Ayushman Card Yojana : Benefits, Eligbility, Application Process, & Coverage

Do you think that quality healthcare has now become a luxury more than a necessity? A luxury that only some people can afford and access while people from low-income or marginalised groups continue to stay deprived of their basic rights. To ensure that quality healthcare services remain accessible and affordable for all, irrespective of their economic backgrounds, the government of India launched the Ayushman card.

Present Condition Of India’s Healthcare Sector

The healthcare sector of India has come a long way, from having no equipment for treatment to developing our hi-tech equipment and medicines. But with such development, the cost of the treatment methods is also developing. This is one of the main reasons why people from the economically weaker section of society are unable to receive medical treatment as and when needed.

Government hospitals do exist to provide them with the needed treatment, but operational malfunctions like inadequate staff, equipment, and medication leave people’s lives hanging.
To resolve all such issues and ensure that everyone receives treatment whenever needed, the government of India launched the Pradhan Mantri Jan Arogya Yojana.

Ayushman card isn’t merely a service for people to use but a necessity at present times.

Latest News About PM-JAY

Recently, two major updates have been introduced under the Pradhan Mantri Jan Arogya Yojana. Those two updates are:

• People above the age of 70 can also apply for the government scheme through the Ayushman Vaya Vandana card. The expanded criteria would help many senior citizens access medical aid when needed.
• More than 10 lakh senior citizens have enrolled in the scheme and around 9 lakh rupees have been invested toward their treatment.
• The government released funds worth Rs. 184 crore as a first instalment of premium towards execution of the PMJAY and SEHAT schemes in the state of J&K.

What Is an Ayushman Card?

The Ayushman Card is an integral part of the Pradhan Mantri Jan Arogya Yojana (PMJAY), one of the world’s largest government-funded healthcare schemes. Launched in September 2018, this scheme aims to provide affordable healthcare services to the economically weaker sections of society, covering millions of Indian citizens under its health insurance plan. Beneficiaries of PMJAY can access cashless treatment services of up to ₹5 lakhs per year at empanelled hospitals across India. The Ayushman Card, also called the PM-JAY card, acts as proof of eligibility and allows beneficiaries to access the scheme's benefits.

India recently launched the Ayushman identification cards to aid the beneficiaries of the Ayushman Bharat Yojana. Known as the Ayushman Card, it aims to create a comprehensive digital health infrastructure. The government scheme offers benefits to Indian citizens by providing access to public hospitals and schemes. This government health insurance scheme covers most medical expenses, medications, and diagnostic costs, extending the free treatment services up to 5 lakh per year.

Around 55 crore people in India have benefitted from the Ayushman Bharat Yojana. The Ayushman Card ensures that citizens who cannot afford expensive healthcare can still receive quality treatment without the burden of financial constraints. This card covers various medical expenses, including hospitalisation costs, diagnostic tests, pre-hospitalisation, and post-hospitalisation care.

About Ayushman Bharat Yojana: Overview

Read More: CMCHIS Scheme

Successful Case Stories Of People

Innumerable people have benefitted from the scheme till now. Below are some case stories of people to showcase how the scheme has been saving precious lives.

1. Heart Surgery

A 60-year-old woman from a village in Jharkhand was suffering from cardiac problems and urgent heart surgery was needed to save her life. With the help of the PM-JAY scheme, she was able to get the treatment at a private hospital without any problems and is now on the path to full recovery.

2. Treatment of Cancer

A labourer from the state of Bihar was diagnosed with oral cancer. He is the sole supporter of his family. He applied for PM-JAY and then was able to receive chemotherapy and surgery completely free of charge.

Key Features Of Ayushman Card

Some of the key features that make the Ayushman card so impressive, unique, and necessary are listed below. Let us learn about it one by one.

Individualised 14-Digit Health ID

Each person has a distinct 14-digit number that serves as their digital health identity.

Digital Health Record Storage

Health records are easily shared with physicians and hospitals thanks to online access and storage.

Interoperability

Enables seamless data exchange between various healthcare providers, guaranteeing uninterrupted patient care.

