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How to Apply for Ayushman Bharat Scheme? Research Team | Posted On Friday, July 19,2019, 04:14 PM

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How to Apply for Ayushman Bharat Scheme?



The Ayushman Bharat Yojana was launched by the honorable Prime Minister Narendra Modi and aims to provide Rs 5 Lakh insurance cover to poor and vulnerable households in India for secondary and tertiary health care.

Ayushman Bharat Yojana was launched all over the country in 445 districts across 30 states and is a government-funded scheme. The beneficiary covered under this scheme is offered cashless benefits at empanelled public/private hospitals along with post-hospitalization care.

The scheme extends the benefits of Ayushman Bharat to all the family members of the insured and helps the beneficiary and his dependents avail, quality health care facilities. The beneficiary can avail treatment by furnishing the Aadhaar card, Voter ID card or Ration card at the empanelled hospitals. The scheme offers cover to all the family members, irrespective of the size of the family, disabilities, age or gender.

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How to Apply for Ayushman Bharat scheme?

Steps to Apply for Ayushman Bharat Scheme:

Step 1: Check the Eligibility for this Scheme:

To enrol under the Ayushman Bharat scheme, you can follow the below mentioned steps:

  • You can check eligibility by enquiring with the staff at empanelled health care providers (EHCP). You can visit their registration desk and confirm eligibility through the ‘am I eligible’ application available with them. You can also find out the eligibility via mobile app or website of Ayushman Bharat Scheme.
  • You may also visit the PMJAY kiosk and check eligibility through the ‘am I eligible’ application.
  • You can also call the toll-free helpline number 14555 of Ayushman Bharat to check eligibility and also lodge complaints and grievances.

See Also: Ayushman Bharat Yojana - National Health Protection Scheme

Step 2: Patient Card Generation:

Once you are deemed eligible for the Ayushman Bharat Scheme, you (patient) will be directed to the Ayushman Bharat Kiosk where the Pradhan Mantri Arogya Mitra will verify requisite documents. He will confirm the beneficiary identity and eligibility, using the beneficiary identification system. Post identification, the new beneficiary receives his/her e-card (golden record) which confirms enrolment under the PMJAY database. 

Step 3: Expenses of the Treatment:

The appointed executive (Pradhan Mantri Arogya Mitra), shares details on expenses with the beneficiary. The beneficiary is also briefed on the charges they have to bear in case they are not hospitalized (These are charges for diagnosis but not any other medical treatment). The Pradhan Mantri Arogya Mitra informs the beneficiary on the charges and what is covered under the Ayushman Bharat scheme.

Step 4:

In this step, the doctor conducts a diagnosis of the patient and provides details on his/her disease and the medical treatment required.

See Also: Ayushman Bharat Scheme: All You Must Know

Step 5:

In case the beneficiary is suffering from a chronic disease or requires urgent medical attention, the doctor must prescribe the necessary medicines and get the patient hospitalized in case of severe ailments. The beneficiaries must keep in mind that he bears the consultation fees and the cost of medicines in case he is not hospitalized.

Step 6:

Listed below are some of the instructions for a beneficiary who has been hospitalized:

  • The beneficiary must undergo treatment only at empanelled hospitals.
  • The hospital or any staff or doctor will not charge fees from the beneficiary before diagnosis.
  • The doctor who is in charge of the beneficiary’s treatment must provide the relevant documents to the Pradhan Mantri Arogya Mitra like authorization form, diagnostic reports, lab test reports and so on.  
  • For government verification purposes, the Pradhan Mantri Arogya Mitra must click a picture of the beneficiary on the hospital bed and upload to the transaction management system.
  • After receiving proper treatment and medical care, the patient may be discharged.

See Aslo: All You Need to Know About Ayushman Bharat Yojana

Step 7:

After discharge, the hospital takes care of post-hospitalization expenses like medicines, as per the package for up to 15 days.


What are the Benefits Available Under PMJAY Scheme?

The PMJAY scheme offers health insurance cover to all the beneficiaries for secondary and tertiary hospitalization. The scheme also covers pre-existing medical conditions and post-hospitalization expenses for up to 15 days.

What are the Health Services Available Under the PMJAY Scheme?

The medical and health care services available under the PMJAY scheme are as follows:

  • Surgery and treatment
  • Day Care treatment
  • Medicine, transport and diagnosis
  • Hospitalization expenses
  • Pre and post-hospitalization care
  • Follow-up care and expenses benefits
  • Maternity services and natal care

Who is Eligible to Receive the Benefits of the PMJAY Scheme?

The scheme can be availed by all BPL citizens and covers more than 10 Crore poor and vulnerable households in India. The members insured under this scheme are poor rural families, farmers, certain specified occupational groups; members enrolled under the social-economic caste censure (SCSS) data and so on. The scheme enrols all family members of the insured, without any restrictions.

Will the Beneficiaries Have to Pay to Get Treatment Under This Scheme?

The beneficiaries registered under the PMJAY scheme can avail treatment free of cost under the public and private empanelled hospitals. The insured can avail cashless and paperless access to healthcare services on hospitalization.

What is the Enrolment Process? Is There Any Time Period for Enrolment?

The scheme was launched by the Government of India for the benefit of the economically deprived sections of society. There is no elaborate enrolment process or a specific enrolment date. Families who are listed under the BPL database, SECC database and certain occupational groups can avail the benefits of this scheme. However, the beneficiary must be enrolled under the voter and Aadhaar database.

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