Ayushman Bharat Yojana – Everything you Need to Know
Initiated by the Government of India, Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat Yojana aims to aid economically backward Indians with medical facilities.
It is a health insurance policy that caters to the healthcare needs of the financially weaker sections of Indian society. The scheme was initiated in September 2018.
By September 2019, more than 18,000 hospitals were incorporated under this initiative, which was ready to serve the 10 Crore plus e-cards which were already circulated. Additionally, by September 2019, more than 44 Lakh beneficiaries had already availed the facilities at these hospitals.
Understanding health insurance under Ayushman Bharat Yojana
Under this initiative, the Government of India provides numerous benefits and features, which even include pre-hospitalization costs as well as post-treatment expenses. Individuals applying for this scheme are issued with digital e-cards which enable customers to avail cashless treatment at registered hospitals. It aims to provide healthcare facilities to 10 Crore Indian families of which around 8 Crore are from rural belts while a little above 2 Crore in urban zones. The subsidy is covered by Central and State Governments at a 60:40 ratio.
With Government initiatives leading the way in this front, numerous financial aggregators and NBFCs are also offering convenient health insurance plans for every section of the society. While customers can go for either PMJAY or different policies offered by NBFCs, it is important they understand the basic features as well as eligibility criteria.
Basic benefits provided by PMJAY.
The benefits offered by this Government initiative have the following basic features –
- The insurance policy covers the whole family of insured individuals.
- A high sum of Rs. 5 lakh is granted in the insurance amount.
- 25 specialized treatments are covered under Ayushman Bharat Yojana, which includes essentials like cardiology, oncology, orthopedics, neurosurgery, pediatrics, etc.
- The highest package cost for the first treatment is followed by a 50% waiver on the second and 25% waiver on the third treatment, if necessary.
Eligibility criteria for PMJAY
Aiming to cater to affordable healthcare facilities to the poor and economically suppressed individuals, the eligibility criteria for Ayushman Bharat registration is split into two sections based on where these individuals live. Underneath, both rural and urban eligibility criteria are discussed in details.
For rural beneficiaries, any of the following eligibility criteria are required to be fulfilled –
- Individuals from scheduled castes or scheduled tribes.
- Families with no individuals between 16 and 59 years of age.
- Families with a disabled member and no able-bodied adult individuals.
- Landless households like casual manual laborers, beggars, etc.
- Primitive tribal communities.
- Legally released bonded laborers.
In the case of urban beneficiaries, any one of the underneath eligibility criteria must be fulfilled to avail PMJAY benefits.
- Washerman, chowkidars, masons, construction workers, porters, welders, rag-pickers, domestic help, etc. with low income.
- Mechanics, electricians, repair workers without proper housing.
- Plumbers, sanitation workers, gardeners, sweepers, etc. who make living by menial works.
- Home-based artisans like tailors, handicraft workers, etc.
- Street and pavement based hawkers and service providers like cobblers, tea-sellers, etc.
- Individuals working in the transport sector like drivers, conductors, rickshaw pullers, etc.
- Assistants, peons, delivery boys and even small shopkeepers with low income.
With financial assistance assured under the Ayushman Bharat Yojana initiative, low-income individuals can easily avail of all medical and healthcare essentials without having to worry about its affordability.
In situations where individuals are aware of specific upcoming health care needs like delivery of a child, they can also avail additional cover policies from companies like Bajaj Finserv. They provide specialized healthcare policies like maternity health insurance plans and others, which further protects families with medical facilities and financial protection.