Privacy and Security

Individuals control the sharing of their data, and healthcare providers can only access it with their permission.

Objectives Of Ayushman Card

There are some major objectives of the Ayushman card. Some of its major objectives are listed below in brief:

1. Financial coverage

The government scheme provides health coverage of Rs. 5 lakh to every registered family under the scheme.

2. Priority

The scheme gives priority to girls, women, and senior citizens above the age of 60 years.

3. Cashless treatment

The scheme enables people to go for treatment without the need to pay up front.

4. Pre-existing diseases

The scheme covers even those individuals with pre-existing illnesses or diseases and enables them to access medical help.

How Does the Ayushman Card Work?

Ayushman card is used to avail the benefits under the government healthcare scheme, Ayushman Bharat Yojana. Here’s how the PM-JAY card works to ensure health insurance coverage benefits to low-income citizens.

• The Ayushman card works as a health ID for citizens. This includes diagnoses, treatments, hospitalisations, lab reports, and prescriptions.

• These cards digitise health records through a unique 14-digit identification number.

• They enable citizens to share their health data with doctors and health providers.

• The records reflect details of medical tests and previous prescriptions. Details can be obtained through the official website or mobile app using the ID.

Benefits Of The Ayushman Card

The Ayushman Bharat Yojana is a significant government health scheme that benefits nearly 40 percent of Indian citizens by providing healthcare insurance to needy sections of the nation.

Over 2.2 crore individuals have availed of treatments worth Rs 30,000 crore through Ayushman cards since 2018. Given below are some of the key benefits of the PM-JAY card to the beneficiaries of the Ayushman Bharat Yojana.

Enhanced Convenience

The card provides tremendous convenience by eliminating unnecessary, repeated medical tests. It makes the lives of people as convenient and simple as possible.

Lower Costs

The PM-JAY card plays a significant role in helping cut costs and make premium healthcare services accessible to low-income and vulnerable groups.

Eligibility For PM JAY Yojana

The PM-JAY card allows citizens to register for the Pradhan Mantri Jan Arogya Yojana. It is India’s public healthcare program.

Up to 5 lakhs of healthcare benefits

Cardholders become eligible for treatment worth Rs. 5 lakh per family per year in the hospitals listed. This helps in removing the financial burden from the shoulders of the families.

High-Quality Medical Care

By bearing the costs of surgeries and treatments, the cards have enabled high-quality care for lower-income groups. Surgeries and medications aren’t affordable even for the middle-income groups at present; hence, the scheme is a boon at today’s time.

Wide Coverage

Complex procedures like cancer surgery, heart implants, and joint replacements are affordable. Cashless coverage has reduced high out-of-pocket expenditures.

Research shows that over 63 million Indians fall into poverty due to unaffordable healthcare costs every year. By covering hospitalisation costs, the PM-JAY card shields a vulnerable section of society. This supports the continuity of children’s education and the livelihoods of millions.

Healthcare is witnessing unprecedented penetration into remote regions. 30,000 underserved sub-health centres are also converted to health and wellness centres. It also plays a major role in securing India’s informal workforce.

As the world’s most populous country, safeguarding India’s workforce through a health insurance safety net is vital.

Also read: Ayushman Yojana: Major Changes in 2024

Aim Of Ayushman Card

Some of the key objectives of the PM-JAY card are listed below in brief for one’s better understanding. The key objectives are as follows:

• Ayushman cards aim to build comprehensive health profiles of Indian citizens. They gather all medical records from a single source.
• They enhance access to paperless health services. This helps India’s digital health infrastructure benefit crores of citizens.
• Ayushman Card's convergence of public funding through the insurance model. This has disrupted traditional incentivisation, delivery, and access across India’s healthcare landscape.
• This can be seen happening at an unprecedented pace and scale, benefiting citizens, providers, and the economy at large.

With increased budgetary allocations and technology integrations, Ayushman cards promise financial health assurance. This card also provides medical security to crores of vulnerable Indians.

