Ayushman Bharat Yojana (Pradhan Mantri Jan Arogya Yojana)
Ayushman Bharat Scheme provides an insurance cover up to Rs 5 lakh per family, per year for secondary and tertiary hospitalization. All pre-existing conditions are covered from day 1 of implementation of PM-JAY in respective States/UTs.

Ayushman Bharat Yojana PMJAY Benefits cover under various Government-funded health insurance schemes in India have always been structured on an upper ceiling limit ranging from an annual cover of INR30,000 to INR3,00,000 per family across various States which created a fragmented system. PM-JAY provides cashless cover of up to INR5,00,000 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 treatment and consultation

1) Medical Management
2) General Surgeries
3) Cardiac Surgeries
4) Urology
5) Gynecology
6) ENT
7) Ophthalmology
8) Emergency medicine
9) Obstetrics and Gynaecology
10) Neurology
11) Pathology
12) Oncology
13) Gestroenterology
14) Onco Surgery
15) Neurosurgery
16) Dialysis
and many more.

under cover in Ayushman Bharat yojna.

* 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

The benefits of INR 5,00,000 are on a family floater basis which means that it can be used by one or all members of the family. The RSBY had a family cap of five members. However, based on learnings from those schemes, PM-JAY has been designed in such a way that there is no cap on family size or age of members. In addition, pre-existing diseases are covered from the very first day. This means that any eligible person suffering from any medical condition before being covered by PM-JAY will now be able to get treatment for all those medical conditions as well under this scheme right from the day they are enrolled.

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