Ayushman Bharat Yojana Key Benefits – A Detailed Guide


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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
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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.

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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

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To Sum Up

The Ayushman Bharat Yojana doesn’t put any cap on the age or size of the family members. The sum assured of this plan can be shared by a family on a floater basis. The family that is eligible under the plan can receive cashless hospitalization under the coverage from day 1 of availing the scheme.

For Ayushman Bharat Yojana registration, all you need is to visit the pmjay.gov.in site and check Ayushman Bharat Yojana Eligibility with the help of the Aadhar Card Number of the individual. Once done, you can register if you are eligible for the Yojana and start using claims under the plan. The Ayushman Bharat yojana apply online is very easy and can be done without any hassle.

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FAQs: Key Benefits of Ayushman Bharat Yojana

What are the benefits of Ayushman Bharat?

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.

What is the limit of the Ayushman card?

Under the Ayushman card, the eligible families can get coverage of a sum assured of INR 5 lakh per year.

Does Ayushman Bharat cover all diseases?

The policy covers as many as 1,393 treatments and procedures along with covering 9 critical illnesses.

What health services are available under PM-JAY?

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.

Is the Ayushman card valid for pregnancy?

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

Who is responsible for Ayushman Bharat?

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.

What is Ayushman Bharat Yojana in Hindi called?

It is called Ayushman Bharat Yojana (आयुष्मान भारत) in Hindi

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Mar 14, 2023
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