Ayushman Bharat Covered Diseases List - Download PDF

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Medically Reviewed by Dr. Aman Priya Khanna
Written by Hexahealth Care Team, last updated on 8 August 2023
Ayushman Bharat Covered Diseases List - Download PDF

Ayushman Bharat is a health insurance scheme that provides financial protection and quality healthcare to the financially weaker sections of society. One of the key components of this scheme is the Ayushman Bharat Covered Diseases List, which includes a wide range of medical procedures and treatments for various diseases. 

Under this scheme, eligible beneficiaries can avail of cashless treatment or reimbursement for medical expenses incurred during hospitalisation for the covered diseases. Read the blog to check if your condition is covered under the scheme.

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About Ayushman Bharat Disease List

Ayushman Bharat Yojana, or Pradhan Mantri Jan Arogya Yojana (PMJAY), is a health insurance scheme launched by the Government of India in 2018. The beneficiaries are entitled to free medical treatment for a wide range of illnesses and medical conditions they would otherwise not be able to afford.

The Ayushman Bharat Covered Diseases List is a comprehensive list of medical procedures and treatments covered under the Ayushman Bharat Yojana. The National Health Authority periodically updates it.

The list includes over 1,500 medical procedures and treatments for a wide range of illnesses and medical conditions. It covers inpatient and outpatient treatments and procedures for various medical conditions.

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Benefits of Ayushman Bharat Health Package

The Ayushman Bharat Yojana has led to the creation of new healthcare facilities and the strengthening of existing ones, which has improved the overall healthcare infrastructure in the country.

  1. Access to Quality Healthcare: The Ayushman Bharat Covered Diseases List provides the beneficiaries with quality healthcare services. It ensures that they receive the necessary medical treatment without any financial burden.
  2. Wide Coverage: The list covers over 1,500 medical procedures and treatments across different medical specialities, such as cardiology, neurosurgery, oncology, and more.
  3. No Restriction on Family Size: The scheme provides coverage to families of all sizes, with no limit on the number of family members.
  4. Cashless Treatment: The Ayushman Bharat cardholders can avail of cashless treatment at any of the empanelled hospitals across the country.Benefits of PMJAY Health package image

Ayushman Bharat Covered Disease List

Families and individuals eligible for the programme can take advantage of nearly 25 specialities. They are: 

  1. Ayushman Bharat Yojana covers medical procedures related to heart conditions, such as angioplasty, pacemaker implantation, and bypass surgery.
  2. Medical procedures related to conditions affecting the nervous system, such as brain tumour surgery, treatment for epilepsy, and nerve decompression surgery, are included in the scheme.
  3. It covers procedures related to cancer treatment, such as chemotherapy, radiation therapy, and surgery.
  4. The scheme involves medical treatment for burns, injuries, and fractures, such as skin grafting, wound dressing, and orthopaedic surgeries.
  5. Ayushman Bharat Yojana provides coverage for medical procedures related to conditions affecting the kidneys, such as kidney stone removal, dialysis, and kidney transplantation.
  6. The scheme covers medical treatment for infectious diseases like tuberculosis, malaria, and HIV/AIDS.
  7. It provides medical treatment for mothers and newborns, such as delivery, cesarean section, and treatment for newborns with birth defects.
  8. Mental health issues are also included in PMJAY. E.g. depression, anxiety, and bipolar disorder.
  9. It covers medical procedures and treatments for digestive system conditions, such as gastroenteritis, hepatitis, and pancreatitis.
  10. The scheme provides medical treatment for eye-related conditions, such as cataract surgery, glaucoma treatment, and retinal detachment surgery.
  11. It includes treatments for conditions affecting the bones and joints, such as joint replacement surgery, spinal surgery, and treatment for osteoporosis.Specialities under PMJAY image

The table below includes the list of speciality covered under Ayushman Bharat with package details and costs:

S. No.

Speciality Cost Range
1

Burns Management

₹ 7,000 to ₹ 80,000
2

Cardiology

₹ 5,000 to ₹ 1,10,000
3

Cardiothoracic and Vascular Surgery

₹ 1,000 to ₹ 2,70,000
4

Emergency Room Packages

(Care requiring less than 12 hours stay)

