Does Ayushman Card cover pre-existing diseases?

Dear Sushant Bedi ji,

Yes, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) covers pre-existing diseases from day one for eligible beneficiaries. Unlike many private health insurance plans, there is no waiting period for approved pre-existing medical conditions under the scheme.

If you are eligible for PM-JAY, you can receive cashless treatment of up to ₹5 lakh per family per year for approved medical conditions and surgeries at PM-JAY empanelled hospitals.

What Are Pre-Existing Diseases?

A pre-existing disease is a medical condition that a person already has before receiving the Ayushman Card or before seeking treatment.

Examples include :

• Heart disease

• Diabetes

• High blood pressure

• Kidney disease

• Cancer

• Stroke

• Chronic liver disease

• Arthritis

• Asthma and other chronic respiratory diseases

Coverage depends on the approved PM-JAY treatment package and your doctor's medical evaluation.

What Does the Ayushman Card Cover?

Eligible beneficiaries receive coverage for

• Hospitalisation for approved medical conditions.

• Approved surgeries and procedures.

• Medicines and consumables during hospitalisation.

• ICU charges, if required.

• Diagnostic tests included in the approved package.

• Doctor's consultation during admission.

• Pre-hospitalisation and post-hospitalisation expenses as per PM-JAY guidelines.

Important Things to Know

• There is no waiting period for approved pre-existing diseases.

• Treatment is available only at PM-JAY empanelled hospitals.

• Cashless treatment is provided only for approved PM-JAY packages.

• The hospital will verify your eligibility and obtain the required pre-authorisation before treatment, wherever applicable.

How to Check Whether the Hospital Accepts Ayushman Bharat (PM-JAY)?

Before taking treatment, verify whether the hospital is empanelled under PM-JAY.

Online Verification

• Visit the PM-JAY Hospital Finder.

• Select:

  • State

  • District

  • Hospital Name (or Specialty, if required).

• Click Search.

• Confirm that the hospital is PM-JAY empanelled.

How HexaHealth Can Assist You

• Ayushman Bharat Guidance: We help you understand PM-JAY eligibility, coverage, and benefits for pre-existing diseases.

• Coverage Verification: We help you understand whether your medical condition or treatment is covered under the approved PM-JAY package.

• Hospital Selection: We help you find PM-JAY empanelled and HexaHealth partner hospitals near your location.

• Specialist Consultation: We help connect you with experienced specialists based on your medical condition.

• Documentation Support: We guide you on the documents required for PM-JAY verification and cashless treatment.

• Appointment Assistance: We help coordinate doctor consultations, treatment planning, and hospital appointments.

Please share

• Your medical condition or diagnosis.

• Your city and state.

Based on these details, we can help you find a suitable HexaHealth partner hospital or PM-JAY empanelled hospital and guide you through the next steps.

Wishing you and your family good health always.
Warm regards,
Team HexaHealth