Ayushman Bharat Health Insurance- Everything you Need to know, Check Benefits and Eligibility

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Ayushman Bharat Health Insurance- Everything you Need to know, Check Benefits and Eligibility
Ayushman Bharat Health Insurance- Everything you Need to know, Check Benefits and Eligibility

Ayushmna Bharat Scheme was announced by Prime Minister Narendra Modi in his Independence Day Speech. The Scheme offers up to 5 lakh free health insurance. So let us check if you are eligible or not and what does Ayushmna Bharat offer.

Pradhan Mantri Jan Arogya Abhiyaan, also known as Ayushman Bharat or the National Health Protection Mission (AB-NHPM) or Modicare, will be launched on 25 September.

The scheme will be providing free health insurance coverage of up to 5 lakh to every family, this can be availed at any government or impanelled private hospitals across the nation.

The Ayushman Bharat will be launched for economically weak and poor people. Everyone is not eligible to take benefit from free medical insurance.

The scheme is also known as Modicare and will be made available for 10.74 crore eligible families and will serve to over 50 crore citizens of India.

    Source- CII PwC report

Ayushman Bharat Scheme- What does it offer?

  1. Once launched all over the country, Ayushman Bharat will give a medical cover of Rs 5 lakhs per family every year for secondary and tertiary medical care facilities.
  2. Eligibility of Modicare is based on Socio-Economic Caste Census (SECC) database. In case you fall under this criteria, you will get the health insurance coverage without much effort.
  3. In the scenario of being hospitalized, you are not liable to pay any amount to the government or empanelled private hospital. Ayushman Bharat scheme will provide you for the treatment.
  4. Unlike other medical insurance schemes, Ayushman Bharat covers all kind of diseases. The scheme includes a benefit for both pre and post hospitalization expenses.
  5. In order to avail the benefits of Ayushman Bharat, it is not mandatory to have the Aadhaar card, you can just carry the particular ID to get the free treatment at any government or empanelled private hospital

Ayushman Bharat scheme: What is the Eligibility criteria

For rural areas:

  • SC/ST households
  • Families of Manual scavenger
  • Legally-released bonded laborer
  • Primitive tribal groups
  • Families residing in only one room with “kuchcha walls and kuchcha roof”
  • Families with least one disabled member and no able-bodied adult member
  • Families who are headed by a female and no male is present aged between 16-59
  • Families without any adult members aged between 16 and 59
  • Landless households earning a major part of their income from manual casual labor
  • Destitute and those surviving on alms

For urban areas:

For the urban area the government has curated a list of 11 occupational categories of workers who are included in the list:

  • Beggar
  • Ragpicker
  • Street vendor/cobbler/ hawker/ other service provider working on streets
  • Domestic worker
  • Construction worker/ plumber/ Mason/ labour/ painter/ welder/ security guard/ coolie and other head-load workers
  • Home-based worker/ artisan/ handicrafts worker / tailor
  • Sweeper/ sanitation worker/gardener
  • Shop worker/ assistant/ peon in small establishment/ helper/ delivery assistant / attendant/ waiter
  • Transport worker/ driver/ conductor/ helper to drivers and conductors/ cart puller/ rickshaw puller
  • Washer-man/ chowkidar
  • Electrician/ mechanic/ assembler/ repair worker

As stated on the official website of Ayushman Bharat:

Ayushman Bharat (AB) is an attempt to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. Ayushman Bharat aims to undertake path-breaking interventions to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level. Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components.

It will help India capitalize on its demographic dividend, ensure enhanced productivity, well-being and avert wage loss and impoverishment.

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