Table of Contents
- Features of the Pradhan Mantri Jan Arogya Yojana
- Ayushman Card Benefits
- 1. Zero Premium
- 2. PMJAY Insurance Coverage
- 3. Free Hospitalization
- 4. PAN India Service
- 5. Pre-existing Disease
- 6. Family Size
- 7. RSBY Families
- 8. Coverage from Day One
- 9. Awareness Building
- 10. Poverty Upliftment
- 11. Priority to Women and Senior Citizens
- 12. Secondary and Tertiary Care
- 13. Pre-hospitalization
- 14. Post-hospitalization
- 15. Medical Cost
- 16. Benefits of Ayushman Card – Speciality
- 17. Package and Procedures
- 18. Surgery Reimbursement
- 19. Treatment Resulting in Complications
- 20. Cancer – Ayushman Card Benefit
- Compare Benefits of Ayushman Card with Private Health Insurance
- Ayushman Card Eligibility
- The Ayushman Card Benefits – FAQs
Apart from being the world’s largest insurance scheme, the Ayushman Bharat scheme offers many benefits to those, covered by it. In this blog post, we will see 20 Ayushman Card Benefits, along with some other important information related to the scheme.
Read the entire article for all the Benefits of Ayushman Card which are provided by the Ayushman Bharat Yojana.
Ayushman Bharat Scheme
Ayushman Bharat Yojana or Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is an Indian government insurance scheme that provides insurance coverage of Rs.5 lakh per year per family to India’s poor and middle-income group.
Ayushman Bharat Yojana provides cashless medical facilities to approx 50 crore individuals and it was launched on 23 September 2018 by the honorable prime minister of India Shree Narendra Modi.
What is Ayushman Card or Ayushman Bharat Card?
When an individual is entitled to receive cashless medical treatment under the Ayushman Bharat Yojana, he/she is provided with a card that is called Ayushman Card or you can even say it, Ayushman Bharat Card.
Ayushman Bharat Scheme Details
The most important key points of the PMJAY scheme are listed below.
|Ayushman Bharat Scheme Details
|AB PMJAY Full Form
|Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
|Government of India in 2018
|Citizens of India
|Approx 40% of the Indian population
|Ayushman Bharat Health Insurance Coverage Amount
|Rs.5 Lakh per year per family
|Ayushman Bharat Eligible Candidates
|Eligibility as per Socio-Economic Caste Census 2011
|More than 27,000
|26 Specialities like Oncology and Neurosurgery
|Package and Procedure
|920 Packages covering more than 1670 Procedures
|Ayushman Bharat Login
|PMJAY login for eligibility check
|PMJAY Official Website
|Click here for Ayushman Bharat Portal
Features of the Pradhan Mantri Jan Arogya Yojana
Pradhan Mantri Jan Arogya Yojana is a flagship scheme of the Government of India, which has unique features as compared to other insurance schemes. Before we see Benefit of Ayushman Card, we should first read about the features of the scheme.
- Largest Insurance Scheme: Pradhan Mantri Jan Arogya Yojana is the world’s largest insurance scheme.
- Financing: Pradhan Mantri Ayushman Yojana is funded by Centre and State Governments with a cost-sharing agreement of 60:40 respectively.
- Population Covered: Pradhan Mantri Ayushman Yojana covers more than 10 crore poor and needy families, which is equal to approx 40 crore individuals.
- Family Floater: Ayushman Bharat is a family floater scheme that covers the entire family with a single insurance plan.
Ayushman Card Benefits
From zero insurance premiums to maximum insurance coverage, Pradhanmantri Ayushman Yojana offers a variety of benefits to its policyholders. Here are the top Benefits of Ayushman Card, you should be aware of.
1. Zero Premium
Have you ever listened to that insurance companies provide insurance coverage to their policyholders without a premium?
But Pradhanmantri Ayushman Yojana provides insurance coverage to entitled beneficiaries at zero cost or without a premium amount which means you don’t have to pay any Rupee to remain active of this policy.
2. PMJAY Insurance Coverage
PMJAY Scheme offers Rs.5 Lakh insurance coverage per year to lower middle-income families of India.
Any entitled beneficiary who wants to receive treatment under the PMJAY scheme can go to any empanelled hospital where he can get treatment up to their card limit. The card limit is given Rs.5 lakh per family per year.
After the treatment, you can enquire about the remaining amount on your card from the hospital staff or PMAM (Pradhan Mantri Ayushman Mitra).
Let us understand it with an example: Assume that you got a treatment of Rs.1 Lakh during the above-said treatment. Now the remaining balance on your card is Rs.4 Lakh, which can be used for another family member’s treatment.
PMAM Full Form: Pradhan Mantri Ayushman Mitra
What is PMAM: Pradhan Mantri Ayushman Mitras are individuals who are appointed at all empanelled public or private hospitals to assist Ayushman Card Holders in the hospitalization process.
3. Free Hospitalization
All PMJAY Bharat Card holders are given cashless treatment at all the empanelled public and private hospitals, which means PMJAY beneficiaries are not charged money for their treatment.
The Indian government is strict on that no Ayushman Bharat Health Card holder is charged money for their treatment and has placed a separate procedure to stop this.
If somebody in the hospital demands money from you for the treatment, you can file a complaint to PMAM or on the PMJAY Official Website.
Want to Know Step by Step process on how to file a PMJAY complaint, see this blog post – Ayushman Bharat Yojana by Finance Expert.
4. PAN India Service
Although many state governments provide insurance coverage to their citizens, those citizens can only receive medical treatment within the borders of that particular state. They cannot use that state’s program in other Indian states.
But in the PM Jan Arogya Yojana, Ayushman Card holders get free treatment at any empanelled public or private hospital all over India.
For example, a person residing in Rajasthan can get free treatment in any other Indian state including Rajasthan.
5. Pre-existing Disease
Some health insurance schemes exclude pre-existing diseases before the insurance policy starts. But PM Jan Arogya Yojana also covers pre-existing diseases which is one of the most important Benefits of Ayushman Card.
6. Family Size
Learning from the mistakes of the previous State Government’s health insurance schemes, there is no cap on the family size in the Ayushman Bharat.
7. RSBY Families
All the eligible beneficiaries are included on the basis of the Socio-Economic Cast Sensus 2011, in addition, P M Jan Arogya Yojana also covers those families who were part of the erstwhile Rasthiya Swashtya Bima Yojana which was launched in 2008.
8. Coverage from Day One
Unlike other health insurance policies, P M Ayushman Yojana provides insurance coverage from the start of day one, which is also one of the most important Benefits of Ayushman Card.
9. Awareness Building
The health insurance penetration in India is very low compared to other developed countries.
By providing health insurance to the person standing at the end of the row, the Government aims to increase awareness about the importance of having insurance among the middle-class and poor citizens of this nation.
10. Poverty Upliftment
By offering free medical care to eligible beneficiaries, P M Ayushman Yojana saves nearly 6 crore Indians from falling into poverty each year and thus also helps the nation to achieve Sustainable Development Goals (SDG).
11. Priority to Women and Senior Citizens
Special regard and privilege are given to the women and senior citizens during the treatment under this insurance scheme.
12. Secondary and Tertiary Care
Ayushman Scheme offers Rs.5 Lakh insurance coverage per year to 40% Indian population for Secondary and Tertiary Care hospitalization.
Primary Care: It is the first point of medical consultation where you get treatment related to flu, cold, infection, a broken bone, etc.
Secondary Care: When your primary care doctor refers you to a specialist who has some specialty in a specific disease. Neurologists, cardiologists, and Cardiac surgeons are some examples of Secondary Care.
Tertiary Care: If you require a higher level of care during your secondary care hospitalization, then you are referred to a highly specialized doctor who has more specialty than your Secondary Care counterpart.
Coronary artery bypass, Severe burn treatments, and Dialysis are some examples of Tertiary Care.
PMJAY Yojana covers Pre-hospitalization Expenses of up to 3 days.
Pre hospitalization Expenses: Healthcare expenses paid by an insured person before being admitted to a hospital are known as Pre-hospitalization expenses.
Before being admitted to the hospital, medical tests done like x-rays, medical diagnostic tests, doctor consultation fees, and medicines prescribed, are some examples of Pre-hospitalization expenses.
PMJAY Yojana covers Post-hospitalization Expenses of up to 15 days which is another one of the top Benefits of Ayushman Bharat Scheme.
Post hospitalization Expenses: Healthcare expenses paid by an insured person after discharge from a hospital are known as Post hospitalization expenses.
