AYUSHMAN BHARAT YOJANA

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Introduction to Ayushman Bharat Yojana

Pradhan Mantri Jan Arogya Yojana (PM-JAY), another name for the Ayushman Bharat Yojana, is a historic healthcare program that the Indian government introduced in 2018. It seeks to give the less fortunate segments of society access to high-quality, reasonably priced healthcare. Ayushman Bharat is a component of the National Health Policy 2017, which aims to meet the healthcare needs of more than 50 crore people in order to realize the goal of Universal Health Coverage (UHC).

The largest government-funded healthcare program in the world, this initiative provides eligible families in both rural and urban areas with cashless and paperless treatment. It aims to promote fair access to healthcare, particularly for disadvantaged and marginalized groups, and lessen the financial burden of medical bills, which frequently force families into poverty.

Key Objectives of Ayushman Bharat

The two primary foundations of the Ayushman Bharat Scheme are:

1. Health and Wellness Centers (HWCs)

• To offer complete primary healthcare services, almost 1.5 lakh HWCs are being established nationwide. These facilities provide free necessary medications, immunizations, maternal and pediatric health care, and diagnostic services.

2. Pradhan Mantri Jan Arogya Yojana (PM-JAY)

• PM-JAY offers health insurance coverage for secondary and tertiary care hospitalizations up to ₹5 lakhs per family annually. It covers a wide spectrum of treatments, such as severe illnesses, cancer care, and procedures.

Benefits of Ayushman Bharat Yojana

One of the main government healthcare programs, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), aims to make health services accessible to the underprivileged and impoverished segments of Indian society. The ten main advantages of the Ayushman Bharat Yojana are as follows:

Free Health Coverage

Every qualifying household is given free health insurance coverage of up to ₹5 lakh annually under the Pradhan Mantri Jan Arogya Yojana. Families can now obtain essential medical care without having to worry about the exorbitant premiums of Medicare.

Coverage for the Whole Family

The family floater benefit of the AB-PMJAY enables all eligible family members to take advantage of this health insurance coverage. This implies that the ₹5 lakh coverage amount can be divided among all eligible family members rather than being restricted to a single person.

No Restrictions on Family Size, Age & Gender

There are no age, gender, or family size limitations under the Ayushman Bharat PMJAY program. Every member of qualified households can take advantage of this government health insurance program because to its flexibility.

Pre-Existing Diseases (PED) Coverage from Day 1

The fact that the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) covers pre-existing conditions from day one is one of its most notable aspects. This implies that individuals with persistent medical conditions can start receiving treatment right away after signing up for this program and are not subject to a waiting period.

Coverage for Pre and Post-Hospitalization Expenses

In addition to hospitalization charges, PMJAY also covers pre- and post-hospital expenses. Up to three days of pre-hospitalization and fifteen days of post-hospitalization costs are covered by this government health program. As a result, beneficiaries are able to oversee their complete medical care journey—from doctor visits and diagnostic testing to follow-up treatment after hospitalization—without having to worry about unforeseen financial obligations.

Extensive Coverage of Medical Procedures

Comprehensive coverage is offered by the Ayushman Bharat Yojana, which covers roughly 1,949 medical procedures, including secondary and tertiary care treatments. The majority of medical costs are fully covered by this plan, including necessary operations, complicated medical procedures, medications, tests, hospital stays, and food costs.

Universal Coverage for All Senior Citizens

Pradhan Mantri’s reach All senior persons 70 years of age and above, regardless of their financial situation, are now eligible for health insurance coverage under the extended Jan Arogya Yojana. Ayushman Bharat 2.0 offers around 6 crore senior adults in India financial assistance.

Nationwide Access to Healthcare Benefits

The Ayushman Bharat PMJAY scheme’s mobility is another important benefit. No matter where they live, beneficiaries can receive cashless care at any hospital that has an affiliation with the program. This guarantees that beneficiaries have access to healthcare services whenever they’re needed.

Cashless Hospitalization

In India, both public and private hospitals that are affiliated with the Pradhan Mantri Jan Arogya Yojana, or PMJAY, offer cashless hospitalization to their beneficiaries. This implies that individuals are exempt from having to pay in full for medical care. Rather, the program will cover the adjacent Ayushman Hospital’s expenditures up to the ₹5 lakh total insured limit. As a result, it will lessen the strain and inconvenience of having to pay for medical emergencies.

