Ayushman Bharat Yojana: Who can avail benefits under PMJAY health cover scheme? Check eligibility, how to apply

Ayushman Bharat Yojana: Health insurance has become more necessary than ever in the backdrop of Covid and coronavirus-induced side-effects. Often referred to as “mediclaim”, the medical insurance covers expenses incurred due to illness or accident of any kind, in exchange for a premium amount. A health plan also offers other benefits like cashless hospitalization and free medical check-ups.

However, rising health insurance premiums and taxes levied over the premium amount have made the coverage unaffordable for many. Also, the premium is often exorbitant for senior citizens and the elderly — the age group that requires medical insurance coverage the most. Those from economically weaker sections can not afford expensive premiums either. So, the Government of India has introduced the Ayushman Bharat Yojana to help certain individuals and vulnerable sections of society.

What is Ayushman Bharat Yojana?

Under Ayushman Bharat Yojana or PMJAY health cover scheme, health cover of Rs 5 lakhs per family is provided per year for secondary and tertiary care hospitalization.

Ayushman Bharat Yojana: Who can be covered in PMJAY health cover  

1. Those living in scheduled caste and scheduled tribe households
2. Families with no male members aged 16 to 59 years.
3. Beggars and those surviving on alms
4. Families with no individuals aged between 16 and 59 years.
5. Families having at least one physically challenged member and no able-bodied adult member.
6. Landless households who make a living by working as casual manual labourers.
7. Primitive tribal communities.
8. Legally released bonded labourers
9. Families living in one-room makeshift houses with no proper walls or roof.
10. Manual scavenger families

Ayushman Bharat Yojana: People who can’t avail of health coverage under PMJAY Yojana

  • People who own a two, three or four-wheeler or a motorised fishing boat
  • People who own mechanised farming equipment
  • People who have Kisan cards with a credit limit of Rs. 50000
  • People employed by the government.
  • People who work in government-managed non-agricultural enterprises
  • People earning a monthly income above Rs. 10000.
  • People owning refrigerators and landlines.
  • People with decent, solidly built houses
  • People owning 5 acres or more of agricultural land

Ayushmaan Bharat Yojana: Expenses covered

  • Medical examination, treatment and consultation
  • Pre-hospitalization
  • Medicine and medical consumables
  • Non-intensive and intensive care services
  • Diagnostic and laboratory investigations
  • Medical implantation services (where necessary)
  • Accommodation benefits
  • Food services
  • Complications arising during treatment
  • Post-hospitalization follow-up care up to 15 days

Ayushmaan Bharat Yojana: How to apply for PMJAY card

Step 1: Visit to the – https://setu.pmjay.gov.in/

Step 2: Now, register yourself.

Step 3: Enter your mobile number and the CAPTCHA code and click on ‘Generate OTP’.

Step 4: Now, select the state and search by name/ HHD number/ ration card number/ mobile phone number.  

Step 5:  Explore the insurance plans.

Step 6: Complete your KYC process, and wait for approval.

Step 7: Download Ayushmaan card.

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