After discharge from the hospital, medical tests done like follow-up tests and prescribed medications, are some examples of Post-hospitalization expenses.
15. Medical Cost
All costs associated with the subsequent treatments are also covered by the AB PMJAY.
- Medical examination
- Services related to the Intensive and Non-intensive care
- Laboratory investigations
- Medical implantation
- Food-related services
- Medical problems that develop during treatment
16. Benefits of Ayushman Card – Speciality
AB PMJAY offers medical treatment to its beneficiaries in 26 specialties.
Burns management, emergency, infectious disease, cardiology, mental disorder, oncology, orthopedics, and ENT are some examples of AB PMJAY speciality.
17. Package and Procedures
Ayushman Bharat Yoj provides 920 packages covering more than 1670 procedures.
Thermal burns, chikungunya fever, diarrhea, chronic cough, and glaucoma surgery are some examples of AB PMJAY packages.
Malaria, dengue fever, gout, and chronic meningitis are some examples of AB PMJAY procedures.
18. Surgery Reimbursement
When a patient requires multiple procedures, the first one should be paid by the highest package, and the following two should be covered by 50% and 25% of the highest package, respectively.
Thus a patient can take multiple treatments under this scheme, which is another Benefit of Ayushman Card.
19. Treatment Resulting in Complications
According to PM-JAY policy, the treatment package also includes complications arising out of the surgery.
For example, If a complication arises after the treatment of a patient, then it is covered under this scheme and also receives treatment free of cost.
20. Cancer – Ayushman Card Benefit
Cancer treatment is one of the most important Benefits of the Pradhan Mantri Jan Arogya Yojana. It offers treatment for up to 50 types of cancer free of cost.
Compare Benefits of Ayushman Card with Private Health Insurance
In the below table, we have compared the Benefits of Ayushman Card with the benefits of the health insurance provided by private companies.
|Ayushman Card Benefits
|Private Health Insurance Benefits
|All the premium costs are incurred by the center and state governments respectively.
|Premium costs are paid by the policyholder.
|Up to 10 times the annual income.
|Free Health Checkup
Ayushman Card Eligibility
Beneficiaries of the Ayushman Bharat Yojana have been identified from the list of the Socio-Economic Caste Census (SECC) 2011.
The PMJAY Scheme also includes families that were a part of the Rashtriya Swasthya Bima Yojana (RSBY) but were absent in the SECC 2011 database.
The Ayushman Card Benefits – FAQs
Q: What services are offered under the Ayushman Bharat Scheme?
Ans: Ayushman Bharat provides a variety of services, including pre and post-hospitalization, newborn child, and burns management.
Q: What is an Ayushman Bharat card?
Ans: Ayushman Bharat Card is like a physical Aadhar Card, which offered free health insurance coverage of up to Rs.5 Lakh to entitled beneficiaries.
Q: What are the benefits of Ayushman Card?
Ans: Ayushman Card Benefits are listed below.
- Medical examination, treatment, and consultation fee
- Pre-hospitalization expenses
- Non-intensive and intensive care services
- Diagnostic investigations
- Medical implantation services
- Accommodation charges
- Complications arising during treatment
- Post-hospitalization expenses
- Food services
These are the Ayushman Card Benefits provided by the Ayushman Bharat Yojana.
Q: Who is eligible to avail of the benefits of Ayushman Card?
Ans: All the Ayushman Yojana beneficiaries are included on the basis of the Socio-Economic Caste Census (SECC) 2011.
Q: Will beneficiaries have to pay anything to get covered under this scheme?
Ans: No, all the treatment provided under the Ayushman Bharat Yojana is free of cost.
Q: Where can beneficiaries avail of services under PM-JAY?
Ans: Under the scheme, beneficiaries can avail of free treatment of up to Rs.5 lakh per year at any public or private hospital all over India.
Q: Can the benefits of Ayushman Card be available without Aadhar Card?
Ans: Yes, an Aadhar card is not mandatory for getting Ayushman Card Benefit.
Q: Who is Aarogya Mitra?
Ans: Pradhan Mantri Ayushman Mitras are individuals who are appointed at all empanelled public or private hospitals to assist Ayushman Card Holders in the hospitalization process.
|Jan Aadhar Card
|Ayushman Bharat Yojana
|Benefits of Ayushman Card