Ayushman Bharat Pradhan Mantra Jan Arogya Yojana (PMJAY) is a revolutionary health insurance scheme that was launched by the government of India. It aims to provide financial security to financially weaker families by covering the cost of hospitalisation and medical treatment.
According to this scheme, eligible beneficiaries receive an Ayushman Bharat card, giving them access to cashless health services across various hospitals in India. Let's delve deeper to discover a list of diseases covered under PMJAY and how this scheme benefits millions of citizens.
What Is Ayushman Bharat (PMJAY)?
Launched in 2018, PMJAY is one of the world's largest government-sponsored health insurance schemes, providing up to ₹5 Lakh per family per year. The scheme majorly benefits families with low income.
It covers more than 1,500 medical procedures, including hospitalisation, surgery and important treatment. PMJAY covers a wide range of diseases and medical conditions, ensuring that recipients receive the necessary health services without financial stress.
Categories of Diseases Covered Under Ayushman Bharat
The disease covered under Ayushman Bharat covers a wide range of medical conditions, categorised into the following major groups:
1. Cardiovascular Diseases (Heart-Related Conditions)
· Coronary artery disease (CAD)
· Heart attack (Myocardial infarction)
· Congestive heart failure (CHF)
· Hypertension-related complications
· Angioplasty and bypass surgery
2. Cancer Treatment
· Chemotherapy and radiation therapy
· Breast cancer
· Cervical cancer
· Oral cancer
· Gastrointestinal cancers
· Lung cancer
3. Neurological Disorders
· Stroke and paralysis
· Brain tumours
· Epilepsy treatment
· Spinal disorders
· Parkinson’s disease
4. Kidney and Urological Diseases
· Chronic kidney disease (CKD)
· Kidney transplants (partial coverage)
· Dialysis (both haemodialysis and peritoneal dialysis)
· Urinary tract infections (UTI)
· Prostate gland disorders
5. Liver and Gastrointestinal Diseases
· Liver cirrhosis
· Hepatitis B & C
· Gallbladder stones
· Appendicitis surgery
· Hernia repair
6. Respiratory Diseases
· Asthma management
· Chronic obstructive pulmonary disease (COPD)
· Tuberculosis (TB)
· Pneumonia
· Interstitial lung disease (ILD)
7. Orthopaedic Conditions
· Hip and knee replacement surgery
· Fractures and bone injuries
· Osteoporosis treatment
· Rheumatoid arthritis
8. Obstetric and Gynaecological Conditions
· Normal and caesarean deliveries
· Hysterectomy (uterus removal)
· Ovarian cyst surgery
· Infertility treatments (limited coverage)
9. Paediatric Diseases (Children’s Health)
· Congenital heart defects
· Paediatric cancers
· Malnutrition-related conditions
· Neonatal care for newborns
10. Infectious Diseases
· Dengue and malaria
· HIV/AIDS treatment (select services)
· Leprosy
· Typhoid and cholera
11. Endocrine and Metabolic Disorders
· Diabetes-related complications
· Thyroid disorders
· Pituitary gland disorders
· Obesity-related medical treatments
12. Mental Health Disorders
· Schizophrenia
· Bipolar disorder
· Severe depression treatment
· Counselling and psychiatric care
Exclusions: What is Not Covered Under PMJAY?
While PMJAY covers a wide range of diseases, some medical treatments and conditions are excluded from the health insurance plans such as:
· Outpatient department (OPD) consultations
· Cosmetic surgeries (e.g. liposuction, plastic surgery)
· Fertility treatments (IVF, surrogacy)
· Organ transplants (some transplants are partially covered)
· Self-inflicted injuries and substance abuse treatments
Benefits of Ayushman Bharat Health Insurance Plans
There are various benefits of Ayushman Bharat Health Insurance are:
1. Cashless hospitalisation
PMJAY provides cashless treatment in public and private hospitals, which reduces hospital treatment expenses. Patients do not have to worry about prepayment, as the scheme directly covers hospital bills. This ensures quick access to health services without financial stress.
2. Extensive disease cover
This scheme includes over 1500 medical conditions, including critical diseases such as cancer, heart disease and kidney diseases. It includes major surgery, diagnostics and expenses after hospitalisation. This broad coverage helps to ensure medical treatment for individuals and families.
3. Nationwide Accessibility
Beneficiaries can get treatment at any PMJAY Hospitals throughout India, regardless of the status of their home. This function is especially beneficial for migrant workers and families that are often transmitted. Wherever it goes, it ensures uninterrupted access to high-quality health services.
4. No age or family size restriction
PMJAY covers all family members regardless of age, gender or number of dependents. This ensures that every qualified home coverage receives medical protection without worrying about financial burden. It is especially beneficial for families who struggle with high insurance costs.
5. Coverage for pre-existing diseases
Unlike various health insurance schemes, PMJAY covers diseases that have already existed since day one. This means that people with chronic diseases such as diabetes, high blood pressure or cancer can get immediate medical help. This also reduces the waiting time so patients can get the treatment without delay.
Final Thoughts
Diseases covered under PMJAY ensure that lower-income groups receive high-quality healthcare services without financial stress. From the treatment of heart disease and cancer to kidney diseases and mental health care, the Ayushman Bharat card acts as a source of financial freedom for needy families. If you qualify for PMJAY, obtaining an Ayushman Bharat card can help you get cashless treatment and extensive medical coverage throughout various networks across India.
While government-back schemes such as Ayushman Bharat provide a strong foundation, to ensure access to more extensive and advanced treatment. With insurance companies such as Generali Central Insurance, you can get benefits from customised health insurance schemes that meet your specific medical requirements. Explore your options today and ensure a financially stress-free future for your family!
Frequently Asked Questions ( FAQS)
1. Who is eligible for Ayushman Bharat? - H3 Tag
PMJAY is available for the economically weaker families identified under the Socio-Economic Casting People (SECC) 2011.
2. Does Ayushman Bharat cover pre-existing diseases?
Yes, PMJAY covers pre-existing diseases from day one and ensures that individuals receive treatment for health conditions at no extra cost.
3. Can I use Ayushman Bharat cards at private hospitals?
Yes, you can use Ayushman Bharat cards under PMJAY for treatment in private and public hospitals throughout India.
4. What treatments are not covered under PMJAY?
PMJAY does not cover cosmetic surgery, reproductive treatment, OPD consultation, organ transplantation, etc.
5. How can I download the Ayushman Bharat card?
You can download the Ayushman Bharat card by visiting the official website and logging in with your registered details to download the Ayushman Bharat Card.
