ayushman-bharat-yojana-scheme
By Okbima 09 Jan 2024 178

Ayushman Bharat Yojana Scheme 2024 – PMJAY Scheme

 

Ayushman Bharat Yojana Scheme, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY) Scheme , is a government initiative in India aimed at providing healthcare coverage to economically vulnerable families. Launched in 2018, this scheme seeks to address the issue of financial hardships faced by individuals when seeking medical treatment. 

 

What is the Ayushman Bharat Yojana Scheme?

Ayushman Bharat Yojana Scheme, also known as Pradhan Mantri Jan Arogya Yojana (PM-JAY), is a healthcare scheme launched by the Government of India. The program was announced in September 2018 and became operational on September 23, 2018. Ayushman Bharat aims to provide financial protection and improve access to quality healthcare for the economically vulnerable population in India.

 

Benefits of Ayushman Bharat Yojana Scheme

The Ayushman Bharat Yojana Scheme is a healthcare initiative launched by the Government of India. The scheme aims to provide financial protection and healthcare access to economically vulnerable families. 

  1. Financial Protection: Ayushman Bharat Card provides health insurance coverage of up to INR 5 lakh per family per year, offering significant financial protection against healthcare expenses. 

  2. Cashless Transactions: The Ayushman Bharat Card ensures cashless transactions at hospitals, allowing beneficiaries to receive healthcare services without having to make direct payments at the time of treatment.

  3. Wide Network of Hospitals: The scheme has a network of public and private hospitals across India. Beneficiaries can access healthcare services from these hospitals, both urban and rural healthcare development.

  4. Preventive Healthcare Services: Ayushman Bharat Card special importance on preventive healthcare by covering pre-hospitalization and post-hospitalization expenses. 

  5. Empowerment of Women: The scheme prioritizes women by ensuring that they are named as the primary cardholders in eligible families. 

 

Which Diseases Are Covered by the Ayushman Card?

Ayushman Bharat PMJAY scheme provides financial protection to over 10.74 crore vulnerable families, covering approximately 50 crore individuals, providing coverage of up to Rs 5 lakh (per family per year).

Some of the common treatments that are covered under the Ayushman Bharat Yojana Scheme include:

• Medical and Surgical Procedures: The scheme covers a wide range of medical and surgical procedures, including but not limited to cancer treatment, heart surgeries, joint replacements, kidney treatments, and more.

• Maternity and Newborn Care: Maternity-related expenses, including normal and cesarean deliveries, are covered under the scheme. Newborn care is also included.

• Pre-existing Conditions: Ayushman Bharat Card covers pre-existing conditions, ensuring that individuals with existing health issues can also avail of benefits.

• Emergency Room Care: Emergency hospitalization is covered under the scheme, providing financial support during critical situations.

• Follow-up Care: The scheme covers post-hospitalization expenses, including follow-up consultations and medications.

 

Which Diseases are Not Covered by the Ayushman card?

Ayushman Bharat PMJAY scheme covers a broad range of treatments, there may be some exclusions and limitations. Here are some treatments that are not covered:

• Outpatient Care: Ayushman Bharat Card primarily covers inpatient hospitalization expenses. Outpatient care and treatments that do not require hospitalization may not be covered.

• Cosmetic Procedures: Procedures that are primarily cosmetic and not medically necessary are generally not covered.

• Non-Allopathic Treatments: Ayushman Card typically covers treatments under allopathic (modern medicine) systems. Non-allopathic treatments may not be covered

• Non-Hospital Expenses: The scheme is focused on hospitalization expenses. Costs related to outpatient consultations, diagnostic tests outside the hospital, and non-hospital settings may not be covered.

 

How Much Money Do You Get from Ayushman Card?

Under the Ayushman Bharat Yojana Scheme, each eligible family receives coverage of up to Rs. 5 lakh per family per year for hospitalization expenses. This means that if a member of the eligible family requires hospitalization for a covered medical condition or procedure, the insurance coverage provided by the Ayushman Bharat Card can be utilized up to the specified limit of ?5 lakh. The coverage includes a wide range of medical and surgical procedures.

