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Tata Capital > Blog > Medical Loan > Ayushman Bharat Yojana – Are You Eligible for it?

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Ayushman Bharat Yojana – Are You Eligible for it?

Ayushman Bharat Yojana – Are You Eligible for it?

The Ayushman Bharat Yojana is designed to help over 50 crore people pay for their healthcare requirements. This monumental scheme, with its vast coverage, is recognized as one of the largest health assurance programs in the world. Such an extensive initiative reflects India's commitment to elevating its healthcare standards and making quality medical care accessible to a significant portion of its population.

Ayushman Bharat Yojana is designed to meet the needs of the underprivileged and vulnerable so that healthcare can be accessed by every citizen. In this article, we guide you through the various aspects of the Ayushman Bharat Yojana, key features, and the application process.

What is the Ayushman Bharat Yojana?

The Ayushman Bharat Yojana (ABY) is a pioneering initiative by the Indian government, aimed at transforming the country's healthcare system. Launched in September 2018, this program allows India to meet a core requirement of the United Nations' Sustainable Development Goals.

The Ayushman Bharat scheme was introduced to address the challenges of healthcare accessibility and affordability, particularly for India's rural and economically disadvantaged populations. It aims to bridge the gap by providing free health insurance coverage of up to 5 lakh rupees per family per year.

The scheme targets the bottom 40% of India's population, ensuring that quality healthcare is not a privilege, but a basic right.

ABY's impact is profound, as it not only provides health security to millions but also stimulates the development of healthcare infrastructure, particularly in underserved areas.

Features and Benefits

The Ayushman Bharat Yojana is an ambitious health assurance scheme. Let’s look at the key features and benefits of this scheme:

Key Features

1. Comprehensive Coverage: The scheme offers a health insurance cover of up to Rs. 5 lakh per family per year, encompassing a wide range of medical procedures, hospitalisation costs, and even pre-existing conditions.

2. Cashless and Paperless Transactions: Beneficiaries can avail of treatments without the need for cash transactions, ensuring ease and efficiency in accessing medical services.

3. Pan-India Portability: The Ayushman Bharat health card allows beneficiaries to seek treatment at any enlisted hospital across India, breaking the barriers of geographical limitations.

4. No Cap on Family Size and Age: The scheme extends its benefits to all members of an eligible family, with no restrictions on the size of the family or the age of its members.

5. Pre- and Post-Hospitalization Expenses: ABY covers not only the costs incurred during hospitalisation but also the expenses for pre- and post-hospitalization, offering a comprehensive care package.

The ABY scheme can be extremely beneficial to low-income families. Some reasons why you should apply for this scheme if you are eligible include:

1. Reduction in Out-of-Pocket Expenditure: The scheme significantly reduces the financial burden on low-income families by covering major medical expenses.

2. Access to Quality Healthcare: With the Ayushman Bharat health card, beneficiaries gain access to a network of quality public and private hospitals, ensuring better health outcomes.

3. Protection Against Health-Related Financial Risks: By providing substantial insurance coverage, the scheme protects families from the economic shocks often associated with serious health issues.

4. Inclusive Coverage: Special emphasis on women, children, and the elderly ensures that vulnerable groups receive adequate health care attention.

Integration with Pradhan Mantri Jan Arogya Yojana (PMJAY)

The Ayushman Bharat scheme is intrinsically linked with PMJAY, which is essentially its secondary component. PMJAY focuses on providing health insurance to the bottom 40% of the Indian population, identified through a socio-economic caste census. This integration ensures a seamless and unified approach to healthcare coverage, making the system more efficient and beneficiary-friendly.

Eligibility Criteria

Knowing the eligibility criteria for the Ayushman Bharat Yojana (ABY) is crucial if you are seeking to benefit from this comprehensive healthcare scheme. The eligibility for ABY, particularly under the Pradhan Mantri Jan Arogya Yojana (PMJAY) component, is determined through a careful and inclusive process. The eligibility requirements are as follows:

1. Socio-Economic and Caste Census (SECC) 2011: The primary criterion for eligibility under PMJAY is based on the data from the SECC 2011. Families listed in the SECC database for rural and urban areas are considered eligible.

2. Deprivation Categories in Rural Areas: Rural families belonging to one of the six deprivation categories identified in the SECC data are eligible. These categories cover a wide range of socio-economic indicators, including households with no adult members between ages 16 to 59, female-headed households with no adult male members, disabled members and no able-bodied adult member, SC/ST households, landless households deriving a major part of their income from manual labour, and families living in one-room makeshift houses.

3. Automatically Included Groups: In addition to the deprivation criteria, certain groups are automatically included, such as families with no shelter, destitute living on alms, manual scavenger families, primitive tribal groups, and legally released bonded labourers.

Check PMJAY Eligibility

You can check your PMJAY eligibility through the PMJAY portal, by entering your details, like name, ration card number, or mobile number, to verify if they are listed in the SECC database. Additionally, Common Service Centers (CSCs) and empanelled hospitals can assist in checking eligibility.

How to Apply for the ABY Scheme?

Applying for the Ayushman Bharat scheme is a straightforward process, designed to ensure that eligible beneficiaries can easily access the benefits. Here's a step-by-step breakdown of the application process.:

1. Visit the official Pradhan Mantri Jan Arogya Yojana (PMJAY) website or any Common Service Centre (CSC). Use your mobile number, ration card number, or name to check if you're listed in the SECC 2011 database for eligibility.

2. Ensure you have valid identification documents like an Aadhaar card or any government-issued ID.

3. If eligible, you can register for the Ayushman Bharat scheme at a CSC or through an empanelled hospital's help desk. Submit the necessary documentation for verification.

4. Once your application is approved, you will receive an Ayushman Bharat health card. This card is crucial for availing the benefits under the scheme.

Final Thoughts

Ayushman Bharat Yojana is a transformative initiative that ensures inclusive coverage, especially for those who need financial assistance when it comes to healthcare.

While Ayushman Bharat Yojana has stringent eligibility criteria, consider an alternative solution. Tata Capital Medical Loans is a viable option, offering an affordable way to access quality healthcare services. With flexible loan conditions, EMI payments and more, the loans are a step towards equitable medical services to all.

To learn more and talk to our finance experts, check out the Tata Capital website today!

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