Eligibility Criteria For Ayushman Card

To be eligible to avail of the benefits of the PM-JAY card, there is a set of eligibility criteria that individuals need to fulfil. The eligibility criteria are as follows:

Ayushman Card Eligibility For Rural Households:

Families residing in rural areas that fulfil the conditions mentioned below are eligible for availing of the benefits of the PM-JAY card. Those conditions are listed below:

• All members live under one roof with kuccha walls or roof.
• No adult member within the age of 16-59.
• No adult male members within the age range of 16-59.
• No physically abled adult member or at least one adult disabled member
• Receive the major portion of household income as manual labour.
• SC/ST households

Extended Eligibility

There has been an update in the PM-JAY scheme, which allows senior citizens above the age of 70 years to apply for the scheme and reap its benefits. Senior citizens can do so by applying for the new Ayushman Vaya Vandana card.

Ayushman Card Eligibility for Urban Households:

Families residing in rural areas that fulfil the conditions mentioned below are eligible for availing of the benefits of the PM-JAY card. Those conditions are listed below:

• Certain sections, like road accident victims, domestic workers, and homeless citizens.
• Families who receive food rations under the public distribution system.
• Registered construction workers
• Street vendors/cobblers/other street vendor providers.
• Beggars/ragpickers/sanitation workers/home-based workers/artisans/tailors/handicraft workers/washermen/other similar roles.
• Electrician/chowkidar/mechanic/repair workers/rickshaw puller/transport workers/waiter/peon/shop worker/delivery man.

Who Is Not Eligible For Ayushman Card Benefits?

Here is a list of individuals that cannot be considered to avail of the benefits under the Ayushman Bharat Yojana. Those who can’t claim the scheme’s benefits are as follows:

• Government employees
• Individuals with income above INR 10,000 per month.
• Individuals holding Kisan card
• Individuals owning vehicles, such as a two- or three-wheeler or car.
• Individuals owning farming machinery
• Individuals holding land over 5 acres
• Individuals owning motorised fishing boats
• Individuals owning a refrigerator in their home
• Individuals owning landline phones

Also read: Up To 5 Lakh Free Healthcare To Senior Citizens

List Of Ayushman Card Registered Hospital List

One can find the list of registered hospitals under the Ayushman Card hospital list by following some simple steps mentioned below:

• Please visit the official website of PMJAY.
  
• Click on ‘Find hospitals’ and fill in the required details like state, district, hospital type, name of the hospital, speciality, and type of registration.
  
• Enter the correct captcha code.
• View the list of the hospitals in the Ayushman card hospital list.

How To Apply For Ayushman Card Online?

Registering for PM JAY Yojana is a simple process. Read the steps given below to apply for an Ayushman card online.

• Visit the official National Health Authority website.
  
• If you are already a beneficiary, sign in using your registered mobile number. If you are a new user, you can log in using your registered mobile number to check if you are a beneficiary.
  
• Submit the captcha, mobile number, and OTP, and check if you fall under the PM-JAY list.
  
• Now download and open the Ayushman app (download here) or visit the official PM JAY website.
• You will find the option ‘Am I Eligible’ to confirm if you are eligible to fall under the PM-JAY scheme beneficiary list.
• Next, log in using your mobile number and enter the requested details, including your name, state, ration card number, household number, and mobile number.
• If your family is covered under the Ayushman Bharat scheme, it will be confirmed.

Documents Required

The essential documents needed to apply for the PM-JAY card, without which an applicant won’t be able to apply for the scheme. The list of those required documents is as follows:

• Age Proof (birth certificate)
• Identity Proof (PAN card, aadhar card)
• Income certificate
• Caste Certificate
• Family status proof (aadhar cards of all family members)

Cost Of Treatment Under Ayushman Card

The Ayushman Bharat scheme offers completely free of cost treatment to its beneficiaries. This is one of its most appealing features, as it provides families with an insurance coverage of Rs. 5 lakhs. It consists of both secondary and tertiary medical expenses of the patients. People can go to registered hospitals to access treatment with the Ayushman card.

How To Update Information In The Ayushman Card?

One can update their information on the Ayushman card either by calling the toll-free number of Ayushman Bharat Yojana (145555) or by visiting the Common Service Centres.

