Health Benefit Package of Ayushman Bharat and Diseases Covered

The Government of India announced in February 2018 to create 1,50,000 HWCs by transforming the primary health centres and sub-centres to provide Comprehensive Primary Health Care (CPHC) to needy people. It covers health services for maternal and child health and non-communicable diseases and provides diagnostic services and free essential medicines. The expanded range of services includes:

1. Contraceptive services, family planning, and other reproductive health care services
2. Care in pregnancy and childbirth
3. Infant and neonatal health care services
4. Childhood and adolescent health care services
5. Basic oral health care
6. Management of communicable diseases
7. Management of common communicable diseases and general out-patient care for simple acute illnesses and minor ailments
8. Care for common ophthalmic and ear, nose, and throat (ENT) problems
9. Screening, control, prevention, and management of non-communicable diseases and chronic communicable diseases like Leprosy and Tuberculosis (TB)
10. Emergency medical services
11. Screening and basic management of mental health ailments
12. Palliative and elderly health care services

The Pradhan Mantri Jan Arogya Yojana

Shri Narendra Modi, the honorable Prime Minister of India, launched the PM-JAY in Ranchi, Jharkhand, on 23rd September 2018. Earlier, this scheme was known as the National Health Protection Scheme (NHPS). This scheme provides health insurance to 10.74 crore needy families, which is around 40% of the population of India. The Indian government entirely funds this scheme, and the implementation cost is shared with the state and central governments. The benefits of PM-JAY health insurance include the following components:

1. Gives five lakh per family per year for secondary and tertiary health care across private and public hospitals in India
2. More than 10.74 vulnerable and low-income families are eligible for this scheme
3. Gives cashless access to health care services
4. There are no restrictions based on gender, age, or family size
5. Covers around three days of pre-hospitalisation expense
6. Covers 15 days of post-hospitalisation expenses like medicines and diagnostics
7. Can avail the scheme in private and public hospitals all over India
8. Covers all pre-existing conditions from day one
9. Covers medical examination, consultation, and treatment
10. Covers medical implantation services 
11. Provides food services
12. Covers expenses for complications occurring during the treatment
13. Provides services for around 1393 procedures and covers costs related to treatment, medicines, diagnostic services, supplies, room charges, doctor’s fees, Intensive Care Unit (ICU) and Operation Theatre (OT) charges, and many more

The following specialities are covered under PMJAY:

1. Cardiology 
2. General Medicine
3. Burns Management
4. Cardiothoracic and Vascular Surgery
5. General Surgery
6. Emergency Room Packages
7. Ophthalmology
8. Gynaecology and Obstetrics
9. Interventional Neuroradiology
10. Medical Oncology
11. Neurosurgery
12. Neonatal Care Packages
13. Mental Disorders Packages
14. Orthopaedics
15. Oral and Maxillofacial Surgery
16. Paediatric Surgery
17. Otorhinolaryngology
18. Polytrauma
19. Paediatric Medical Management
20. Paediatric Surgical Package
21. Surgical Oncology
22. Plastic and Reconstructive Surgery
23. Urology
24. Unspecified Surgical Package 
25. Radiation Oncology

Ayushman Bharat is a great initiative taken by the Government of India. This scheme is on a family floater basis, which means the procedure can be used by a single member of the family or the entire family.

Connect with our experts at HexaHealth to learn more about the illnesses covered by Ayushman Bharat and the surgeries under the programme. Our knowledgeable doctors would be pleased to assist you with any questions or concerns.

Q. How much will it cost to buy Ayushman Bharat Health Insurance?
A. The Ayushman Bharat Health Insurance is free for users in India.

Q. Does pregnancy come under Ayushman Bharat?
A. Yes, pregnancy comes under the Ayushman Bharat Scheme.

Q. How many diseases are covered in Ayushman Bharat?
A. Around 1393 health conditions are covered under Ayushman Bharat Scheme.

Q. How will Ayushman Bharat be implemented?
A. Ayushman Bharat will be implemented via the insurance companies. In states/union territories, the scheme will be implemented in society/trust mode.

Q. What are the inclusions of Ayushman Bharat Health Insurance?
A. PM-JAY helps the poor and vulnerable families by funding five lakh rupees per family per year to avail facilities at secondary and tertiary hospitals. It extends coverage for 1393 medical packages at empanelled private and public hospitals. A few critical diseases covered are COVID-19, Prostate cancer, etc.