Ayushman Bharat Yojana Eligibility & Online Registration

To combat the rising costs of medical treatments, the government has introduced various health-related schemes. These plans aim to provide high-quality medical treatments at affordable costs, along with financial support. One such noteworthy scheme is the Ayushman Bharat Yojana.

The Ayushman Bharat Scheme is a significant health cover launched by the Indian government. It aims to provide universal health coverage, as recommended by the National Health Policy 2017. The primary goal of this scheme is to ensure healthcare for all citizens.

It aims to improve health services through comprehensive care rather than only focusing on specific areas. The scheme provides healthcare at all levels, including primary, secondary, and tertiary, by focusing on prevention, promotion, and treatment.

The Ayushman Bharat Scheme has two main components:

• Health and Wellness Centres (HWCs)

• Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Here are the steps you need to follow to register for the Ayushman Bharat Yojana:

1. Visit the official government website for the PMJAY scheme

2. Find the ‘Am I Eligible’ tab on the page under the Portals section of the ‘Quick Links’ tab and click on it

3. Login by entering your mobile and Auto code if you already have an account under the ‘Beneficiary’ option

4. Click on ‘Operator’ and choose the ‘Sign Up’ option if you do not have an account

5. On the new page, enter your Aadhaar number, validate it, enter the CAPTCHA 

6. Click on ‘Submit’ after choosing the E-KYC Mode

With the Ayushman Bharat Yojana, you get the following benefits:

• Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PMJAY) offers coverage of up to ₹5 Lakhs per family annually for secondary and tertiary care hospitalisation

• Eligible families can access high-quality health services without facing financial difficulties

• PMJAY ensures cashless and paperless access to healthcare services directly at the point of service

• The program aims to alleviate the financial burden of hospitalisation, reducing the risk of impoverishment from fatal health expenses

Here are some of the attractive features of the scheme that you must be aware of:

• PM-JAY is the world's largest government-funded health insurance scheme, and there are no limitations on family size, age, or gender

• The scheme benefits over 12 crore families, which amounts to approximately 55 crore beneficiaries

• It offers coverage of up to ₹5 Lakhs per family in a year for secondary and tertiary care hospitalisation at both public and private hospitals in India

• PM-JAY provides cashless healthcare access directly at the hospital

• The scheme aims to ease the financial burden of medical expenses that push nearly 6 crore Indians into poverty annually

• It covers up to 3 days of pre-hospitalisation and 15 days of post-hospitalisation expenses, such as diagnostics and medications

• The scheme covers all pre-existing conditions from the start

• The benefits are portable all over the country, allowing you to access cashless treatment at any public or private hospital

• The scheme includes approximately 1,929 procedures, covering all related treatment costs, including supplies, diagnostic services, doctor's fees, room charges, etc.

• Public hospitals get reimbursement for healthcare services at the same rate as private hospitals

Expenses for the following are covered under the Ayushman Bharat Yojana:

• Costs for medical examination, consultation, and treatment

• Expenses for pre-hospitalisation

• Post-hospitalisation follow-up care up to 15 days

• Costs for medicine and medical consumables

• Expenses for non-intensive and intensive care services

• Diagnostic and laboratory investigation costs

• Costs for medical implantation services (where necessary)

• Accommodation and food expenses

• Expenses for complications arising during treatment

The Ayushman Bharat Yojana does not cover the expenses for the following:

• Cosmetic surgeries

• Drug rehabilitation

• Fertility treatment

• Organ transplant

• Dental treatment and surgery

• Immunisation

• Vaccination

• Outpatient care

1. PMJAY Scheme: Eligibility Criteria for Rural Households

Here are the individuals eligible for the scheme in rural areas:

• D1- Only one room with kucha walls and kucha roof

• D2- No adult member between the ages of 16 and 59 years

• D3- Households with no adult male member between the ages of 16 and 59 years

• D4- Disabled member and no able-bodied adult member

• D5- SC/ST households

• D7- Landless households deriving a major part of their income from manual casual labour

2. PMJAY Scheme: Eligibility Criteria for Urban Households

The following individuals are eligible for the scheme in urban areas:

• Ragpickers

• Beggars 

• Domestic workers

• Washer-men, Watchmen

• Sweepers, Sanitation workers, Gardeners

• Electricians, Mechanics, Assemblers, Repair workers

• Home-based workers, Artisans, Handicrafts workers, Tailors

• Street vendors, Cobblers, hawkers and other service providers working on streets

• Transport workers, Drivers, Conductors, Helpers to drivers and conductors, Cart pullers, Rickshaw pullers

• Shop workers, Assistants, Peons in small establishments, Helpers, Delivery assistants, Attendants, Waiters

• Construction workers, Plumbers, Masons, Labours, Painters, Welders, Security guards, Coolies and other head-load workers

For verification purposes, you need to submit some documents when applying for the scheme. Here is the required list of paperwork to apply for the Ayushman Bharat Yojana:

• Identity Proof: Aadhaar card or any other government-issued ID

• Family Details: Ration card as it provides details about family and background

• Income Proof: Some states may request for an income certificate

• Address Proof: Utility bills or other documents confirming your residence

The scheme provides coverage for various diseases, illnesses and treatments. Here is a list of the same:

• COVID-19

• Prostate cancer

• Skull base surgery

• Anterior spine fixation

• Double valve replacement

• Carotid angioplasty with stent

• Coronary artery bypass graft

• Pulmonary valve replacement

• Laryngopharyngectomy with gastric pull-up

• Tissue expander for disfigurement following burns

There are several differences between regular health insurance plans and the schemes that the Government offers. Refer to the following table to know the differences: