AYUSHMAN CARD

Ayushman Card Introduction:

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), commonly known as the Ayushman Card is a government health insurance scheme.  It was launched by the government of India in 2018. The scheme aims to ensure that all eligible beneficiaries have access to quality healthcare services, regardless of their financial status, by providing coverage for various medical procedures, treatments, and surgeries. It provides health coverage to the economically weaker section of families across the country. Under this scheme, the eligible beneficiaries receive a health insurance card which is often known as an Ayushman Card.  The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a health protection insurance scheme that provides insurance to the citizens of India. It covers up to Rs.5,00,000 lacs annually for a family to receive primary, secondary, and tertiary health care services. The Ayushman Bharat aims to provide health insurance coverage to over 500 million economically weaker and vulnerable citizens of India. Under this scheme, only eligible beneficiaries receive an Ayushman card which can be used to avail of cashless treatment at empanelled hospitals. It covers medical expenses up to a certain limit to support the financial burden on millions of families across India. The Ayushman Bharat scheme aims to provide financial support against healthcare expenses to access quality healthcare services for millions of vulnerable families in India.

Table of Contents:

1. Features
2. Benefits
3. Eligibility
4. Diseases covered
5. Empanelled hospital
6. How to apply for an Ayushman card
7. Document required for Ayushman card
8. Website
9. Helpline number
10. FAQ

Ayushman card Features:

Here are some features of the Ayushman Card:                                                                                              

1. Cashless treatment: Under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the beneficiaries can avail of cashless treatment in any of the empanelled hospitals across India. They do not have to pay for treatment at the time of admission.
2. Coverage of medical expenses: Under this scheme, covers a wide range of medical expenses including hospitalization, diagnostics, surgeries, and medications.
3. Amount coverage: Under the Ayushman Bharat scheme, the eligible family is entitled to get Rs. 5 lacs per family per year for hospitalization expenses.
4. Paperless and digital: Ayushman card is issued in digital format and reduces physical paperwork. It is convenient for beneficiaries to carry on and access their health insurance information.
5. Family coverage: Under Ayushman Bharat scheme, covers the entire family members including the head of the family, spouse up to five dependent family members. The family is identified through the SECC database.
6. Pre-existing conditions: Ayushman card covers pre-existing conditions from day one. It ensures the beneficiaries that the existing health issues are not excluded from receiving the benefits.
7. No age bar: Underthe Ayushman Bharat scheme, there is no age limit, i.e. both elders and children can avail of benefits.
8. Validity of Ayushman card: The beneficiaries are subject to continue for the validity of the Ayushman card. As per the Ayushman card guidelines, it needs to be renewed periodically.
9. Portability: The Ayushman card isportable. The beneficiaries of the Ayushman card can avail of the health facility in any empanelled hospital in India.
10. No enrolment fee: The beneficiaries do not need to pay any fee for enrolment of the Ayushman card. Under the AB-PMJAY scheme, the Ayushman card is provided free of cost.

Ayushman Card Benefits:

The Ayushman Bharat scheme provides many benefits to the beneficiaries. The beneficiaries of the Ayushman cardholders will get benefits for the following services:

1. Consultation fees, medical examination, and treatment expenses are borne under the Ayushman Bharat scheme.
2. Pre-hospitalization and post-hospitalization expenses.
3. Cost of medicines
4. Food services
5. Accommodation
6. Intensive and non-intensive care services
7. Treatment in complicated cases.Top of Form

Ayushman Card Eligibility:

Here are some eligibility criteria for the Ayushman card:

1. Socio-Economic criteria: The Ayushman Bharat scheme aims to provide financial support to the economically weaker section of the society based on Socio-Economic and Caste Census (SECC) 2011 database.
2. Household income criteria: There is a specific criteria amount for households for eligible an Ayushman Bharat card. They may vary from state to state.
3. Exclusion criteria: The exclusion criteria exclude households having government employees, pensioners, four-wheelers, and kisan credit cards with a specific amount.
4. No age bar: There is no age barfor the beneficiaries under the Ayushman Bharat scheme. All members of eligible families can avail the benefits of the Ayushman Bharat scheme.
5. Identification: The identification of beneficiaries can be done using the Ayushman Bharat Family Health Card or Ayushman Bharat card issued by the respective states.
6. Priority: Priority is given to specific groups such as senior citizens, pregnant women, newborn babies, children, and especially disabled people.

Ayushman Card Diseases cover:

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), aims to access to ensure quality healthcare services without financial hardship for eligible beneficiaries. Here are some diseases and medical conditions that are covered under this scheme:

In addition to the above diseases, AB-PMJAY includes the following services:

• Pre-hospitalization
• Consultation, Medical examination and treatment
• Diagnostic and laboratory testing
• Medicine and medical supplies
• Intensive and non-intensive care services
• Complications that occur during treatment
• Accommodation
• Food services

Ayushman Card Empanelled Hospital:

Under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), there is a network of empanelled hospitals across India where eligible beneficiaries can access quality healthcare services. The empanelled hospitals may be both public and private healthcare facilities that meet the accreditation and quality standards set by the National Health Authority (NHA) and the respective state governments.