₹ 1,700 to ₹10,000
5

General Medicine

₹ 2,700 to ₹ 4,500
6

General Surgery

₹ 1,500 to ₹ 51,600
7

Interventional Neuroradiology

₹ 70,000 to ₹ 1,60,000
8

Medical Oncology

₹ 5,800 to ₹ 1,60,000
9

Mental Disorders Packages

₹ 1,000 to ₹ 10,000
10

Neonatal Care Packages

₹ 500 to ₹ 15,000
11

Neurosurgery

₹ 15,000 to ₹ 75,000
12

Obstetrics & Gynaecology

₹ 9,900 to ₹ 38,500
13

Ophthalmology

₹ 3,000 to ₹ 23,900
14

Oral and Maxillofacial Surgery

₹ 500 to ₹ 15,000
15

Orthopaedics

₹ 2,000 to ₹ 1,77,000
16

Otorhinolaryngology

₹ 1,200 to ₹ 48,900
17

Paediatric Medical Management

₹ 1,800 to ₹ 45,000
18

Paediatric Surgery

₹ 5,000 to ₹ 30,000
19

Plastic & Reconstructive Surgery

₹ 2,000 to ₹ 50,000
20

Polytrauma

₹ 1,000 to ₹ 75,000
21

Radiation Oncology

₹ 1,100 to ₹ 90,000
22

Surgical Oncology

₹ 20,000 to ₹ 98,000
23

Urology

₹ 1,000 to ₹ 42,000
24

Paediatric Cancer

₹ 5,000 to ₹ 30,000
25

Unspecified Surgical Package

₹ 330 to ₹ 5,000

You must visit "How to Use Ayushman Card in Hospital?" to know the necessary steps of hospitalisation. 

Treatment Included in PMJAY

The Health Benefit Packages under the scheme includes all the expenses incurred for hospitalising beneficiaries. Ayushman Card download is a must to enjoy the benefits of Ayushman Bharat. The following are included in Ayushman Card Disease List:

  1. Medical examination, treatment, and consultation
  2. Pre-hospitalization
  3. Medicine and medical consumables
  4. Non-intensive and intensive care services
  5. Diagnostic and laboratory investigations
  6. Medical implant services (where necessary)
  7. Accommodation benefits
  8. Food services
  9. Complications arising during treatmentTreatment included under PMJAY image

Treatment Excluded in PMJAY

It is not possible to receive reimbursement for medical and surgical costs simultaneously. The surgery with the maximum cost will be covered first in case of multiple surgeries. The Ayushman Bharat Yojana does, however, have several exclusions, which include the following:

  1. Drug rehabilitation program
  2. Cosmetic procedures
  3. Out-Patient Department (OPD) expenses
  4. Individual diagnostics
  5. Organ transplant 
  6. Fertility-related proceduresExcluded treatements under PMJAY image

The first kidney transplant in J&K hospitals was performed at SKIMS under the Ayushman Bharat Scheme with a patient from Poonch whose expenditures were paid under the Scheme.

The PMJAY scheme did not initially cover the cost of kidney transplantation. Still, patients who require kidney transplantation are supported financially, and SKIMS is the first hospital to do so under the Ayushman Bharat Scheme.

Access to Health Benefits Package

The status of the Health Benefits Package for Ayushman Bharat diseases list can be checked in two ways. These are:

  1. Through HexaHealth
  2. Through PMJAY Official Website

Through HexaHealth

You can download all the specialities covered under Ayushman Bharat from the official website of HexaHealth. It provides an extensive list of the specialities and treatment costs. 

Go to the link Download Disease Covered in Ayushman Bharat Hospitals PDF to access the list of diseases covered under Ayushman Bharat.

