Pradhan Mantri Ayushman Bharat Yojana

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Over the last two years, the world has witnessed the consequences of undermining healthcare. Experts opine that having a better healthcare system in place would drastically reduce the occurrences of pandemics, or even epidemics for that matter. However, we all know that at some point, availing the benefits of healthcare becomes an expensive affair and this, therefore, makes it inaccessible to those from the poorer strata of society.

The Ayushman Bharat Yojana, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY) is a scheme that is directed towards helping people from the lower strata of the economy.

Medical packages under PMJAY

Under this scheme, individuals in specific and even families, in general, will avail the benefits of the ₹5 lakh insurance cover. This lump sum is basically enough to cover essential medical and surgical treatments in 25 specialities which include the following:

  • Cardiology
  • Neurosurgery
  • Oncology
  • Paediatrics
  • orthopaedics

In the case of multiple surgeries, the highest package cost is paid for in the first instance which is followed by a 50% waiver in the second one, followed by a 25% waiver on the third one, if required.

As opposed to other schemes available out there, the PMJAY necessitates no waiting period for pre-existing diseases. Under the protective umbrella of the scheme, should there be any individual requiring hospitalisation, they need not pay anything, provided they are admitted in any of the empanelled government or private hospitals.

List of critical illnesses covered under PMJAY

Here is a list of critical illnesses covered:

  • Prostate cancer
  • Coronary artery bypass grafting
  • Double valve replacement
  • Carotid angioplasty with stent
  • Pulmonary valve replacement
  • Skull base surgery
  • Laryngopharyngectomy with gastric pull-up
  • Anterior spine fixation
  • Tissue expander for disfigurement due to burns

Eligibility criteria for the PMJAY scheme

In the rural areas of India, the benefits of the PMJAY scheme are available to those meeting the following criteria:

  • The applicant resides in scheduled caste and scheduled tribe households
  • The family has no male member in the age group 16-59 years
  • Beggars and those living on alms are also eligible for the scheme
  • Families that have at least one physically challenged member and no able-bodied adult member
  • Landless households who make a living by carrying out casual/manual labour
  • Primitive tribal communities can also avail the benefits of the PMJAY scheme
  • Manual scavenger families
  • Families living in make-shift houses with no proper roof over their heads

Advantages of the PMJAY

Under the protective financial cover of the PMJAY, the benefactor receives upto ₹5 lakh insurance cover. The government offers further convenience by digitising this process so the applicant can apply for these online. There are several sections present under the scheme that you can cover yourself for, and then rest assured that the government fund has your back when it comes to spending on treating said ailments. Through the scheme, the government aims to bring forth a sense of security and financial assistance. During the pandemic, people saw the full effect of medical adversities and the havoc it can wreak! Through the PMJAY scheme, the government looks to offer reassurance.

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