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Can You Get Free Treatment In Private Hospitals Using Ayushman Bharat Scheme? Explained

Ayushman Bharat provides cashless cover of up to Rs 5 Lakh to each eligible family per annum for listed secondary and tertiary care conditions. 

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Ayushman Bharat: Rs 5 Lakh Free Health Insurance: Can You Get It In Private Hospitals?
Ayushman Bharat: Rs 5 Lakh Free Health Insurance: Can You Get It In Private Hospitals?

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) that recently included senior citizen above 70 years too, provides cashless access to health care services for the beneficiary at the point of service, that is, the hospital. All pre–existing conditions are covered from day one. Benefits of the scheme can be availed both at public and private hospital. 

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AB PM-JAY: Can You Get Rs 5 Lakh Worth Free Treatment In Private Hospitals
AB PM-JAY: Can You Get Rs 5 Lakh Worth Free Treatment In Private Hospitals

However, the point to note is that treatment at private hospitals under the Ayushman Bharat scheme, is allowed only at empaneled hospitals. Benefits of the scheme are portable across the country i.e. a beneficiary can visit any empanelled public or private hospital in India to avail cashless treatment. Public hospitals are reimbursed for the healthcare services at par with the private hospitals.

 

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Empaneled/Eligible Hospitals Under Ayushman Bharat Scheme
Empaneled/Eligible Hospitals Under Ayushman Bharat Scheme

Go to the Ayushman Bharat direct link https://pmjay.gov.in/

Now from the navigation carousal, click 'FIND HOSPITAL' option

A new page will open

You will be given a couple of selections to fill up like --State, District, Hospital Type, Speciality, Hospital Name, Empanelment Type 

Fill those details, enter captcha code and click 'SEARCH'

Now you can view the list of eligible Ayushman Bharat hospitals near you 

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Medical Expenses Covered Under Ayushman Bharat
Medical Expenses Covered Under Ayushman Bharat

PM-JAY provides cashless cover of up to Rs 5,00,000 to each eligible family per annum for listed secondary and tertiary care conditions. The cover under the scheme includes all expenses incurred on the following components of the treatment.

Medical examination, treatment and consultation Pre-hospitalization Medicine and medical consumables Non-intensive and intensive care services Diagnostic and laboratory investigations Medical implantation services (where necessary) Accommodation benefits Food services Complications arising during treatment Post-hospitalization follow-up care up to 15 days

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Procedures Covered Under Ayushman Bharat
Procedures Covered Under Ayushman Bharat

Ayushman Bharat Yojana Services include approximately 1,929 procedures covering all the costs related to treatment, including but not limited to drugs, supplies, diagnostic services, physician's fees, room charges, surgeon charges, OT and ICU charges etc.

 

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Ayushman Bharat Yojana Rs 5 Lakh Health Cover
Ayushman Bharat Yojana Rs 5 Lakh Health Cover

The senior citizens of the age 70 years and above belonging to families already covered under AB PM-JAY will get an additional top-up cover upto Rs 5 lakh per year for themselves (which they do not have to share with the other members of the family who are below the age of 70 years). All other senior citizens of the age 70 years and above will get a cover upto Rs 5 lakh per year on a family basis. 

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Ayushman Bharat Yojana For Senior Citizen
Ayushman Bharat Yojana For Senior Citizen

Cabinet recently approved the health coverage with Rs 5 Lakh free health insurance cover on a family basis to all the senior citizens aged 70 years and above irrespective of income under the flagship scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). With this approval, all senior citizens of the age 70 years and above irrespective of their socio- economic status would be eligible to avail the benefits of AB PM-JAY. The eligible senior citizens would be issued a new distinct card under AB PM-JAY. 





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