Through PMJAY Official Website

You can view the Ayushman Bharat Covered Diseases List from the official website. Follow the steps below:

  1. Go to the official website of Ayushman Bharat, ‘https://www.pmjay.gov.in/’.Ayushman Bharat Official Website image
  2. Click 'Menu' on the left side of the homepage.Click Menu Image
  3. Select 'Transaction Management System (TMS)' under 'Portals'.Click TMS Image
  4. Fill in the Username, Password, State and Captcha'. Tick the declaration and click 'Login.'Click TMS Image
  5. You can view the TMS Dashboard.TMS Dashboard image
  6. Click 'Register Patient' under 'Patient' on the left panel of the dashboard.Register patient image
  7. Select 'ID Type' as 'PMJAY ID'.Select PMJAY ID image
  8. Fill in the 'ID Number' and select 'Retrieve'.Enter ID Number image
  9. You can now view your details.Beneficiary details image
  10. Scroll down and tick both declarations. Now, click 'Verify and Register'.declaration image
  11. Enter the OTP and Click 'Validate'.OTP Validation image
  12. You are now registered. Click 'OK'Registration completion image
  13. Select the desired option under 'Patient Type' and Click 'Submit IPOP'.Submit IPOP image
  14. All medical procedures are linked to their corresponding specialities. You can select the procedures as per your requirement. PMJAY Procedure selection image

Conclusion

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, targeted at underprivileged families, has received a successful response in its initial phases. With several diseases covered under the scheme, the Ayushman Bharat Yojana can help poor people access quality healthcare. Through this project, the Indian government has shown its commitment to strengthening the healthcare ecosystem in the country. 

Visit HexaHealth and contact the experts to learn more about the package and the surgeries covered under the scheme. Our expert will be happy to help you with your queries and concerns.

Suggested List

To know more about Ayushman Bharat, visit the links below:


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Frequently Asked Questions

How to get Ayushman Bharat covered diseases list?

Visit Download Disease Covered in Ayushman Bharat Hospitals PDF to check the Ayushman Bharat diseases list.

What is Ayushman Card disease list?

The Ayushman Bharat Yojana covers 1393 defined packages, including one unspecified surgical package and 24 specialities. The scheme helps families access healthcare services at empanelled hospitals across the country.

How many diseases cover in Ayushman Bharat?

The scheme covers medical and surgical expenses for 25 critical specialities. Some of them are:

  1. Cardiology
  2. Neurosurgery
  3. Paediatrics
  4. Oncology
  5. Orthopaedics

Does Ayushman Bharat cover hernia surgery?

Yes, Ayushman Bharat covers hernia surgery. It provides appropriate therapy for patients with disorders of the breast, hernia, soft tissues, skin, and skin-related trauma.

Is eye treatment covered in Ayushman card?

Yes, all PMJAY-eligible patients will receive necessary eye care per governmental regulations.

Does Ayushman card cover knee replacement?

Yes, under the Ayushman Bharat programme, beneficiaries can now avail procedures like hip and knee replacements.

Does Ayushman Bharat cover physiotherapy?

Yes, it covers physiology. The Ayushman Hospital and Health Services department of physiotherapy and rehabilitation is well-equipped with the newest technology for various physiotherapy subspecialties.

Is MRI free in Ayushman card?

Yes, the beneficiaries will now have free access to expensive testing like MRIs and PET scans. You need to download Ayushman Card to access imaging tests. 

Does Ayushman cover pregnancy?

Pregnant women may receive financial coverage of up to Rs. 5 lakhs under the PMJAY or Ayushman Bharat Yojana. 

Is Ayushman card valid for dialysis?

Yes, the Ayushman card is valid for dialysis. Additionally, the districts covered in the program are guaranteed to have at least one dialysis facility under the plan.

Is chemotherapy covered by Ayushman Bharat?

Yes, Ayushman Bharat covers chemotherapy. It offers cancer health coverage based on the therapeutic regimen.

Does Ayushman Bharat cover kidney transplant?

Yes, Ayushman Bharat now covers kidney transplants. Patients from economically weaker sections can now avail the facility of organ transplant treatment such as kidney or bone marrow transplants. 

References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. Official website of Ayushman Bharat Yojanalink
  2. Official website of National Health Authoritylink

Updated on : 8 August 2023

Reviewer

Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More

Author

About Authors

HexaHealth Care Team

HexaHealth Care Team brings you medical content covering many important conditions, procedures falling under different medical specialities. The content published is thoroughly reviewed by our panel of qualified doctors for its accuracy and relevance.

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