Benefits of The Pradhan Mantri Ayushman Bharat Yojana (PMJAY)

Some of the major benefits of the Pradhan Mantri Jan-Arogya Scheme under the Pradhan Mantri Ayushman Bharat Yojana are as follows:

• A health insurance cover of ₹5 lakh per family per annum
• Provision of cashless health insurance to over 10 crore poor and vulnerable families in the country
• Coverage for hospitalisation expenses for up to 3 days
• A post-hospitalisation cover of up to 15 days, including the expenses for diagnostics and medicines
• No limit on the number of family members one can cover under this scheme
• Coverage for 1,393 medical procedures and all the costs pertaining to those procedures
• Coverage for the expenses for drugs, physician's fee, surgeon's fee, OT and ICU charges, room charges, etc.
• Coverage for accommodation expenses
• Coverage for food expenses
• Coverage for the cost of Medical Implantation Services

What Is Covered Under Ayushman Bharat Health Insurance Scheme?

Some of the major benefits of the Pradhan Mantri Jan-Arogya Scheme under the Pradhan Mantri Ayushman Bharat Yojana are as follows:

• Coverage includes expenses for medical tests, treatment and consultation fees.
• Under this scheme, the beneficiary is offered coverage for pre-hospitalisation expenses and expenses for post-hospitalisation is offered for up to 15 days.
• Ayushman Bharat Yojana scheme offers coverage for medicine consumables, medicine cost, hospitalisation accommodation expenses, ICU and Non-intensive services.
• The beneficiary is also offered coverage for expenses incurred towards diagnostic procedures, complications that arise during treatment and similar expenses.
• It also offers coverage for medical implantation services wherever needed.

Critical Diseases Covered Under PMJAY Scheme

Some of the critical illnesses covered under PMJAY are as follows:

• Prostate Cancer
• Carotid Angioplasty with stent
• Skull base surgery
• Coronary artery bypass grafting
• Anterior spine fixation
• Pulmonary Valve Surgery
• Surgery for Double valve replacement

Pradhan Mantri Ayushman Bharat Yojana Eligibility Criteria

For rural recipients

Apart from the above-mentioned deprivation category, the following people are automatically eligible for enrollment under this scheme: people living on charity, households engaged in manual scavenging, families belonging to primitive tribal groups and legally released bonded labour.

For urban recipients

People living in the urban areas of the country and engaged in any of the following occupations are eligible to be enrolled in the Pradhan Mantri Ayushman Bharat Yojana: ragpicking, begging, domestic labour, street vending, construction work, plumbing, masonry, welding, sweeping and sanitation work, artisanship, handicraft work, and tailoring, driving, cart pulling, rickshaw pulling, working in shops, as peons, attendants, or waiters, working as an electrician, mechanic, and repair, and assembly worker, and working as a watchman or delivering laundry services.

Who All are not Eligible to Receive Coverage Under PMJAY Scheme?

The following individuals are not offered coverage under Ayushman Bharat Health Insurance Scheme:

• Individuals, who own vehicles such as cars, three-wheeler and two-wheeler
• Individuals with a monthly income of more than Rs. 10,000
• Government Employees
• People having farming equipment, machinery, motorized fishing boats and a kisan card.
• People living in proper houses or having agriculture land more than 5 acres.
• Individuals employed under non agricultural enterprises run by the government.

Documents Needed to Register for Ayushman Bharat Yojana Scheme

You require the following list of documents to apply for Ayushman Bharat Yojana Scheme:

• Identity and Age Proof (PA Card/Aadhar Card)
• Contact Information (email. Address, mobile number)
• Income Certificate
• Caste Certificate
• Document proof for the present status of the household to be covered (whether nuclear or joint)