10 Major Benefits of Ayushman Bharat Yojana
10 Major Benefits of Ayushman Bharat Yojana
Published on July 03, 2023. EST READ TIME: 3 minutes
In an era of increasing medical costs and unforeseen healthcare needs, having access to dependable health insurance has become a vital component of a well-rounded financial plan. Health insurance acts as a safeguard, providing individuals and families with the necessary financial security against unanticipated medical emergencies. Recognising the significance of affordable healthcare for all, the Government of India launched Ayushman Bharat Yojana — Pradhan Mantri Jan Arogya Yojana (PM-JAY), a ground-breaking endeavour aimed at revolutionising healthcare access and coverage for millions of Indian citizens. Let’s explore its key features and the 10 significant Ayushman Bharat Yojana benefits.
Key Features of Ayushman Bharat PM-JAY
The primary attributes of Ayushman Bharat Yojana are as follows:
• Ayushman Bharat Yojana policy offers cashless coverage of up to Rs 5 lakh per family in a year. The benefits can be availed by one or all members of the family.
• Covers both secondary and tertiary care hospitalisation as listed in the scheme.
• Covers the cost of nearly 1,929 procedures, including room rent, diagnostic tests, doctors’ fees, surgeon charges, OT and ICU charges, etc.
• Beneficiaries of the Ayushman Bharat Yojana policy can avail of cashless treatment in any of the empanelled public and private hospitals across the country.
• Pre-existing diseases are covered right from the day of enrolment. There’s no waiting period.
• Ayushman Bharat Yojana policy covers up to 3 days of pre-hospitalisation and 15 days of post-hospitalisation expenses, including medicines and diagnostics.
• There’s no cap on age, family size, or gender under the Ayushman Bharat Yojana policy.
• Public hospitals receive reimbursement at par with private healthcare institutions.
• More than 2 crore families (nearly 55 crore beneficiaries) belonging to the poor and vulnerable sections of society are eligible for Ayushman Bharat Yojana.
10 Benefits Covered Under PM-JAY
All expenses incurred for the below services or treatments are covered under the Ayushman Bharat Yojana policy:
• Medical consultation, examination, and treatment of the beneficiary
• Pre-hospitalisation
• Post-hospitalisation of up to 15 days
• Cost of medicine and medical consumables
• Non-intensive and intensive care services
• Diagnostic and laboratory tests
• Medical implantation, if required
• Accommodation during hospitalisation
• Food services
• Any complications arising during treatment are covered under the Ayushman Bharat Yojana policy Those eligible for Ayushman Bharat Yojana can avail of the above Ayushman Bharat benefits in any empanelled hospital in India.
PM-JAY Critical Illness Coverage
Apart from covering pre-existing illnesses and daycare procedures, Ayushman Bharat Yojana also provides coverage for critical illnesses. Treatments can be availed in any public or private empanelled hospital pan India up to the sum insured of Rs 5 lakh per year under the Ayushman Bharat Yojana policy.
List of Critical Diseases covered under Ayushman Bharat Health Scheme
The critical illnesses covered under Ayushman Bharat Yojana are:
• Prostate cancer
• Double valve replacement
• Coronary artery bypass graft (ABG)
• Carotid angioplasty with stent
• Anterior spine fixation
• Pulmonary valve replacement
• Skull base surgery
• Laryngopharyngectomy
• Tissue expander in case of disfigurement due to burns
Exclusions
There are some medical conditions which are not covered under Ayushman Bharat Yojana, such as:
• OPD expenses
• Organ transplantation
• Cosmetic surgeries
• Fertility related procedures
• Drug rehabilitation
Conclusion
With an aim to make healthcare accessible and affordable to the poor and vulnerable, the Government of India launched the Ayushman Bharat Yojana, one of the world’s largest health insurance schemes. Every family under the Ayushman Bharat Yojana policy gets coverage of up to Rs 5 lakh per year, which any one or all family members can utilise. The eligible beneficiaries can avail of Ayushman Bharat benefits in any of the empanelled public and private hospitals across India. Ayushman Bharat Yojana policy is also open to all – there’s no bar on age, number of family members or gender.
Disclaimer : The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales
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