified under the Socio-economic caste census, 2011, are eligible to apply for this scheme. To register for the PMJAY scheme online, follow the below-mentioned easy steps:

Step 1: Go to the official government website for the Ayushman Bharat Scheme. Click on the ‘Am I eligible’ tab.
Step 2: Submit your contact number and captcha code. Then, generate the OTP by clicking on the option provided.
Step 3: Enter your name, state, phone number, ration card number, and household number.
Step 4: In case your family members are covered under this scheme, then your name will be displayed in the search results.

Eligibility Criteria for the Pradhanmantri Jan Arogya Yojana

To check your eligibility for this Pradhan Mantri medical insurance, you need to check the data of the Socio-Economic Caste Census. If your name is listed on this, you can apply for an Ayushman Bharat Health Insurance card online or offline. Moreover, listed below are the group of people who are eligible to buy this scheme:

• Any household with no male earning member and an age group between 16-59 years
• Family living in kutcha walls
• A household without any adult earning member and one disabled member
• A family of manual scavengers
• Ragpickers, beggars, ragpickers, washerman
• Home-based artisan, rickshaw puller, cobbler

How to Check Your Name on the PMJAY Ayushman Bharat Scheme?

You can check your name on PMJAY health insurance in different ways such as the following:

• Visit the official website of the National Health Authority for Ayushman Bharat Yojana and check your name.
• You can also make a visit to your nearest Common Service Centre or any of the impaneled hospitals to get details.
• Alternatively, call the toll-free number to seek details about your name on the Ayushman Bharat card.

How to Download Ayushman Bharat Card (PMJAY Card)?

Here are the steps you need to follow this prime minister’s health insurance scheme, Ayushman Bharat scheme:

• Click on the official website of the Ayushman Bharat Yojana
• Enter your email address and password
• Enter your aadhaar card number
• Then, click on the approved beneficiary option, after which you will be taken to their help center
• Next, enter your password and PIN
• Then, you will be taken to the home page from where you can download the Ayushman Bharat card

Hospitalization Process Through PMJAY Scheme

The Ayushman Bharat Yojana streamlines the hospitalization process and does not involve payment of premiums. Under this scheme, eligible beneficiaries receive cashless access to quality healthcare services. The process begins when a patient is identified at an Ayushman Bharat impaneled hospital. The hospitalization process is simplified, with no need for upfront payments. Patients are provided with a unique ID and their medical expenses are directly settled through the Ayushman Bharat National Health Authority. Moreover, at the linked hospitals, beneficiaries also get QR codes which is scanned for verification purpose. Thus, through this scheme, the hospitalization process has become way too easy for several people.

Documents Needed to Register for PMJAY Ayushman Bharat Yojana Scheme

You require the following list of documents to apply for Ayushman Bharat Health Insurance:

• Identity and Age Proof (PA Card/Aadhar Card)
• Contact Information (email. Address, mobile number)
• Income Certificate
• Caste Certificate
• Document proof for the present status of the household to be covered (whether nuclear or joint)