Ayushman Bharat – Insurance coverage of ₹5 Lakh per Family Per Year. One of the largest government sponsored health schemes in the world.
We know that access to decent healthcare services is going beyond the reach of common people in India, where rising cost of healthcare services remains a significant challenge. Among 1.4 billion people in India, a large segment struggles to afford quality medical treatment and care. In order to bring a change and make healthcare accessible for the masses, PM Narendra Modi launched Ayushman Bharat Scheme in 2018. The Government of India aimed to provide financial protection and accessibility of quality healthcare facilities to millions of people in India.
What is Ayushman Bharat?
Ayushman Bharat, which was launched in September 2018, is one of the largest government sponsored health schemes in the world. It focuses mainly on two major components:
- Health and Wellness Centers – Along with the slogan “Arogyam Param Dhanam”, the health and wellness centers (HWCs) focus on selective health care including preventive, curative, rehabilitative and palliative care for all ages.
- Pradhan Mantri Jan Arogya Yojana (PM-JAY) – It is the largest health insurance scheme in the world which provides a health cover of Rs. 5 lakhs per family per year to the economically weaker section of society and senior citizens aged above 70 irrespective of the family income.
Key Features of Ayushman Bharat PM-JAY
Features | Description |
Coverage | Eligible families and senior citizens receive a health insurance coverage of up to ₹5 lakh per year for hospitalization expenses. |
Cashless & Paperless Treatment | Eligible families and senior citizens can avail the benefit of cashless treatment at any 25000+ network hospitals under the scheme. Hospitals are both government and private, ensuring wider accessibility. |
PED Cover | All pre-existing medical conditions are covered under this policy from day one. No Waiting Period. |
Eligibility criteria |
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Fees | No yearly premium or enrollment fees. Ayushman Bharat Scheme is fully funded by the Central and State Governments, meaning beneficiaries pay nothing for insurance.
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Network Hospitals | Around 25000+ network hospitals are empaneled under the scheme. Both Govt and Private hospitals are meeting the quality criteria to be a part of the scheme. Hospitals are instructed to provide standard treatment protocols, ensuring that no claim rejection happens. |
How to check the eligibility for Ayushman Bharat Scheme?
To check eligibility:
- Visit the official PM-JAY website (https://pmjay.gov.in).
- Click on “Am I Eligible?” and enter your mobile number linked with Aadhaar.
- Fill in your details and Aadhar number to check your SECC status.
Beneficiaries do not need to enroll separately. Eligible families are automatically covered and can avail services using their Ayushman Bharat Card.
Benefits of Ayushman Bharat Scheme?
- Financial Security: With the PM-JAY scheme, the middle class and lower middle class families are relaxed as the scheme provides cover up to ₹5 Lakh per Family, which reduces the burden of rising medical cost in India.
- Improved Healthcare Facility: Ayushman Bharat scheme covers the treatment like cancer care, cardiology, orthopaedics and many more.
- Encourages Preventive Care: With health and wellness centers (HWCs), people are encouraged to focus on disease prevention and health promotion to stay healthy.
Challenges and Limitations of Ayushman Bharat.
While Ayushman Bharat is a great initiative by launched by The Government of India, there are some challenges:
- Lack of Awareness: Many eligible beneficiaries are unaware of their entitlement.
- Fraud and Misuse: Some hospitals exploit the scheme through false claims.
- Healthcare Infrastructure Constraints: Rural areas still lack quality hospitals and specialists.
- Delayed Payments to Hospitals: Sometimes hospitals face delays in receiving reimbursements from the government.
Ayushman Bharat is a great step towards achieving Universal Health Coverage (UHC) in India. As it is providing financial protection through quality healthcare, it has positively impacted millions of families. However, continuous success of the scheme requires continuous improvements in hospital networks, awareness, and implementation efficiency. With good implementation and execution on the ground level, Ayushman Bharat has the potential to reshape India’s healthcare landscape and uplift the lives of millions.
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