Ayushman Bharat Yojana Key Benefits – A Detailed Guide

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