Ayushman Bharat Yojana

The uncertainties in life have led to the growth of the healthcare sector in India. There has been a subsequent rise in the demand for health insurance plans over the past three decades. Due to this reason, the government of India has introduced the Pradhan Mantri Jan Arogya Yojana Scheme or Ayushman Bharat Yojana. This is a flagship program launched by the government, offering financial protection to the poor in case of unannounced medical exigency. The authority’s main aim is to increase the health expenditure to 2.5 percent of the country’s GDP by the year 2025. Read this blog to know more about PMJAY Scheme or Ayushman Bharat Yojana. 

What is Ayushman Bharat Yojana or PMJAY Scheme? 

Ayushman Bharat Yojana is introduced to provide health coverage to approximately 50 crore citizens in India and the average amount to the beneficiary is INR 5 lakhs. The scheme covers the majority of diagnostics, medicines, pre-hospitalization costs, and medical treatment expenses. It provides healthcare facilities accessible to the poorest of poor families residing in India. Hence, the benefits offered below in this scheme are massive: 

Ayushman Bharat Yojana Benefits

• Provides cashless facility to its beneficiaries
• Covers day-care expenses within the insurance package
• Handles all the uncovered hospital expenses with ease
• Covers the transport allowances during pre and post hospitalization period
• Covers pre-existing ailments of the beneficiary 
• Take care of the follow-up treatments of the patient included in the plan 

Ayushman Bharat Yojana Eligibility Criteria

The eligibility criteria are divided between the rural and urban sectors of India. Find out below: 

Rural Sector Of India

In the rural areas, the health facility is available to: 

• Schedule castes and Scheduled tribe families 
• Beggars and those surviving on alms 
• Tribal Communities
• Households with no male member between the age of 16 years – 59 years 
• Households with no individual between the age of 16 years – 59 years
• Households with at least one physically challenged member and no healthy individual 
• Manual Scavenger families 
• Landless families who make a living by working as casual manual labours
• Legally released bonded labourers
• Families living in one-room under no proper walls or roof

Urban Sector of India

In the urban areas, the scheme can be availed mainly by: 

• Domestic help 
• Rag pickers
• Washerman/Chowkidars
• Mechanics, electricians, and repair workers
• Tailors
• Home-based artisans and handicraft workers
• Sanitation workers, gardeners, and sweepers
• Cobblers, hawkers 
• Plumbers, masons, construction workers, porters, welders, painters, etc
• Transport workers such as drivers, conductors, helpers, rickshaw pullers, etc
• Assistants, peons of a small organization, delivery men, shopkeepers, waiters 

Ayushman Bharat Yojana Non-Eligibility

People who are not entitled to health coverage under Ayushman Bharat Yojana: 

• Employed by the Government 
• Owning a refrigerators and landlines 
• Owning a two, three or four – wheeler or motorized fishing boat
• Have a mechanized farming equipment 
• Have a kisan card with a credit limit of INR 50,000
• With a decently built houses 
• Earning a monthly income above INR 10,000 
• Working in government managed non agricultural enterprises 
• Owning a 5 acres or more of agricultural land 

Ayushman Bharat Yojana Medical Packages 

Following are the medical packages covered under this scheme: 

• Individuals or families can utilize the health coverage of INR 5 lakhs 
• Amount covers treatments in 25 specialties including cardiology, neurology, oncology, paediatrics, and orthopaedics. 
• In case of multiple surgeries, the surgery with the highest cost is paid in the first instance; then a 50% waiver is offered for the second surgery; and a 25% discount on the third. 
• Moreover, this scheme provides cashless treatment and hospitalization, primarily because of the 60:40 cost-sharing agreement between the Center and States. 

Ayushman Bharat Yojana Hospitalization Process 

Find the list of impaneled hospitals by following the steps below: 

• Visit the official website;
• Select your state and district area;
• Choose the type of hospital you’re looking for;
• Choose the kind of medical guidance you need
• Enter the captcha mode
• Click on search 

Ayushman Bharat Yojana Card

To get the Ayushman Bharat Yojana Card, follow the below steps: 

• Visit the official PMJAY website 
• Login with your registered number
• Enter the captcha code and generate the OTP
• Opt for the HHD code
• Provide the correct HHD code to the Common Service Center (CSC)
• They will check and verify the details provided
• The CSC representative will complete the remaining process 
• You will have to pay INR 30 to get the Ayushman Bharat Yojana Golden Card 

Ayushman Bharat Yojana Illness Coverage

Some of the critical ailments covered under the plan are as follows: 

• Prostate Cancer
• Double valve replacement
• Skull base surgery
• Carotid angioplasty with stent
• Pulmonary valve replacement
• Drug rehabilitation program
• Anterior spine fixation
• Organ transplant, etc 

Ayushman Bharat Yojana Documents Required

Documents required to apply for the Ayushman Bharat Yojana scheme: 

• A certified document confirming your age and identification 
• Existing contact details of the buyer 
• Income certificate
• Caste certificate 
• A document stating the current family status 

Ayushman Bharat Yojana Lodging of Complaint or Grievance

You can lodge a complaint or grievance online on the CGRMS portal of the scheme on the official website of CGRMS. 

In case you want to complain offline, you can do so by – 

• Contacting the helpline center of the scheme operated by your State/NHA
• Send a letter, email, or fax to the official addresses of the SHA/NHA
• Directly meeting with the district grievance nodal officer (DGNO) of your district 

Ayushman Bharat Yojana Contact Information

The Ayushman Bharat Yojana scheme and mailing information is as follows: 

Contact Number – 14555 or 1800-111-565 (both toll free)

Mailing Address – National Health Authority of India

3rd, 7th, and 9th floor,

Tower – L, 

Jeevan Bharati Building, 

Connaught Place,

New Delhi – 110001

FAQs

The government of India is keen on providing its citizens with better healthcare services to battle medical contingencies. The government schemes are a great initiative to develop the country and the citizens. With the great implementation of all these schemes, India’s economy and different sectors will be a great achievement. For more such awesome content, follow Leverage Edu. For any doubts or queries, feel free to drop a comment!