In his 2018 Independence Day speech, Prime Minister Shri Narendra Modi announced the beginning of the (PMJAY) Ayushman Bharat Yojana. The Pradhan Mantri Jan Arogya Yojana (PMJAY), a significant national health protection initiative, is funded by the Indian government. The Senior Citizen Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojna (RSBY) are both included in the Ayushman Bharat Yojana, also referred to as the AB-PMJAY program. The Ayushman Bharat Yojana initiative benefits poor and impoverished households in rural and urban areas since it helps poor and rural families. Health cards are issued to eligible individuals and families under this scheme, known as Ayushman Bharat health cards.
Ayushman Bharat health cards are a significant way for families to save money on medical expenses. This health card allows individuals and families to access free treatments in both government and private hospitals that are part of the scheme. The card ensures access to free medical care up to a certain limit, regardless of a person’s financial background. It eliminates out-of-pocket medical expenses, which are very common among poor and rural families. The scheme covers 1,393 health procedures, including hospitalizations, specialized treatments, and preventive health care.
What is the Ayushman Bharat Health card?
Prime Minister Narendra Modi launched the Ayushman Bharat Yojana in 2018. The beneficiaries will receive an e-card with access to the Ayushman card benefits if they meet the scheme’s requirements. The Ayushman Bharat Health Card was introduced to access cashless medical care and hospitalization.
By gaining access to primary, secondary, and tertiary healthcare services from public or private hospitals with impaneled status, Ayushman Health Card benefits the recipients. The PMJAY e-card contains information on a patient’s health.
What is the Health ID?
One of the main projects of the ABDH (Ayushman Bharat Digital Health) Mission is the ABHA number, formerly known as the Health ID. It is a simple way to share and access digital health records. Health ID was formerly known as the Ayushman Bharat Health Account Number.
It facilitates communication between patients and participating healthcare providers (labs, hospitals, clinics, and online doctor consultations). It enables patients to obtain prescriptions, digital test results, and diagnoses from reputable healthcare professionals and health service providers.
The ABHA number can also link one’s old and new medical records, including prescriptions from doctors, lab results, hospital records, etc. One can also share the documents with licensed health service providers and medical experts. Additionally, one can access other digital health services while keeping a shared medical history database. The Ayushman Bharat Health Account is the initial step toward developing a person’s and their family’s digital health records more effectively and securely.
Ayushman Bharat Yojana Program features
The Pradhan Mantri Ayushman Bharat Yojana (PMJAY) has the following other significant characteristics in addition to being a life-saving program for lower middle-class people:
- Family floater Ayushman Bharat Yojana scheme has a fund assured of Rs. 5 lakhs for each enrolled family.
- People under the poverty line who do not have access to the internet or online health plans are the target audience for this program.
- The PMJAY scheme enables its recipient to receive cashless healthcare services at any public sector hospital or private network hospital.
- Additionally, the Pradhan Mantri Ayushman Bharat Yojana reimburses the beneficiary for any transportation expenses paid before and during the hospitalization.
- The Ayushman Bharat Yojana insurance package also covers the beneficiary’s daycare and medical treatment costs.
- The PMJAY program also covers several specific pre-existing conditions.
- The government has predetermined a package rate that will be used to calculate the payment for medical expenses.
- According to data from the Socio-Economic Caste Census, many health and wellness centers will be built under the government-sponsored program.
Hospitalization expenses for beneficiaries are covered by the AB-PMJAY health insurance, which contains the following elements:
- Inspection, advice, and treatment from a doctor.
- Services for both non-intensive and intensive care.
- Pharmaceuticals and medical supplies.
- Laboratory and diagnostic services
- Services for medical implants, whenever possible.
- Food delivery.
- A problem that occurs during treatment.
- Expenditures are related to leaving the hospital for up to 15 days.
- Treatment for the COVID-19 (coronavirus).
What Does the Ayushman Bharat Yojana Plan Not Cover?
The Ayushman Bharat Yojana Scheme contains several exclusions, just like other health insurance policies. The plan does not protect the following elements:
- OPD (Outpatient Department) costs.
- Treatment for drug use.
- Cosmetic procedures, fertility procedures.
- Personalized diagnoses.
- Transplanting organs.
Coverage of COVID-19 under the PMJAY Scheme
The Insurance Regulatory and Development Authority (IRDAI) has advised all health and general insurance companies to cover COVID-19 (Coronavirus) hospitalization and treatment charges for beneficiaries to obtain COVID-19 coverage. The PMJAY, also known as the Ayushman Bharat Yojana, covers COVID-19 therapy and hospitalization.
Through the PMJAY scheme, COVID-19 patients can receive free treatment at impaneled facilities. Ascertain that you are a recipient of the government-funded Ayushman Bharat Scheme.
For whom is the Ayushman Bharat Yojana appropriate?
Depending on whether the beneficiary comes from an urban or rural home, there are two qualifying requirements for the Ayushman Bharat Scheme. Look at the following criteria.
Beneficiaries in rural areas:
- Families with a single room that has kaccha walls and a kaccha roof
- Families that do not have any adult men aged 16 to 59.
- Families with impaired children and no adult family members
- Scheduled Caste and Scheduled Tribe households
- Landless homes whose primary source of income is manual casual labor.
How the ayushman bharat health card can save you money:
The Ayushman Bharat Yojana health card comes with a pre-loaded amount of up to Rs. 5 lakhs that can be used to avail of cashless healthcare services. With this card, you will not have to pay any additional amount out of your pocket while taking treatment from any network hospital. Moreover, if you are a senior citizen, you will get an additional cover of up to Rs. 1 lakh under the Ayushman Bharat Yojana health card. This will help you in saving money as the healthcare cost, in general, is very high.
The Ayushman Bharat Digital Health Account (Health ID) would establish a secure, streamlined, and private online platform that will safeguard the privacy and security of personal health information. Furthermore, the government intends to enhance significantly India’s healthcare standards by minimizing the possibility of preventable medical errors.
The Ayushman Bharat Yojana will reimburse medical expenses, improving the availability and affordability of healthcare across India. Make sure you have your Health ID with you whenever you visit a hospital for any treatment.