Ayushman Card Scheme Eligibility Criteria and Coverage Details

The Ayushman Bharat Yojana, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), is a comprehensive healthcare initiative designed to provide financial protection to vulnerable families in India. Central to this scheme is the Ayushman Card, which grants eligible individuals access to a wide range of medical services. This article delves into the eligibility criteria for obtaining an Ayushman Card and details the extensive coverage provided under the scheme.

Coverage Details of Ayushman Bharat Yojana

The Ayushman Bharat Yojana offers extensive coverage for various medical expenses, ensuring that beneficiaries receive necessary healthcare without the burden of financial constraints. The scheme covers the following medical expenses:

1. Medical Examination, Treatment, and Consultation Fees: Beneficiaries can access a wide range of medical consultations, treatments, and examinations without any additional charges.
2. Pre-Hospitalisation Expenses: The scheme covers medical expenses incurred up to three days before hospitalisation.
3. Post-Hospitalisation Expenses: Medical costs for up to 15 days following discharge from the hospital are covered under PMJAY.
4. Cost of Medicine and Medical Consumables: Beneficiaries are provided with the necessary medicines and medical consumables required during treatment.
5. Hospital Accommodation Charges: Both non-intensive and ICU services are covered, ensuring patients receive appropriate care based on their medical condition.
6. Laboratory and Diagnostic Procedures: The cost of laboratory tests and diagnostic procedures is included in the scheme.
7. Medical Implantation Services: Where required, the scheme covers the cost of medical implants.
8. Complications Arising During Medical Treatment: Any complications that arise during the course of medical treatment are also covered.
9. Food Services: The scheme includes provisions for food services during the hospital stay.

Who is Not Covered by Ayushman Bharat Yojana?

Despite its extensive coverage, the Ayushman Bharat Yojana excludes certain categories of individuals to ensure that benefits are directed towards the most vulnerable. The following people are not eligible for coverage under the scheme:

1. Vehicle Owners: Individuals owning vehicles such as two-wheelers, three-wheelers, or cars.
2. Government Employees: All government employees are excluded from the scheme.
3. High-Income Earners: People with a monthly income exceeding Rs. 10,000.
4. Owners of Farming Machinery and Equipment: Those who possess farming machinery and equipment.
5. Properly Built Houses: Individuals living in well-built houses.
6. Kisan Card Holders: Those holding a Kisan card.
7. Motorised Fishing Boat Owners: Individuals owning motorised fishing boats.
8. Large Landowners: Those owning agricultural land of more than 5 acres.
9. Non-Agricultural Government Enterprise Employees: People employed in government-run non-agricultural enterprises.
10. Household Appliances Owners: Individuals who have refrigerators and landline phones in their houses.

Ayushman Bharat Eligibility Criteria for Rural and Urban People

To avail the benefits of the Ayushman Bharat Yojana, it is essential to check for eligibility through the Socio Economic and Caste Census-2011 data. This verification confirms whether a family qualifies for the scheme. Below are the specific eligibility criteria for rural and urban households.

PMJAY Scheme: Eligibility Criteria for Rural Households

The eligibility for rural households is based on six deprivation criteria, targeting the most vulnerable sections of society:

1. Families Living in One Room with Kucha Walls and Roof (D1): Households living in makeshift accommodations with inadequate housing conditions.
2. Households with No Adult Member Aged 16-59 Years (D2): Families that do not have any adult members within the working age group.
3. Families with No Adult Male Members Aged 16-59 Years (D3): Households where there are no adult male members within the working age group.
4. Households Without an Able-Bodied Adult Member or with a Disabled Member (D4): Families that lack an able-bodied adult or have members with disabilities.
5. SC/ST Households (D5): Households belonging to Scheduled Castes (SC) or Scheduled Tribes (ST).
6. Landless Households Earning a Major Part of Their Income from Manual Labour (D6): Households that rely predominantly on manual casual labour for their livelihood.

PMJAY Scheme: Eligibility Criteria for Urban Households

The eligibility for urban households is determined by occupation categories, focusing on those engaged in informal and unorganised sectors:

1. Domestic Workers: Individuals employed in household work, such as maids and cooks.
2. Beggars: People who depend on begging for their livelihood.
3. Ragpickers: Individuals engaged in collecting and selling recyclable waste materials.
4. Home-Based Workers/Artisans/Tailors/Handicrafts Workers: Those involved in small-scale, home-based production activities.
5. Sanitation Workers/Sweepers/Mali: Individuals responsible for cleaning and maintenance, including gardeners.
6. Construction Workers/Labourers/Painters/Welders/Security Guards/Plumbers/Coolies/Masons and Other Head-Load Workers: People working in construction and related manual labour jobs.
7. Chowkidars/Washers: Security personnel and laundry workers.
8. Electricians/Mechanics/Assemblers/Repair Workers: Skilled workers engaged in technical and repair services.
9. Transport Workers/Rickshaw Pullers/Conductors/Cart Pullers/Drivers/Helpers to Drivers and Conductors: Individuals working in transportation and related services.
10. Waiters/Shop Workers/Assistants/Attendants/Helpers/Peons in Small Establishments/Delivery Assistants: People employed in small-scale commercial establishments.
11. Street Vendors/Hawkers/Cobblers/Other Service Providers on the Street: Individuals providing various services and selling goods on the streets.

Ayushman Card Download and Application Process

Check here Ayushman Card download process, eligible individuals must follow these steps:

1. Check Eligibility: Verify your eligibility through the Socio Economic and Caste Census-2011 data.
2. Visit the Official Website: Go to the official PMJAY website and log in using your mobile number and Aadhaar details.
3. Apply Online: Fill out the application form with the necessary details and submit the required documents.
4. Download Ayushman Card: Once approved, you can download the Ayushman Card from the website. This card will grant you access to the various benefits and coverage provided under the Ayushman Bharat Yojana.

Conclusion

The Ayushman Bharat Yojana, with its comprehensive coverage and targeted eligibility criteria, plays a crucial role in providing financial protection and healthcare services to vulnerable families across India. By understanding the eligibility requirements and coverage details, individuals can make informed decisions and benefit from the extensive healthcare services offered under this scheme. The Ayushman Card is a vital tool in ensuring that quality healthcare is accessible to those who need it the most, contributing to a healthier and more equitable society.