What is the eligibility for Ayushman Bharat Health Account (ABHA)?

Hello P. Siva ji,

Thank you for your query regarding the Ayushman Bharat Health Account (ABHA) and its coverage for general surgery. It's essential to understand the distinction between the ABHA card and the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) card to determine eligibility for surgical procedures.

Understanding ABHA and PM-JAY:

• ABHA (Ayushman Bharat Health Account):

  • Purpose: Serves as a digital health ID, allowing individuals to store and access their medical records electronically.

  • Coverage: Does not provide any financial coverage for medical treatments or surgeries.

  • Availability: Open to all Indian citizens, regardless of income or socioeconomic status.

• PM-JAY (Pradhan Mantri Jan Arogya Yojana):

  • Purpose: A health insurance scheme aimed at providing financial protection for secondary and tertiary care hospitalization.

  • Coverage: Offers free treatment up to ₹5 lakh per family per year, including various surgical procedures.

  • Eligibility: Targeted at economically disadvantaged families, identified based on specific criteria.

General Surgery Coverage under PM-JAY:

If you are an eligible beneficiary under the PM-JAY scheme:

• Coverage Amount: Up to ₹5 lakh per family per year.

• Included Procedures: A wide range of general surgeries, such as hernia repair, appendectomy, gallbladder removal, and more.

• Hospital Network: Access to a vast network of empaneled public and private hospitals across India.

How to Check Eligibility and Hospital Empanelment:

1. Check Eligibility:

   • Visit the official PM-JAY portal: https://pmjay.gov.in

   • Use the "Am I Eligible" feature by entering your mobile number and other required details.

2. Find Empaneled Hospitals:

   • Access the hospital search portal: https://hospitals.pmjay.gov.in/Search/empnlWorkFlow.htm

   • Select your state and district to view a list of empaneled hospitals.