The Ayushman Bharat Yojana, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), is a government-run health insurance scheme launched in India in 2018. It aims to provide financial assistance for secondary and tertiary healthcare to over 50 crore Indian citizens belonging to low-income families.
This scheme offers cashless and paperless hospitalization for up to Rs. 5 lakh per family per year. It covers a wide range of medical treatments, surgeries, diagnostics, and pre-hospitalization expenses. Ayushman Bharat Yojana targets economically disadvantaged families identified through the Socio-Economic Caste Census.
The Ayushman Bharat Yojana program is the world's largest government-funded health insurance scheme, which provides financial coverage of up to Rs. 5 lakh per year for eligible families.
Table of Contents:
- ⇾ Features of Ayushman Bharat Yojana
- ⇾ Eligibility Criteria for Ayushman Bharat Yojana
- ⇾ Coverage Under Ayushman Bharat Yojana
- ⇾ Ayushman Bharat Card
- ⇾ Documents Required to Apply For Ayushman Bharat Yojana
- ⇾ Apply For Ayushman Card
- ⇾ Online Method To Apply For Ayushman Card
- ⇾ Offline Method To Apply For Ayushman Card
- ⇾ Medical Procedures & Illness Covered Under Ayushman Bharat Yojana Scheme
- ⇾ Steps To Download The Ayushman Bharat Card
- ⇾ Online Method To Download Ayushman Card
- ⇾ Offline Method To Download Ayushman Card
- ⇾ Benefits Of Ayushman Bharat Yojana
- ⇾ Steps To Check Your Name In The Ayushman Bharat Yojana List
- ⇾ Using Online Portal
- ⇾ Using Helpline Number
- ⇾ Using Common Service Centre (CSC)
- ⇾ Steps To Find PMJAY Hospital List
- ⇾ Frequently Asked Questions
Features of Ayushman Bharat Yojana
The table provided below outlines the features and benefits of the Ayushman Bharat Yojana scheme.
| Feature | Description |
|---|---|
| Financial Coverage | Up to Rs. 5 lakhs per family per year for secondary and tertiary hospitalization |
| Beneficiaries | Low-income families identified through Socio-Economic Caste Census (SECC) 2011 data |
| Hospital Network | Public and empanelled private hospitals across India |
| Cashless Transactions | Avail treatment without upfront payment at empanelled hospitals |
| Coverage Scope | Secondary and tertiary hospitalization expenses including medicines, diagnostics, pre and post hospitalization care (3 days pre and 15 days post) |
| Portability | Benefits are portable across India. A beneficiary can visit any empanelled hospital |
| Pre-existing Conditions | Covered from day one |
| Family Size & Age Limit | No restriction on family size or age |
| Exclusions | OPD expenses, Organ transplants, Cosmetic procedures, Fertility treatments |
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Eligibility Criteria for Ayushman Bharat Yojana
The Ayushman Bharat Yojana (PM-JAY) targets economically disadvantaged families in India. Here's a list of eligibility criteria for the Ayushman Bharat Yojana scheme.
Ayushman Eligibility for Rural Families
Social Category: Belonging to Scheduled Castes (SC) or Scheduled Tribes (ST)
Economic Status:
- Below Poverty Line (BPL) families
- Families with no earning member between 16 and 59 years of age
- Households with a single room having impermanent walls and roof
- Families that lack any land and rely on casual labor for income
Ayushman Eligibility for Urban Families
Must belong to one of the listed occupational categories:
- Street vendors, cobblers, and hawkers
- Domestic workers, rag pickers, and beggars
- Construction workers, plumbers, masons, painters, etc.
- Transport workers (conductors, drivers, etc.)
- Artisans, home-based workers, and tailors
- Sweepers, sanitation workers, and gardeners
- Electricians, mechanics, and repair workers
- Many other occupations are categorized as informal workers
Coverage Under Ayushman Bharat Yojana
The table below provides an overview of the particulars that are covered in Ayushman Bharat Yojana.
| Particulars | Description |
|---|---|
| Secondary and tertiary hospitalization expenses |
Covers hospitalization costs for serious illnesses and injuries requiring advanced medical care |
| Medicines | Covers the cost of medicines prescribed by the doctor during hospitalization |
| Diagnostics | Covers the cost of diagnostic tests required for treatment |
| Pre-hospitalization care (up to 3 days) | Covers medical expenses incurred up to 3 days before hospitalization |
| Post-hospitalization care (up to 15 days) | Covers medical expenses incurred up to 15 days after discharge from the hospital |
Ayushman Bharat Card
The Ayushman Bharat Card is a photo ID card issued to beneficiaries of the Ayushman Bharat Yojana (PM-JAY) health insurance scheme in India. It acts as a proof of entitlement for the cashless medical benefits offered under the scheme.
It's a debit card specifically for covering your medical expenses under Ayushman Bharat. Here are some key points about the Ayushman Bharat Card.
- Function: Beneficiaries can present the card at empanelled hospitals (public or private) to avail cashless treatment for covered illnesses.
