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Ayushman Bharat Yojana Key Benefits – A Detailed Guide
Ayushman Bharat Yojana is a health insurance policy offered by the government of India with the aim to present free access to health insurance for low-income people of the country. Let’s check its benefits in this post.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is a government of India’s health insurance policy that offers coverage of INR 5 lakh to every Indian eligible family. The policy has already covered over 50 crore beneficiaries with healthcare coverage, which included 40% poor families in India. The scheme was introduced with the aim to help alleviate the high rising medical expenses in the country. Let’s understand the policy better.
Key Features of Ayushman Bharat Yojana
Below are the key features of Ayushman Bharat Yojana Card:
- Ayushman Bharat insurance scheme is regarded as one of the largest medical insurance schemes in the world being financed by the Govt. of India
- The policy covers as many as 1,393 treatments and procedures along with offering hospitalization charges, room rent, consultation fee, OT and ICU charges, diagnostic costs and surgeon fee, etc.
- The plan also includes pre-hospitalization of 3 days and 15 days of post-hospitalization which include diagnostics and medicines
- The coverage amount under the scheme is INR 5 Lakh
- The plan covers both tertiary and secondary healthcare services
- Hospitalization under the scheme is available under public as well as private hospitals across India
- Cashless hospitalization is available
- There is no restriction of age, family size and gender under the scheme
- Coverage to pre-existing diseases is offered from first day of the plan
- The plan benefits are available PAN India
10 Benefits of Ayushman Bharat Yojana
Among the many benefits of Ayushman Bharat Yojana, the cover of INR 5 lakh is something which is generally not offered under government health insurance schemes. Along with the sum assured of INR 5 lakh, the facility of cashless medical treatment is also something which serves as a great benefit under the Ayushman Bharat Scheme.
Here are some other Ayushman Bharat Yojana benefits:
- The plan compensates for medical examination, treatment and consultation
- It covers expenses during pre-hospitalization stage
- Allows the insured to avail around 15 days of post-hospitalization care
- Also covers diagnostic and lab charges
- Covers medicine costs and consumable expenses
- Available for intensive as well as non-intensive services
- Covers treatments that results in certain complications
- Offer coverage against medical implantation
- Benefit of food services is also covered
- Accommodation benefits is also offered.
Diseases Covered Under Ayushman Bharat Yojana
- Carotid angioplasty with stent
- Anterior spine fixation
- Coronary ABG
- Double valve replacement
- Laryngopharyngectomy
- Prostate cancer
- Pulmonary valve replacement
- Tissue expander for disfigurement in case of burns
- Skull base surgery
Critical Illness Coverage
The Ayushman Bharat Yojana supports families by giving access to healthcare services along with covering day care procedures and various pre-existing diseases. The scheme covers healthcare packages by both public and private hospitals in India.
Exclusions of Ayushman Bharat Yojana
Here are some exclusions of the plan:
- The plan excludes programmes of drug rehabilitation
- It excludes OPD costs
- It also excludes organ transplant and Cosmetic procedures
- It also excludes procedures related to fertility
Differences between Private Health Insurance vs. Ayushman Bharat Yojana
| Ayushman Bharat Yojana | Private Health Insurance |
| Sum Assured Maximum is up to INR 5 lakh | Sum Assured Maximum can be up to 3 Crore |
| Pre-Hospitalization up to 3 days, Post Hospitalisation up to 15 days | Pre-Hospitalization up to 60 days, Post Hospitalisation up to 180 days |
| No Free Annual Health Check-Up | Annual free health check – up (yearly or once in two-years) |
| 9 Critical illnesses are covered | 20+ Critical illnesses are covered |
| OPD cover not available | OPD expenses covered |
| Premiums paid by government | Premiums paid by policyholder |
| Home treatment not covered | Home treatment covered |
| NCB is not granted | NCB granted for claim free years |
| Tax benefits not available | Tax benefits available |
| Single private room may/may not be available | Single private hospital room can be availed |
Key Benefits of Ayushman Bharat Yojana
There are many benefits of Ayushman Bharat Yojana as mentioned in the post above. It is one of the largest government health schemes in the world and covers the economically poor and weaker sections of the society.
Under the Ayushman card, the eligible families can get coverage of a sum assured of INR 5 lakh per year.
The policy covers as many as 1,393 treatments and procedures along with covering 9 critical illnesses.
The healthcare services available under the scheme are hospitalization expenses, day care surgeries, follow-up care, pre and post hospitalization expenses and new born child/children services etc.
Yes, pregnancy is covered under the provisions introduced by Ayushman Bharat. An eligible pregnant woman can claim an amount up to INR 5,00,000 for all the procedures and surgeries
National Health Authority (NHA) is the apex body that is responsible for implementing “Ayushman Bharat Pradhan Mantri Jan Arogya Yojana”, the flagship public health insurance/assurance scheme in India.
It is called Ayushman Bharat Yojana (आयुष्मान भारत) in Hindi
Author Bio
Paybima Team
Paybima is an Indian insurance aggregator on a mission to make insurance simple for people. Paybima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. Paybima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.
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