Ayushman Bharat Yojana

Ayushman Bharat Yojana (PMJAY) : Ayushman Bharat Yojana is an initiative by the central government to provide medical aid and facilities to the weaker sections. The paperless scheme provides a cashless medical cover of a maximum of Rs 5 lakh.

Ayushman Bharat or Pradhan Mantri Jan Arogya Yojana is a government initiative to provide medical assistance to marginalized sections. Launched by Prime Minister Narendra Modi in 2018, this flagship national health protection scheme is funded by the Government of India. The Senior Citizen Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojana (RSBY) benefit both the poor and destitute families in rural areas.

The scheme, which provides coverage to around 50 crore Indians, aims to make secondary and tertiary healthcare completely cashless for the underprivileged sections. PMJAY e-card holders can avail insurance coverage of up to Rs 5 lakh for each family at any listed public or private health center anywhere within their limits.

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What is Ayushman Bharat Yojana or PMJAY Scheme?

Ayushman Bharat Yojana (PMJAY) is India’s flagship health insurance scheme launched in 2018. It provides free healthcare coverage of up to ₹5 lakh per family annually for secondary and tertiary hospitalization. Targeted at economically weaker sections, the scheme covers over 10 crore families (50 crore beneficiaries) identified through the Socio-Economic Caste Census (SECC).

The Ayushman Bharat Yojana includes nearly 1,949 treatments like skull surgery, knee replacement surgery, etc. Moreover, it covers the cost of follow-up care and treatments to ensure full recovery.

Features of Ayushman Bharat Yojana (PMJAY) :-

Cashless Treatment: Available at empaneled government and private hospitals.
Wide Coverage: Covers 1,500+ medical procedures, including surgeries and critical treatments.
Eligibility: Based on SECC data; no enrollment fee required.
Objective: Reduce out-of-pocket healthcare expenses and improve accessibility.

Benefits of Ayushman Bharat Yojana (PMJAY)

The Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY) provides free treatments and healthcare facilities across India. It ensures access to quality healthcare without financial burden for the economically weaker sections of society.
The scheme covers 27 specialty categories, including medical oncology, orthopedics, emergency care, and urology, offering a wide range of medical and surgical packages. Beneficiaries also receive coverage for pre-hospitalization expenses, reducing out-of-pocket costs.
In cases involving multiple surgeries, the scheme covers costs in a tiered manner. The highest-cost procedure is fully covered, while the second and third surgeries are covered at 50% and 25% of their respective package rates.
PMJAY also extends coverage to cancer treatment, including chemotherapy for 50 types of cancers. However, beneficiaries cannot avail both medical and surgical packages simultaneously for the same condition.

What is Covered Under Ayushman Bharat Yojana?

Medical examination, treatment and consultation fees
Pre-hospitalization expenses for up to 3 days
Post hospitalization expenses for up to 15 days
Non-intensive and ICU services
Medical implanatation services, where required
Food serives

What is Not Covered Under Ayushman Bharat Yojana?

People who own a vehicle like a two wheeler, three wheeler or a car
Government employees
People whose monthly income is more than 10,000
Those who live in properly built houses
Those who hold a kisan card