The network of empanelled hospitals under the Ayushman Bharat scheme is extensive, covering a wide range of medical specialties and services. Beneficiaries can access healthcare services including consultations, diagnostics, treatments, surgeries, and other medical interventions at these hospitals without having to bear the financial burden directly.

To find empanelled hospitals under the Ayushman Bharat scheme, beneficiaries can:

1. Visit the official Ayushman Bharat PM-JAY website i.e. www.pmjay.gov.in or use the Ayushman Bharat mobile application to search for empanelled hospitals in their area.
2. Contact the Ayushman Bharat PM-JAY helpline 14555/ 1800111565, or the State Health Agency (SHA) helpline for assistance in locating empanelled hospitals.
3. Consult with local healthcare authorities, community health workers, or other sources for information on nearby empanelled hospitals.

It’s important for beneficiaries to verify the empanelment status of hospitals before seeking treatment to ensure that they receive coverage under the Ayushman Bharat scheme. Additionally, beneficiaries should carry their Ayushman Bharat Family Health Card (AB-FHID) or Ayushman Bharat PM-JAY card when visiting empanelled hospitals to facilitate the identification and verification process.

How to apply and Fill form for an Ayushman Card:

To apply for an Ayushman Card under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme, you need to follow certain steps. Here are the steps:

1. Visit the nearest Common Service Canter (CSC) located in your village or town. It is the first point of various government services. You ensure or check your eligibility criteria set by the ABPMAY scheme.
2. To provide your requisite documents. The documents are – identity proof, address proof, income certificate, and family details.
3. Fill Application form for the Ayushman Bharat scheme. Make sure that you are providing accurate and complete information.
4. After filling up the Application form along with the requisite documents, the CSC will verify the documents and household details i.e. the identity proof, address proof, income, and other eligibility criteria.
5. If your application is approved you will be issued an Ayushman Bharat card. This card will have a unique identification number and will enable you to have benefits under the Ayushman Bharat scheme. This card will contain details of your health coverage under the scheme.
6. Ensure that the Ayushman card is activated by following the instructions provided by the CSC or the issuing authority. 

Document required for an Ayushman Card:

To apply for an Ayushman card a few documents are needed to be produced. Here are the following.

1. You will need valid identity proof such as an Aadhar card, PAN card, Passport, Voter ID, and any other government document issued with photo ID.
2. Documents as proof of address such as Aadhar card, Passport, Voter ID, Electricity bill, and any other government document issued as address proof.
3. You will need to submit an income certificate to demonstrate your eligibility for the scheme. The certificate should be issued by the relevant authority such as the local revenue office or municipal corporation.
4. You must provide a Caste certificate if you belong to a specific reserved category as per the guidelines set by the authorities.
5. Bank account details should be provided including bank account number, IFSC code, and name of the bank for cashless transactions and reimbursement of medical expenses.
6. You must submit passport-size photographs of yourself and other family members included in the application.
7. All family members’ details, who will be covered under the Ayushman Bharat scheme, must include name, age, and relationship with the primary cardholder.
8. Depending on the requirements of the local authority or agency, you may need to submit additional documents or certificates to complete the application process.

Ayushman Bharat Scheme official website:

The official website for the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme in India is:

The official website of the Ayushman Bharat scheme acts as a platform for information related to the scheme such as eligibility criteria, benefits, empanelled hospitals, etc.

Ayushman Bharat scheme helpline number:

Ayushman Bharat-PMJAY Helpline Number: 14555 / 1800111565

For telephonic help dial 180030003468 or send an E-mail to ayushmanbharat.csc@gmail.com.

FAQ

a.      What is the Ayushman Card?

The Ayushman Card or Ayushman Bharat Pradhan Mantri Arogya Yojana (ABPMAY) is a health care card provided under the Ayushman Bharat scheme, which offers health insurance coverage of up to Rs. 5 lacs per family per year for secondary and tertiary health care hospitalization.

b.     Who is eligible for the Ayushman Bharat scheme?

The Ayushman Bharat scheme aims to provide financial support to the economically weaker section of the society based on Socio-Economic and Caste Census (SECC) 2011 database. Households having no adult earning member, manual scavenger families, tribal families, and other socio-economically weaker sections.

c.      How to apply for the Ayushman Card?

For applying Ayushman card, visit the official website of PM-JAY or contact a nearby CSC for assistance with proper documents such as ID proof (Aadhaar card, Voter ID), address proof, and SECC 2011 data confirmation.

d.     What benefits does the Ayushman Card provide?

The following benefits are provided by the Ayushman scheme:

1. Coverage of up to Rs. 5 lacs per family per year for medical expenses.
2. Coverage for nearly 1,500 medical procedures including surgery, hospitalization, and post-hospitalization costs.
3. Cashless and paperless access to services at empanelled public and private hospitals.

e.      How to check if a hospital is empanelled under PM-JAY?

You can check the list of empanelled hospitals on the PM-JAY official website or by contacting the PM-JAY helpline.

f.       What documents are required for the application?

The following documents are needed for the Ayushman card:

1. Aadhaar Card or Voter ID

2. Ration card
3. SECC 2011 reference number
4. Mobile number
5. Proof of residence (if applicable)