- Benefits Covered: The card covers hospitalization expenses up to Rs. 5 lakh per family per year.
- Issuance: The card is issued free of charge to identified beneficiaries.
- Eligibility: Having the card doesn't guarantee eligibility. You must be included among the beneficiaries identified through the Socio-Economic Caste Census (SECC) data.
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Documents Required to Apply For Ayushman Bharat Yojana
The documents required to apply for Ayushman Bharat Yojana (AB-PMJAY) can vary slightly depending on your location, but these are the primary documents that are needed.
- Aadhaar Card: This is the primary ID proof and used for biometric verification.
- Ration Card or Socioeconomic Caste Certificate (SECC) Data: This document helps determine your eligibility based on socio-economic status. In some cases, an AAY (Antyodaya Anna Yojana) Ration Card or a letter from the Prime Minister (PM) or Chief Minister (CM) may be accepted as alternatives.
- Proof of Address: This might not always be mandatory, but could be helpful if your address isn't already linked to your Aadhaar Card.
- Income Certificate: Some states may request proof of income for verification.
Apply For Ayushman Card
The Ayushman Card is issued to beneficiaries identified through the Socio-Economic Caste Census (SECC) data. The steps provided below show how to apply for the Ayushman card.
Steps to Apply For Ayushman Card Online
- Step 1: Go to the Ayushman Bharat Yojana's official website.
- Step 2: Click on the "Am I Eligible" section on the homepage.
- Step 3: Enter your mobile number and the captcha code displayed.
- Step 4: Click on "Generate OTP" and enter the One-Time Password received on your phone for verification.
- Step 5: You'll be asked to fill in some personal details like name, state, age, and family member information.
- Step 6: The website will then display your eligibility status based on the Socio-Economic Caste Census (SECC) data.
Offline Method to Apply For Ayushman Card
- Step 1: Visit your nearest empanelled hospital or Ayushman Mitra (community health worker).
- Step 2: They will guide you through the process and help you check your eligibility using their system.
- Step 3: You might need to provide identification documents like an Aadhaar card for verification.
Medical Procedures & Illness Covered Under Ayushman Bharat Yojana Scheme
The table below provides a comprehensive overview of the medical procedures and serious illness that is covered under the Ayushman Bharat Yojana Scheme.
| Category | Examples |
|---|---|
| Cancer | All types of Cancers (e.g., Breast Cancer, Lung Cancer, Leukemia) |
| All types of Cancers (e.g., Breast Cancer, Lung Cancer, Leukemia) | Coronary artery bypass grafting (CABG), Valve replacement surgery, Percutaneous coronary intervention (PCI), Aortic aneurysm repair, Congenital heart defects |
| Kidney Diseases | Chronic kidney disease, Kidney failure, Dialysis, Kidney transplant |
| Liver Diseases | Liver cirrhosis, Hepatitis B and C, Liver cancer |
| Respiratory Diseases | Chronic obstructive pulmonary disease (COPD), Bronchiectasis, Interstitial lung disease, Lung cancer |
| Neurological Disorders | Epilepsy, Parkinson's disease, Alzheimer's disease, Meningitis, Brain tumor |
| Bone and Joint Diseases | Total knee replacement, Total hip replacement, Ilizarov surgery for fractures |
| Gastrointestinal Diseases | Peptic ulcer disease, Inflammatory bowel disease (IBD), Gastrointestinal cancers |
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Steps to Download Ayushman Bharat Card
The Ayushman Bharat Card provides access to free and cashless healthcare services and having your Ayushman Bharat Card readily available can be helpful when seeking medical care.
Let's take a look at the steps involved in downloading the Ayushman Bharat card.
Steps to Download Ayushman Card Online
- Step 1: Visit the official website of Ayushman Bharat PMJAY.
- Step 2: Click on the "Am I Eligible?" tab on the homepage.
- Step 3: Enter your mobile number registered with your Ayushman Bharat account.
- Step 4: Enter the OTP that you will receive on your registered mobile number.
- Step 5: If you are eligible, you will be redirected to a page where you can download your Ayushman Bharat card (PMJAY Golden Card) in PDF format.
Steps to Get Ayushman Card Offline
- Step 1: Visit your nearest Common Service Center (CSC). You can find a CSC near you using the official website.
- Step 2: Provide your mobile number for verification at the CSC center.
- Step 3: The CSC staff will verify your details and may ask for additional documents for reference (not mandatory for download but might be helpful).
- Step 4: Once verified, they can help you download your Ayushman Bharat Card.
Benefits of Ayushman Bharat Yojana
The Ayushman Bharat Yojana, also known as Pradhan Mantri Jan Arogya Yojana (PMJAY), offers several benefits to eligible beneficiaries in India. Here are some of the primary benefits and advantages of this scheme.
- Financial Security: It provides cashless and paperless coverage of up to Rs. 5 lakh per year per family for hospitalization. This can be a huge financial relief for families facing medical emergencies, especially those struggling financially.
- Wide Coverage: The scheme covers a broad range of medical expenses, including pre-hospitalization costs (up to 3 days), hospitalization charges, post-hospitalization care (up to 15 days), medicines, diagnostics, surgeon fees, and critical illness treatments.
- Access to Quality Care: Beneficiaries can avail of treatment at both public and empanelled private hospitals across India. This increases options for choosing quality healthcare facilities.
- Pre-existing Conditions: Unlike many private insurance plans, Ayushman Bharat Yojana covers pre-existing medical conditions.
- Empowerment: The scheme empowers beneficiaries to seek medical care without worrying about upfront costs.
- Reduced Out-of-Pocket Expenses: By covering a significant portion of medical bills, Ayushman Bharat Yojana helps reduce the financial burden on families, particularly those who might have hesitated to seek medical attention due to cost concerns.
- Improved Overall Health: By making healthcare more accessible and affordable, the scheme can contribute to an overall improvement in public health in India.
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Steps to Check Your Name In Ayushman Bharat Beneficiary List
Checking your name on the Ayushman Bharat Yojana beneficiary list will help you plan ahead for medical needs and access quality care at empaneled hospitals across India, potentially saving a substantial amount on healthcare costs.
You can check your name on the beneficiary list using the online portal, helpline, or Common Service Centre (CSC).
Check Beneficiary List Using Online Portal
- Visit the official PMJAY beneficiary portal: [beneficiary.nha.gov.in]
- You can search by:
- Mobile Number: Enter your registered mobile number and follow the verification steps.
- Other Details: If you have your PMJAY ID, Ration Card Number, Family ID, or Aadhaar Card number, you can use them to search directly.
Check Beneficiary List Using Helpline Number
- You can also call the Ayushman Bharat Contact Center helpline at 14555 or 1800-111-565 to inquire about your beneficiary status.
Check Beneficiary List Using Common Service Centre (CSC)
- You can find your nearest CSC by searching online or asking local authorities.
- Inform the CSC operator that you want to check if your name is on the AB-PMJAY beneficiary list.
- Be prepared to share your Aadhaar card number, ration card number (if applicable), or any other relevant information that might help with the search.
- The CSC operator will guide you through the process based on their available resources. They might help you search online, check local lists, or suggest alternative verification methods.
Steps to Find PMJAY Hospital List
Here are the steps to find the PMJAY hospital list online:
- Step 1: Visit the official PMJAY website.
- Step 2: Click on "Find Hospital" which is usually located in the top menu bar.
- Step 3: Enter your search criteria:
- Location: Select your state and optionally, the district from the dropdown menus.
- Hospital type: You can choose between public and private hospitals based on your preference.
- Step 4: Click the search button to view a list of PMJAY empanelled hospitals matching your criteria.
Check more on the Ayushman Bharat Scheme from the links below:
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Frequently Asked Questions
The Ayushman Bharat Yojana, also called PMJAY, is a government health insurance program in India that provides free hospitalization coverage of up to ₹5 lakh per year to low-income families.
The Ayushman Bharat Yojana targets poor and vulnerable families in India, identified through a government survey. This includes people from Scheduled Castes/Tribes, those with no earning members, and lower-income families.
The Ayushman Bharat Yojana provides financial coverage of up to Rs. 5 lakh per year for hospitalization costs to over 50 crore poor and vulnerable families in India.
Ayushman Bharat Yojana (PMJAY) covers a wide range of critical illnesses including cancer, heart diseases, kidney diseases, and surgical procedures like knee replacements and bone marrow transplants. It doesn't cover outpatient care, dental, or cosmetic procedures.
There are two main ways to check your Ayushman Bharat Yojana eligibility: Search your name online or call the PMJAY helpline at 14555.
Yes, you can use Ayushman Bharat Yojana (PMJAY) in empanelled private hospitals. Search for the list of hospitals on the PMJAY website to see which ones accept Ayushman Bharat cards.
To apply for Ayushman Bharat Yojana, you'll need an Aadhaar card for verification and proof of belonging to a beneficiary family (ration card/ govt. letter).
Visit the PMJAY website, and enter your state and hospital type (public/private) to find Ayushman Bharat Yojana empanelled hospitals near you.
Visit the PMJAY website, and enter your state and hospital type (public/private) to find Ayushman Bharat Yojana empanelled hospitals near you.
The Ayushman Bharat Yojana offers a coverage limit of up to ₹5 lakh per family per year. This helps eligible families pay for secondary and tertiary hospitalization expenses.
You can download your Ayushman Bharat Yojana card (PMJAY card) through DigiLocker or by visiting your nearest CSC center for offline assistance.
You can check your Ayushman Bharat Yojana application status by logging in to the PMJAY beneficiary portal with your registered mobile number and the OTP received.
To claim benefits under Ayushman Bharat Yojana, first check your eligibility online or at a CSC. Then, visit an empanelled hospital with your Ayushman Bharat Golden Card for cashless treatment.
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