The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a key health insurance program launched by the central government of India. Recently, this scheme has been extended to include senior citizens aged 70 and above, making healthcare more accessible for older adults.
What’s New in the Scheme?
The government has announced that all senior citizens over 70 years, who are part of families already covered under AB-PMJAY, will be eligible for an additional annual top-up coverage of ₹5 lakh. This means that families can share this coverage among their senior members, ensuring they have the financial support needed for medical treatments.
Options for Health Insurance Holders
If you’re a senior citizen enrolled in public health insurance schemes like the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), or Ayushman Central Armed Police Force (CAPF), you have a choice. You can either continue with your current health insurance plan or switch to the new benefits provided under AB-PMJAY. Additionally, seniors with private health insurance or those under the Employees’ State Insurance Scheme can also avail this extra coverage.
Comprehensive Health Coverage
The Ayushman Bharat scheme offers health coverage of up to ₹5 lakh per eligible family per year. This extensive coverage includes a variety of medical expenses, particularly for secondary and tertiary care treatments. Here’s a breakdown of what is covered:
- Consultations and Treatments: All costs related to diagnosis, consultations, and treatments are included.
- Pre-Admission Costs: You can claim coverage for up to three days before hospitalization, including medications and diagnostic tests.
- Medicines and Consumables: All necessary medicines and consumables used during treatment are covered.
- Intensive Care: Coverage includes both regular and specialized intensive care, such as in the ICU.
- Diagnostic Tests: Any required tests or lab investigations are also covered.
- Implants: Costs for implants, like stents or pacemakers, required during treatment are included.
- Hospital Stay: The scheme covers expenses for hospital stays, whether in general wards or specialized units.
- Meals: Meals provided during your hospital stay are also part of the coverage.
- Complications: Any complications arising during your treatment are covered.
- Follow-Up Care: Up to 15 days of follow-up care after discharge is also included, ensuring continued treatment.
Finding Eligible Hospitals
If you need to look for hospitals that are eligible under the Ayushman Bharat scheme in your state, follow these simple steps:
- Visit the Official Website: Go to pmjay.gov.in.
- Find Hospitals: Click on the ‘find hospital’ option in the top menu.
- Select Your Location: Choose your state and district from the drop-down menus.
- Choose Hospital Type: Select whether you are looking for a government or private hospital.
- Filter by Specialty: If needed, filter the hospitals by specialty.
- Enter Captcha: Fill in the captcha code displayed on the screen.
- Submit: Click ‘submit’ to see the list of hospitals registered under the scheme in your area.
Registering for the Ayushman Card
To register for the Ayushman card, follow these steps:
- Visit the Registration Links: Open ayushmanup.in or setu.pmjay.gov.in/setu/.
- Quick Links: Scroll down and click on ‘Register Yourself on SETU’ under quick links.
- Fill the Registration Form: Click on the ‘register’ button and fill in all the mandatory fields.
- KYC Verification: After submitting the form, complete the KYC process and wait for approval.
- Download Your Ayushman Card: Once your application is approved, return to the portal, click on ‘download Ayushman card’, select your state, enter your Aadhaar card number, verify via OTP, and click on the download button.
Conclusion
The Ayushman Bharat PM-JAY scheme is a significant step towards providing better healthcare access to senior citizens in India. With the recent expansion of coverage, families can ensure their elderly members receive the necessary medical care without the burden of high costs. Whether you’re considering switching plans or need assistance finding a hospital, this scheme is designed to make healthcare easier and more affordable for everyone.