Ayushman Bharat Yojana: Meaning, Feature, Benefits, & Eligibility Criteria

The Pradhan Mantri Jan Arogya Yojana (PM-JAY) or Ayushman Bharat Yojana, is a flagship healthcare scheme or health insurance scheme launched by the Government of India. This ambitious initiative aims to provide affordable and accessible healthcare to millions of Indians deprived of quality medical services due to financial constraints. Let's delve into the key features, benefits, and impact of Ayushman Bharat health insurance.

Key Features of Ayushman Bharat Yojana

The following are the features of the Ayushman Bharat Yojana:

Health Coverage for the Economically Vulnerable

Ayushman Bharat Yojana aims to provide health coverage to 10.74 crore families (a benefit cover of Rs. 500,000 per family per year). This includes poor, deprived rural families, and certain identified occupational categories of urban workers’ families.

Cashless Treatment

Under this scheme, eligible beneficiaries are entitled to cashless treatment at empanelled public and private hospitals across India. They can avail of medical services without worrying about financial burdens during critical healthcare situations.

Coverage for Secondary and Tertiary Care

Ayushman Bharat Yojana covers a wide range of secondary and tertiary care treatments, including hospitalisation, surgeries, medications, diagnostics, and post-operative care. It ensures that individuals have access to quality healthcare services without facing excessive financial strain.

Extensive Network of Hospitals

The scheme has a vast network of empanelled hospitals, both public and private, across the country. This network ensures that beneficiaries can seek medical treatment at nearby facilities and choose the hospital of their preference.

Health and Wellness Centres

In addition to hospitalisation coverage, Ayushman Bharat Yojana focuses on establishing and strengthening Health and Wellness Centres (HWCs) across India. These centres provide comprehensive primary healthcare services, preventive care, and health awareness programs at the grassroots level.

Portable Benefits

The scheme offers portability of benefits, allowing beneficiaries to avail treatment at any empanelled hospital across states and union territories. This feature is particularly beneficial for individuals who frequently migrate for work or reside away from their native places.

Benefits and Impact of Ayushman Bharat Yojana

Here are the key benefits of Ayushman Bharat Yojana for better understanding of the scheme.:

Financial Protection

Ayushman Bharat Yojana may be able to provide a crucial safety net for vulnerable sections of society by reducing the financial burden of medical expenses. It may protect families from falling into the vicious cycle of debt due to healthcare costs.

Improved Healthcare Access

The scheme significantly improves access to quality healthcare services, especially for those residing in rural and remote areas. By establishing empanelled hospitals and strengthening primary healthcare centres, Ayushman Bharat Yojana aims to bridge the healthcare divide and ensure equitable distribution of medical facilities.

Enhanced Health Outcomes

By providing timely access to secondary and tertiary care, Ayushman Bharat Yojana is expected to improve health outcomes and reduce the morbidity and mortality rates among beneficiaries. Early diagnosis, appropriate treatment, and follow-up care contribute to better health management and improved quality of life.

Boost to the Healthcare Industry

The scheme may also help stimulate the healthcare industry by increasing the demand for medical services. It may provide financial incentives to empanelled hospitals, encourage investments in infrastructure and technology, and promote a more inclusive healthcare ecosystem.

Social Empowerment

Ayushman Bharat Yojana may help promote social empowerment by ensuring individuals from marginalised sections of society receive equal opportunities for healthcare. It may address healthcare disparities and fosters inclusivity, ultimately contributing to the socio-economic development of the nation.

Should You Opt for This Insurance?

The Ayushman Bharat Yojana is a plan by the government for bringing the marginalised sections of the society into the folds of the mainstream by giving them access to fundamental healthcare that they otherwise may not be able to afford. It does provide considerable benefits to people who are economically marginalised or have a lower source of income. However, the coverage might seem limited for many. The coverage amount is Rs.5 Lakhs, which might not be sufficient for everyone, especially if there are senior citizens with serious health issues in their families. The plan also has many exclusions that might hinder your chances at accessing better healthcare services. An alternative you may consider is going for a standard health insurance policy. The coverage amount under this policy is higher than that of Ayushman Bharat Yojana. The inclusions are also wide, with a better network of hospitals within the policy. You also get the benefit of riders which enhances the coverage. Claims are subject to terms and conditions set forth under health insurance policy.

Conclusion

Ayushman Bharat Yojana is a landmark initiative that aims to revolutionise healthcare in India. By providing health coverage to the economically vulnerable population, the scheme ensures financial protection and improves access to quality medical services. In addition to this policy, you can also consider going for a standard health plan for enhanced coverage for you and your family. Use the health insurance calculator to get a quote for the policy you are looking to purchase.   *Standard T&C apply. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.