How Can One Check Their Name In The Ayushman Bharat Yojana List?

One can check their name in the Ayushman Bharat Yojana list in several ways. All of the ways are mentioned below:

1. Website

Please visit the official website of NHA, log in by verifying your phone number, security question, and captcha, and check your name.

2. Common Service Centres

Please visit the nearest Common Service Centre or any registered hospital and request them to see if your name is on the list or not.

3. Helpline

Please dial 14555, which is a toll-free number of PM-JAY, and check whether your name is on the list or not.

Expenses Covered Under Ayushman Card Benefits

The Ayushman Bharat insurance coverage covers a wide variety of medical services, such as:

• Medical examination fees include the cost of initial check-ups, consultations, and later treatment.
• Hospital accommodation charges are also covered right from the date the individual is admitted into the hospital.
• Expanses of all lab and diagnostic tests used to detect illnesses or diseases are also covered.
• All the treatment expenses, such as surgeries, medications, and therapies, are covered under the scheme.
• Pre-hospitalisation expenses of up to 3 days that cover initial check-ups, consultations, etc. are covered.
• Post-hospitalisation expenses of up to 15 days, which include medications and any therapies if needed, are covered.
• Complications that may arise during treatment are also covered.

Medical Illnesses Covered Under Ayushman Bharat Scheme

Many illnesses and diseases are covered under the Ayushman Bharat Yojana; some of the major life-threatening illnesses covered under the Ayushman card include:

• Cancer
• Heart diseases
• Burn injuries
• Neonatal concerns
• Kidney diseases
• Congenital disorders
• Neurological disorders
• Respiratory issues
• Liver disease
• Mental illnesses

List Of Diseases Not Covered Ayushman Bharat Yojana

Some diseases are not covered under the benefits of the Ayushman Card. Those uncovered illnesses are as follows:

• Fertility-related procedures, such as IVF
• Dental procedures
• AIDS/HIV
• Cosmetic surgeries
• OPD consultations and services
• Fertility treatment
• Organ transplant
• Individual diagnostics
• Drug rehabilitation

How To Download Ayushman Bharat Card?

One can download the Ayushman card by following some simple steps mentioned below in detail:

1. Visit the official National Health Authority website.
   
2. Log in using your mail ID, password, and Aadhar card.
   
3. Select the ‘Approved Beneficiary option’.
4. Fill in your password and PIN.
5. Download the Ayushman card in PDF format.
   View the card.

What Is an ABHA Card?

Under the Ayushman Bharat Digital Mission (ABDM), the Indian government introduced the ABHA Card, also known as the Ayushman Bharat Health Account Card. People can access, store, and share their digital health records with healthcare providers nationwide by using it as a distinct health ID. You can create an ABHA card online if you are an Indian citizen. The government primarily targets economically disadvantaged families, so your family's annual income must mostly not exceed Rs. 2.5 lakh to apply for an ABHA card. One can create an ABHA card through ABDM’s official portal or application (android and iOS)

Other Government Health Insurance Schemes

There are many other government health insurance schemes that people can benefit from. Some of the major schemes are:

1. Rashtriya Swasthya Bima Yojana

The Rashtriya Swasthya Bima Yojana was launched to provide families who fall below the poverty line with health insurance coverage worth Rs. 30,000 per year. It works in partnership with PM-JAY and aims to help as many people as it can.

2. Pradhan Mantri Suraksha Bima Yojana

The Pradhan Mantri Suraksha Bima Yojana is an insurance scheme that protects people against unfortunate and never-predictable accidents. The premium of the scheme is very affordable and helps policyholders and their families in such unfortunate times.

Conclusion

The Ayushman Bharat card under the Pradhan Mantri Jan Arogya Yojana isn’t just another government scheme but a lifeline for those who come from the economically weaker section of society. It is one of the most impressive schemes that the government has introduced for the betterment of people.

Stay updated with Jaagruk Bharat to get the latest information on government healthcare schemes and more, and reach out to us via our community page if you have any questions.

Government Sources

Official Website

Contact Number: 1800-111-565/ 14555