Reducing Financial Burden

About 12 crore vulnerable families, or 55 crore beneficiaries, who make up the poorest 40% of the Indian population, are to have their financial burdens lessened by the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. The program helps keep these families from sinking further into poverty as a result of growing Medicare expenses by providing significant mediclaim insurance coverage.

How to Apply for an Ayushman Bharat Card?

Under the PMJAY program, you can receive cashless medical care and hospitalization services via the Ayushman Bharat card. You can take advantage of the program’s benefits at any public or private hospital that has an agreement with this golden card. Additionally, by following the instructions below, you can quickly apply for an Ayushman card both online and offline:

Online Application Process:

To apply for an Ayushman Bharat Card online, follow these easy steps:

Step 1:Go to Pradhan Mantri’s official website. Click the ‘Am I Eligible’ tab in the menu bar to access the Jan Arogya Yojana.

Step 2: You must choose the ‘Beneficiary’ option and log in by providing your cell number, captcha code, and the OTP that was sent to your phone after being transferred to the Beneficiary NHA portal.

Step 3: Choose the ‘PMJAY’ scheme and select the other necessary information, such as the district and state.

Step 4: In the Search By column, select ‘Aadhaar Number’ and input your Aadhaar number.

Step 5: Every member of the family will be listed, along with the status of their Ayushman cards.

Step 6: You can select ‘Apply Now’ from the ‘Action’ column if your Ayushman Bharat card status is ‘Not-Generated’.

Step 7: Enter the OTP that was sent to your registered cellphone number to authenticate yourself using your Aadhaar number.

Step 8: To finish the Ayushman card online application procedure, enter the family members’ requested information, including their mobile numbers, and submit it.

Your Ayushman Bharat card will be available for download after approval.

Offline Application Process:

You can go to an Ayushman Mitra or a local hospital that has been accredited to apply for an Ayushman Bharat card offline. To finish the registration process, make sure you have your identifying documents with you, including your Aadhaar card and other crucial paperwork. To obtain your Ayushman Bharat card, the staff will help you with the next stages.

Documents Required to Apply for Ayushman Bharat Card Online

Examine the list of documents you might require for the online application process for an Ayushman card:

• Aadhaar card for biometric and identity validation
• Certificate of income
• Family records such as a ration card, CM letter, or PM letter
• Certificate of caste
• Documents pertaining to bank accounts.

Who Can Apply for an Ayushman Bharat Card?

Depending on their wealth, individuals in rural and urban India have different requirements for the Ayushman Bharat card. However, under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the Union Cabinet expanded health insurance coverage to all senior adults 70 years of age and over in September 2024. The Ayushman Bharat eligibility list for urban and rural households is as follows:

1. PMJAY Eligibility for Rural Households:

To apply for an Ayushman Bharat card, rural families must fulfill at least one of the requirements listed below:

• living in a single room with a roof and walls made of kucha.
• No adult participant between the ages of 16 and 59
• No male adult member between the ages of 16 and 59.
• lacking an adult member who is able-bodied or having a person with a disability.
• being a member of a Scheduled Tribe (ST) or Scheduled Caste (SC).
• The main source of income for landless households is manual, casual labor.

2. PMJAY Eligibility for Urban Households:

 In metropolitan regions, the following types of workers are eligible to receive an Ayushman card:

• Beggars
• Ragpickers
• Domestic helpers
• Watchmen and washermen
• Cobblers, hawkers, street sellers, and other street service providers
• Plumbers, headloaders, laborers, masons, welders, coolies, security personnel, painters, and construction workers
• Gardeners, sweepers, and sanitation personnel
• Workers who work from home, artists, craftspeople, and tailors
• Drivers, rickshaw pullers, cart pullers, conductors, and assistants to conductors and drivers
• Shop employees, helpers, delivery assistants, waiters, peons in small businesses, and attendants
• Repairers, assemblers, mechanics, and electricians.

Conclusion

An important step in realizing India’s vision of “Health for All” is the Ayushman Bharat Scheme. The program is fostering preventative health practices, increasing access to high-quality healthcare, and offering financial protection in order to create a more just and healthy society.

The Ayushman Bharat Scheme has already had a significant impact on millions of lives, guaranteeing that no Indian is refused access to healthcare because of financial limitations, even though there is still opportunity for improvement.

This flagship program will be vital in determining the direction of healthcare in India and building a more resilient and inclusive country with continued work and improvements.

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