 

How to Use an Ayushman Bharat Card in a Hospital?

To use the Ayushman Bharat card in a hospital, follow these general steps. The processes may vary depending on the hospital and region, so it's advisable to confirm the specific procedures with the hospital staff.

  1. Check Hospital List: Make sure the hospital is approved to offer services under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Only approved hospitals can participate in the program.

  2. Carry Ayushman Bharat Card: Show your Ayushman Bharat card (also known as the Ayushman Gold Card) at the hospital's registration desk when you visit for treatment. 

  3. Verification and Authorization: The hospital staff will verify the details on the Ayushman Bharat card. Once the eligibility is confirmed, the hospital will seek authorization from the Ayushman Bharat system for the proposed treatment.

  4. Medical Treatment: If the treatment is authorized, you can proceed with the required medical procedures. The hospital will provide the necessary healthcare services as per the treatment plan.

  5. Claim Processing: The hospital will process the insurance claim with the Ayushman Bharat system. This involves submitting the necessary documentation and details of the treatment provided.

  6. Cashless Treatment: The Ayushman Bharat Card generally operates on a cashless basis, meaning that the hospital bills are settled directly between the hospital and the Ayushman Bharat system.

  7. Post-Treatment: After the treatment, it's important to keep any relevant documents provided by the hospital for future reference. This may include discharge summaries, prescriptions, and any other documents related to the hospitalization.

 

How Many Times Can an Ayushman Card Be Used?

The Ayushman Card offers health insurance that lasts for one year. Each eligible family can get coverage up to ?5 lakh per year. This money is meant to help with hospital expenses for different medical treatments. You can use the Ayushman card as many times as needed within the one-year coverage period. But once you've used up the ?5 lakh for that year, you have to wait until the next year for more benefits.

 

How to Check Ayushman Card Balance?

You can check your Ayushman Card Balance by using the PMJAY website, the UMANG app, and the Ayushman Mitra Helpline.

1. Using PMJAY Website

Step 1: Visit the official PMJAY website, and click on "Am I Eligible?"

pmjay-website

 

Step 2: Enter your mobile number, click on verify, and enter the OTP and captcha code.

pmjay-login

 

Step 3: Once, you log in, you can able to see details like your family members covered under the scheme, available treatments, and previous hospitalizations.

 

2. UMANG App

Step 1: Download the UMANG app on your phone.

umang

Step 2: Register or log in using your mobile number and Aadhaar card details, and search for "Ayushman Bharat PMJAY".

Step 3: Click on "Beneficiary Status" and enter your mobile number or Ayushman card number.

Step 4: You'll get information about your family's coverage and any previous claims.

 

3. Ayushman Mitra Helpline

Step 1: Call the toll-free Ayushman Mitra helpline number 1800-111-565.

Step 2: Provide your Ayushman card number or any other necessary details.

Step 3: The helpline personnel can assist you with your queries about coverage, treatment availability, and claim status.

 

What is the Difference Between a Health Card and an Ayushman Card?

A health card and an Ayushman card are two different types of healthcare cards available in India. A health card is usually provided by insurance companies or employers and provides coverage for medical expenses depending on the policy. 

On the other hand, an Ayushman Yojana card is issued by the government and provides free health insurance coverage for low-income families under the Ayushman Bharat Yojana scheme.

 

Feature

Health Card

Ayushman Card

Purpose

Proof of identity for availing healthcare benefits from various schemes

Access to cashless treatment under Pradhan Mantri Jan Arogya Yojana (PMJAY) for eligible families

Target Group

All citizens, depending on the specific scheme

Economically weaker sections of society as defined by PMJAY criteria

Cost

Free or subject to a nominal fee as per the scheme

Free for eligible families

 

How to Apply Ayushman Yojana Card in 2024?

To apply for the Ayushman Yojana Card in 2024, you need to follow a simple process. This government initiative aims to provide health insurance coverage to vulnerable citizens. 

Step 1: Visit abha.abdm.gov.in, and click on "Create ABHA Number"

abha-website

Step 2: Click on "Create your ABHA number using Aadhar".

create-abha-number

Step 3: Enter your Aadhaar card number, fill in the captcha, and click “Next”.

enter-aadhar-number

Step 4: Verify with the “OTP” and, fill in the application form with personal details, and income.


