What are the key features of the Ayushman Bharat (PMJAY)?
Given below are the key Ayushman Bharat card benefits:
Under the scheme, eligible individuals can avail of cashless healthcare services for up to Rs. 5 lakh per family per year. The service can be availed at empanelled hospitals and healthcare providers.
The scheme is available to families that are identified as deprived and vulnerable based on the Socio-Economic Caste Census (SECC) 2011 data.
PMJAY provides coverage for a range of health services, including medical procedures, diagnostic tests, consultation, and treatment for a variety of ailments and diseases. It also covers secondary and tertiary hospitalisation expenses.
The scheme is applicable across the country, and eligible individuals can access healthcare services at any empanelled hospital or healthcare provider, regardless of their location.
Paperless and cashless transactions:
The PMJAY scheme operates on a paperless and cashless mode. All transactions made under the scheme are done through an online portal, eliminating the need for cash transactions.
Pre and post hospitalisation expenses:
PMJAY provides coverage for pre-hospitalisation expenses for up to 15 days before hospitalisation and post- hospitalisation expenses for up to 60 days.
The scheme provides portability of benefits, allowing beneficiaries to access healthcare services at any empanelled hospital or healthcare provider, regardless of their location.
No age limit:
PMJAY does not have any age limit, and all eligible individuals can benefit from the scheme's coverage.
Empanelled hospital network:
PMJAY has an extensive network of empanelled hospitals and healthcare providers across the country, ensuring that eligible individuals can access healthcare services without any hassle.
List of critical diseases covered under Ayushman Bharat Health Scheme
Given below is the list of diseases covered under PMJAY:
- Kidney diseases
- Heart diseases
- Liver diseases
- Respiratory diseases
- Neurological disorders
- Mental illnesses
- Burn injuries
- Neonatal diseases
- Congenital disorders
- Communicable diseases (such as tuberculosis and malaria)
- Daycare procedures and surgeries
Eligibility for PM-JAY healthcare scheme in rural and urban areas
The scheme has defined beneficiaries for rural and urban areas. Given below is the distribution for the same:
D1- Only one room with kucha walls and kucha roof.
D2- No adult member between ages 16 to 59.
D3- Households with no adult male member between ages 16 to 59.
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.
For urban areas, the following 11 occupational categories of workers are eligible for the scheme:
- Domestic worker
- Street vendor/cobbler/hawker/other service provider working on streets
- Construction worker/ plumber/mason/labour/painter/welder/ security guard/ coolie and other head-load worker
- Sweeper/sanitation worker/mali
- Home-based worker/artisan/handicrafts worker/Tailor
- Transport worker/ driver/ conductor/ helper to drivers and conductors/ cart puller/ rickshaw puller
- Shop worker/ assistant/ peon in small establishment/ helper/delivery assistant / attendant/ waiter
- Electrician/ mechanic/ assembler/ repair worker
- Washer-man/ chowkidar
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