Does the Ayushman Card cover maternity expenses?

Dear New Community Lead ji,

I can certainly help you with information regarding maternity benefits under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme.

Does Ayushman Bharat Card Cover Maternity Expenses?

Yes, maternity benefits are covered under Ayushman Bharat – PMJAY for eligible beneficiaries at PMJAY-empanelled hospitals. Coverage may include :

• Normal delivery

• C-section (Cesarean) delivery

• High-risk pregnancy management

• Hospital admission and stay

• Medicines and investigations related to hospitalization

• Newborn care under eligible packages 

  
  

What Is the Maximum Coverage Amount?

PMJAY provides cashless health coverage of up to ₹5 lakh per family per year for approved treatments and hospitalization packages. The maternity package itself does not have a single fixed amount for all cases; the applicable package rate depends on the treatment and hospital-approved PMJAY package. 

What Should You Confirm With the Hospital?

Please ask :

• Is the hospital PMJAY empanelled?

• Is maternity/delivery covered under PMJAY?

• Is normal delivery covered?

• Is C-section covered if medically required?

• Is the treatment completely cashless?

• Is pre-authorisation required?

Documents Usually Required

• Ayushman / PMJAY Card

• Aadhaar Card

• Pregnancy reports

• Ultrasound reports

• Doctor's prescription

How to Check the Hospital?

Verification Steps

• Visit Ayushman Bharat Official Portal

• Open the "Find Hospital" section

• Select your State and District

• Choose Obstetrics & Gynecology specialty

Alternative Verification

• Call the Ayushman Helpline 14555

• Contact the hospital's Ayushman Help Desk directly

Key Aspects of Maternity Coverage

• Comprehensive Care : The scheme covers a wide range of services for pregnant women, including
  
  
  • Antenatal care (pre-delivery check-ups and consultations)
    
    
  • Delivery services (normal deliveries and C-sections)
    
    
  • Postnatal care (check-ups and care for the mother and newborn after delivery)
    
    
  • Complications during pregnancy or childbirth
    
    
  • Certain newborn care services

• Maximum Coverage : The Ayushman Bharat PMJAY scheme provides a health cover of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization, which includes maternity-related expenses. There is no specific sub-limit for maternity; it falls under the overall ₹5 lakh family cover.

• Cashless Treatment: Eligible beneficiaries can avail of cashless treatment at empaneled public and private hospitals across India.

Tips for Availing Maternity Benefits

• Eligibility Check: Ensure your family is eligible for the Ayushman Bharat scheme.
  
  
• Empaneled Hospitals: Seek treatment at hospitals that are empaneled under the PMJAY scheme.
  
  
• Required Documents: Always carry your Ayushman card or e-card along with a valid ID proof when visiting the hospital.

How HexaHealth Can Assist

• Eligibility Support : We can help you understand your eligibility for the Ayushman Bharat scheme.
  
  
• Hospital Network : Our team can connect you with empaneled hospitals that offer quality maternity services under PMJAY.
  
  
• Seamless Process : We assist you in navigating the process of availing cashless treatment for your maternity care, making your healthcare journey smoother.

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