Ayushman Bharat Yojana - Coverage and Benefits
The government runs various schemes for the welfare of the people, providing benefits to millions of citizens. These schemes are designed to ensure that people don’t have to empty their pockets for treatment, education, and basic needs. Health-related schemes have especially come as a big relief for the poor and low-income families. One of the most important among these is the Prime Minister Ayushman Bharat Yojana.
Under this scheme, the Ayushman card has become a guarantee of treatment for millions of families. However, there is still confusion about how the Rs. 5 lakh coverage limit works, how many times a person can be admitted to the hospital in a year, and which diseases are covered. Let's answer all these questions.
How does the Ayushman Card work?
The Ayushman card is issued under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, which was launched in 2018. It is a digital health card that allows eligible families to get free treatment of up to Rs. 5 lakh annually at listed government and private hospitals across the country. This benefit is available for the entire family, not just one individual. There is no need for an agent, and the entire process is online. Once the card is downloaded, it can be used for treatment. This scheme is especially beneficial for families who find it difficult to afford expensive treatment.
How many times can treatment be availed in a year?
Many people believe that they can avail unlimited free treatment under the Ayushman card throughout the year. The reality is a bit different. The Rs. 5 lakh coverage limit applies to the entire family. So, if there are five or six members in the family, the total treatment costs for all family members combined cannot exceed Rs. 5 lakh per year. There is no restriction on the number of times a person can be admitted to the hospital, but the total cost for the family cannot exceed the Rs. 5 lakh limit. Once this limit is exhausted, any further treatment expenses will need to be borne by the family.
Which diseases are covered?
The Ayushman card is highly beneficial for the treatment of serious diseases. It covers major surgeries such as heart valve replacement, pacemaker implant, prostate cancer, spine surgery, skull base surgery, kidney transplant, and corneal transplant. In these cases, the hospital bills are fully covered under the scheme. However, OPD visits, normal medications, X-rays, and blood tests are not covered. This scheme is for economically weaker sections, people working in the unorganized sector, those over 70 years of age, and individuals who are outside the purview of ESIC and PF benefits. Eligible individuals can easily apply for the Ayushman card through mera.pmjay.gov.in or visit the nearest CSC center.