Step 5: Apply and once your application is approved, you'll receive a notification and your Ayushman Bharat Health Account (ABHA) card will be generated.

How to Download Ayushman Bharat Card?

You can download your Ayushman Bharat card (also known as Pradhan Mantri Jan Arogya Yojana or PMJAY card) in two ways: online or through the UMANG app.

1. Downloading Online

Step 1: Visit the official PMJAY website, on the homepage, click on "Am I Eligible?" in the top menu.

Step 2: Enter your mobile number linked to your Ayushman Bharat account and Click on "Generate OTP", enter the received OTP, and captcha code.

Step 3: Once your identity is confirmed, you'll be redirected to a new page where you can download your Ayushman Bharat card.

Step 4: Click on the "Download Card" option provided on the screen.

Step 5: Your Ayushman Bharat card will be downloaded in PDF format.

 

2. Downloading through UMANG App:

Step 1: Download the UMANG app (Unified Mobile Application for Government India) on your phone. It's available on both Android and iOS.

Step 2: Register or log in using your mobile number and Aadhaar card details, and search for "Ayushman Bharat PMJAY".

Step 3: Click on "Beneficiary Status" and enter your mobile number or Ayushman card number.

Step 4: You'll get information about your family's coverage and any previous claims.

Step 5: Click on "Download e-Card" to download your Ayushman Bharat card in PDF format.

 

Who is Eligible for the Ayushman Bharat Yojana Card?

Ayushman Bharat Yojana Scheme is primarily based on certain criteria related to economic status. The scheme aims to provide financial protection to economically vulnerable families. Eligibility is determined through the Socio-Economic Caste Census (SECC) data. Here are the key eligibility criteria for Ayushman Bharat Yojana:

• Economic Criteria: Families identified as economically vulnerable based on the SECC data are eligible for Ayushman Bharat Yojana. This data is used to identify households that fall into specific deprivation categories.

• Deprivation Criteria: The SECC data categorizes households based on various deprivation indicators such as housing, education, occupation, and more. Families falling under identified deprivation categories are considered eligible.

• Urban and Rural Areas: The scheme covers both urban and rural areas, and eligible families from both settings can benefit from Ayushman Bharat.

• No Age Limit: There is no specific age limit for eligibility. The scheme covers all family members, including children and the elderly.

 

What Documents are Required for an Ayushman Card?

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) aims to provide financial protection to economically vulnerable families in India. 

  1. Identity Proof: Aadhar Card, Voter ID, Passport, and any other government-issued photo ID

  2. Address Proof: Aadhar Card, Voter ID, Passport, and Utility bills (electricity, water, gas, etc.).

  3. Family Structure Details: Documents proving family structure, such as a ration card or a family certificate

  4. Income Certificate: Proof of income or a certificate demonstrating economic status. This could include salary certificates, income tax returns, or any other income-related documents.

  5. Caste Certificate: In some cases, a caste certificate may be required as part of the eligibility criteria.

  6. Bank Account Details: A bank account may need to be linked to receive cashless benefits under the scheme.

 

Who Cannot Make an Ayushman card?

While the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) aims to cover a significant portion of the population, certain individuals may not be eligible to make an Ayushman Yojana card. 

• Higher Income Individuals: The scheme is designed to provide financial protection to economically vulnerable families. Individuals or families with higher income levels may not qualify for the Ayushman Bharat card.

• Non-Indian Residents: The scheme is typically intended for Indian residents. Non-Indian citizens may not be eligible for enrollment.

• Families Not Identified in SECC Data: The Ayushman Bharat scheme uses the Socio-Economic Caste Census (SECC) data to identify eligible families. If a family is not included or identified in the SECC data, they may not be eligible for the Ayushman Yojana card.

 

Can an Ayushman Card be Made Without a Ration Card?

Yes, an Ayushman Card can be made without a ration card. The eligibility for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is determined based on various socio-economic factors, and possession of a ration card is not a mandatory requirement for enrollment. 

