Ayushman Bharat Yojana: eligibility, benefits, how to apply, diseases and coverage

In today’s time, you never know when illness will strike, especially if you have elderly parents or grandparents in your family. In such a situation, we always worry about being financially strong, but now the government has removed your worry with “Ayushman Bharat Yojana.” Ayushman Bharat Yojana was started by Prime Minister Modi in September 2018, and till now Benefits have been availed by 12.34 crore families including 55 crore citizens.

Earlier the age limit was fixed for this scheme, but now the government has amended this scheme and said that now only people 70 years of age or above will get its benefit, who were earlier deprived of it. Under Ayushman Bharat Yojana, the government is to provide health insurance of up to Rs 5 lakh to the elderly aged 70 years or more. Let us know about the benefits of this scheme, eligibility and the complete process of applying for it. 

Ayushman Bharat Yojana

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) was launched by Prime Minister Narendra Modi in September 2018. This scheme provides both financial and medical security to senior citizens. Initially, the age requirement for availing the benefits was set at 60 years, and beneficiaries were entitled to free insurance for up to five treatments per year.

Currently, the scheme aims to assist all citizens of India who are 70 years of age or older. It offers free health coverage of up to ₹5 lakh per year to approximately 4.5 crore families, including many senior citizens. Under the Ayushman Bharat Yojana, 37 lakh ASHA (Accredited Social Health Activist) and Anganwadi workers, along with their families, are also entitled to free healthcare benefits. These individuals play a crucial role in promoting government initiatives across the country.

Since its launch, approximately 55 crore people have benefited from the scheme, positively impacting around 12.34 crore families, and helping them avoid financial crises. The government continues to support those using this scheme. Out of those who have utilized the benefits, about 7.37 crore individuals have been admitted to hospitals for treatment, while others have availed themselves of the benefits without requiring hospitalization.

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The Ayushman Bharat Yojana offers cashless and paperless services to beneficiaries in approximately 29,000 hospitals across the country. This ensures that individuals do not have to travel far and can access the scheme easily and promptly.

To qualify for this scheme, if you or any member of your family is 70 years or older, your financial income or family status will not be taken into account. The Indian government aims to provide free medical facilities to as many people as possible.

Benefits of Ayushman Bharat Yojana

The benefit of this scheme will be given by the government in cases ranging from minor diseases to diseases like cancer, heart and kidney. Its applicant must be 70 years of age or older, for that the government will provide health insurance up to Rs 5 lakh per year. It is valid in more than 29,000 hospitals in India where you will get instant access to facilities like cashless and paperless.

Under Ayushman Bharat Yojana, this insurance will be free for which you will not have to pay even a single rupee to anyone. You can also apply for this from your home which is easy and fast. As part of this scheme, the beneficiary will be provided with the following health-related services detailed below:

• Free checkup, tests and medicines 
• Lab tests and other investigations
• recruitment facility 
• ICU services
• Organ transplant
• accommodation + food upon admission 
• Post-discharge care for 15 days

The benefit of this scheme will also be available to those people who are already taking benefits of other health schemes of the government like CGHS, ECHS, and ACAPF. If the applicant wants to avail the benefits of Ayushman Bharat Yojana then they will have to first leave the ongoing government health scheme because a person can avail the benefits of only one government scheme.

Therefore first, make sure which scheme you want to join. If the person wants to join Ayushman Bharat Yojana only, then he will have to close the earlier scheme and then only later he can apply for it. Under this scheme, the beneficiary will get coverage of Rs 5 lakh per year for the following diseases: 

Ayushman Bharat Yojana Eligibility Criteria

To avail of the benefits of the Ayushman Bharat Yojana, the first condition is that your age must be 70 years or older. Earlier, citizens of 70 years or above were not eligible to apply for this scheme. Now, with the amended guidelines, elderly individuals can benefit from this free health insurance plan.

However, if you are already enrolled in any government health scheme like CGHS, ECHS, or ACAPF, you cannot take advantage of the Ayushman Bharat Yojana. To benefit from Ayushman Bharat, you would need to discontinue any ongoing government health schemes, as per the government guidelines, which allow the use of only one government health scheme at a time.

In case there are multiple family members aged 70 years or older, the health insurance amount can be shared among them, but this cannot be extended to family members below the age of 70. Additionally, individuals who have private health insurance can still apply for Ayushman Bharat Yojana, provided they meet the age requirement of 70 years or more.

• Age Requirement
• Eligibility Restrictions
• Discontinuation of Other Schemes
• Sharing with Family Member
• Other Policy Holders

How to Apply for Ayushman Bharat Yojana

1. First of all, you have to go to the official website of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana https://abdm.gov.in/ 
2. Then you have to go to the PMJAY kiosk of Arogya Mitras and check whether you are eligible for Ayushman Bharat Yojana or not.
3. If you are eligible then here you have to verify your Aadhar Card and Jan Aadhar and submit the identification proof of the family.
4. After submitting the document, you will get AB-PMJAY ID from AB-PMJAY and with this your submission is complete.
5. Keep this AB-PMJAY ID carefully because based on this, you will get coverage in future. 

Required Documents:

• Aadhar card 
• E-mail and Mobile number
• Electricity bill
• Valid Address proof 
• Pan card
• Jan Aadhar card

Disadvantages of Ayushman Bharat Yojana?

The OPD costs are not reimbursed by the Ayushman Bharat Yojana, which is one of its main drawbacks. In today’s world, with the rising prevalence of diseases, the medical sector has evolved into a significant business that plays a crucial role in the country’s economy.

This facility is only available in large-scale private and public hospitals, where patients often encounter long queues and lengthy processes to access the scheme. Not all medical services are covered under this initiative. However, it is fair to say that the benefits of this scheme outweigh its drawbacks, as it promotes better health for every citizen.

Emergency cover by Ayushman Bharat Yojana?

According to the National Health Authority website, all treatment-related charges, including pre- and post-hospitalisation fees, are bundled together in a package that covers a range of facilities. The insured person/SHA makes a single, comprehensive payment to the EHCP for the surgical package as part of the bundled care.

The medical package is paid to the EHCP daily, with specific pre-arranged add-ons paid individually depending on the unit of admission (general ward, HDU or ICU). The scheme also provides essential services in case of emergency such as general medicine, surgery, oncology, cardiology, etc.

Conclusion

The Ayushman Bharat Yojana, launched by Prime Minister Modi in 2018, is a vital health scheme that offers financial and medical security, particularly for elderly citizens. Following recent updates, the scheme now provides free health insurance of up to ₹5 lakh per year for individuals aged 70 and above. This coverage allows for treatment of both minor and serious illnesses, including cancer and heart diseases.

With coverage for over 4.5 crore families, the scheme facilitates cashless and paperless treatment at more than 29,000 hospitals across the country, making it a crucial and accessible support system for older adults. In this article, we discuss important information about the scheme, including eligibility, benefits, how to apply, and the range of diseases covered. If you found this information helpful, please share it with your family and friends.

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