The scheme primarily relies on the Socio-Economic Caste Census (SECC) data to identify and include economically vulnerable families. While a ration card is one of the documents that can be used to support the application, individuals and families without a ration card can still apply for and receive the Ayushman Card. 

 

Is the Ayushman Card Renewed Every Year?

No, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana does not require annual renewal. Once a family or individual is enrolled and eligible for the scheme, the coverage continues without the need for annual renewal.


The eligibility and enrollment process typically involves verification of socio-economic criteria, and once approved, the Ayushman Yojana Card remains valid for the duration of the scheme. There is no need for beneficiaries to go through a yearly renewal process.

 

FAQs

Can I apply for an Ayushman card online?

Yes, you can apply for an Ayushman card online through the official Ayushman Bharat website or by visiting the Common Service Centers (CSCs) designated for this purpose.

 

When will the Ayushman card be made?

The Ayushman card is usually generated shortly after the successful online application process. 

 

How do I make an Ayushman card at home?

Making an Ayushman card at home is not possible. It can be obtained through the official application process online or by visiting a Common Service Center (CSC).

 

What is the other name of Ayushman Card?

The Ayushman Card is also known as the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) card.

 

How to upload a photo on an Ayushman card?

During the online application process, there will be a step where you can upload a passport-sized photo. Follow the instructions provided on the official Ayushman Bharat website.

 

Can a wife get treatment through her husband's Ayushman card?

Yes, family members, including the wife, can receive treatment through the primary cardholder's Ayushman card.

 

Can a government employee make an Ayushman card?

Yes, Ayushman cards are available to all eligible individuals, including government employees.

 

What is free on Ayushman's card?

Ayushman Bharat provides coverage for various medical treatments and procedures. The specific services covered can be checked on the official website or through the information provided during the application process.

 

How much does it cost to make an Ayushman card?

The Ayushman card is issued free of cost. There is no fee associated with the application or the generation of the card.

 

What is the age required to make an Ayushman card?

There is no specific age requirement to get an Ayushman card. It is available for individuals of all ages.

 

Can one get treatment in a private hospital with an Ayushman card?

Yes, Ayushman Bharat allows treatment in private hospitals, expanding the options for healthcare services.

 

When was the Ayushman Bharat scheme launched?

The Ayushman Bharat scheme was launched on September 23, 2018.

 

Is Ayushman Bharat free?

Ayushman Bharat provides financial protection for eligible beneficiaries, covering medical expenses. However, the services are not entirely free, and there may be co-payment or additional costs depending on the treatment.

 

Who started the Ayushman Bharat Yojana?

Ayushman Bharat Yojana was launched by Prime Minister Narendra Modi.

 

How to avail benefits of Ayushman Bharat?

To avail of benefits, individuals need to check their eligibility, apply for the Ayushman card online, and seek treatment at empaneled hospitals.

 

Who can apply Ayushman Bharat Yojana?

Ayushman Bharat Yojana is available to economically vulnerable families in India, identified based on socio-economic criteria in the SECC (Socio-Economic Caste Census) database.

 

Which hospital uses the Ayushman Bharat Yojana?

Ayushman Bharat empanels both public and private hospitals meeting the scheme's criteria. Beneficiaries can receive healthcare services at any empaneled hospital.

 

How Ayushman Bharat scheme work?

Ayushman Bharat provides financial protection by offering health insurance coverage. Eligible families receive an Ayushman card, allowing cashless treatment at empaneled hospitals for specified medical conditions.

 

Is the Ayushman Bharat scheme available in Kerala?

Yes, Ayushman Bharat is a national scheme, and it is available in Kerala. Beneficiaries in the state can access healthcare services through empaneled hospitals.

 

Is the Ayushman Bharat scheme for everyone?

Ayushman Bharat targets economically vulnerable families identified through the SECC database. While not for everyone, it aims to cover a significant portion of India's population.

 

How many members should there be in the family for an Ayushman card?

Ayushman Bharat covers families with up to five members. The Ayushman card is issued to eligible families, providing them access to health insurance benefits under the scheme.

 

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