Compare & Buy Car, Bike and Health Insurance Online - InsuranceDekho
Claim, renew, manage & moreLogin
Hurry Up!
Save upto ₹75,000 on taxes in 80D. Buy a health insurance now!
View Plans

Ayushman Bharat Health Insurance Benefits

Updated On May 31, 2022

Ayushman Bharat Yojana is the world’s largest health insurance scheme that provides a health insurance cover of Rs 5 lacs to each Indian family who is eligible. The scheme caters to nearly 50 crore beneficiaries and provides them access to tertiary and secondary care hospitalization, which is 40% of the Indian poor and vulnerable families. Ayushman Bharat Yojana eligibility is divided among the households in both rural and urban areas, which are categorized based on the occupational and deprivation criteria of Socio-Economic Caste Census 2011.

It was launched with a vision to help mitigate exorbitant medical expenses that push close to 6 Crore Indians towards poverty annually. Before it was rechristened the scheme was termed as the National Health Protection Scheme. It subsumed the current Rashtriya Swasthya Bima Yojana that was launched in 2008. It also covers the families that were covered under RSBY but are not present in the SECC 2011 database. This scheme is funded by the Indian Government.

Ayushman Bharat Health Insurance Benefits

10 Benefits Cover Under PM-JAY

Most of the Government-funded medical insurance schemes offer a limit cover up to Rs 3 Lakh only. However, Ayushman Bharat Yojana or PM-JAY provides cover up to Rs 5 Lakh along with cashless medical treatment facility to the beneficiaries in both public and private hospitals in India.  Each family in India who fit the Ayushman Bharat Yojana eligibility criteria can avail this sum insured for defined secondary as well as tertiary care conditions. This scheme recompenses all the expenses incurred on the following medical treatments.

  • Medical examination, treatment and consultation
  • Pre-hospitalization expenses
  • Post-hospitalization follow-up care up to 15 days
  • Diagnostic procedures and lab investigation charges
  • Cost of Medicine and medical consumables expenses are covered
  • Non-intensive and intensive care services
  • Accommodation benefits
  • Medical implantation services (where necessary)
  • Food services
  • Treatment resulting in complications

List of Critical Diseases covered under Ayushman Bharat Health Scheme

Some of the Critical illnesses that the policy covers are as follows:

  • Double valve replacement
  • Prostate cancer
  • Coronary ABG
  • Carotid angioplasty with stent
  • Anterior spine fixation
  • Pulmonary valve replacement
  • Skull base surgery
  • Laryngopharyngectomy
  • Tissue expander for disfigurement in case of burns

Conclusion

While RSBY covered only five members, PM-JAY does not put any capping on the age, size and the number of insured members. The benefits offered under this scheme are up to Rs 5 lakh and can be availed on a family floater basis. The eligible households can be covered under a single plan and can avail cashless hospitalization cover up to the coverage amount. It implies that any person who is eligible to get coverage under Ayushman Bharat scheme and suffering from health issues before PMJAY can avail treatment benefits under this scheme right from the day of enrolment.

Also read-What Are The Advantages Of Family Floater Plans?

Everything You Need To Know About COVID

Disclaimer

This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

Health Insurance Coverage Calculator

Who do you want to insured ?

  • Individual
  • Couple
  • Family
  • Parents

Age of eldest insured member ?

Where do you live ?

Metro
Non-Metro
Disclaimer : Actual Coverage might vary basis your location, age and number of members

Best Health Insurance Plans In India

  • Cover 5 L
    Starting at 832/month*
    No room rent limit 100% no claim bonusUnlimited restoration benefits3 years PED waiting period
    View All Features
  • Cover 10 L
    Starting at 739/month*
    No room rent limit Unlimited restoration benefits50% no claim bonus4 Years PED Waiting period
    View All Features
  • Cover 5 L
    Starting at 447/month*
    No room rent limit 33% no claim bonus100% restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 1,312/month*
    No room rent limit 50% no claim bonus100% restoration benefits3 yrs PED waiting period
    View All Features
  • Cover 5 L
    Starting at 448/month*
    Single Private A/C Room 20% no claim bonus100% restoration benefits1 year PED waiting period
    View All Features
  • Cover 5 L
    Starting at 664/month*
    No room rent limit 20% no claim bonus100% restoration benefits2 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 675/month*
    No room rent limit 50% no claim bonusUnlimited restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 690/month*
    Single Private A/C Room 100% restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 546/month*
    Twin sharing room Zero no claim bonus100% restoration benefits2 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 566/month*
    No room rent limit 20% no claim bonus100% restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 1,770/month*
    Zero no claim bonusNo restoration benefits1 year PED waiting period
    View All Features
  • Cover 40 L
    Starting at 62/month*
  • Cover 2 L
    Starting at 146/month*
  • Cover 5 L
    Starting at 806/month*
    Single Private Room 10% no claim bonus100% restoration benefits2 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 476/month*
    60% no claim bonus150% restoration benefits4 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 526/month*
  • Cover 5 L
    Starting at 855/month*
    25% no claim bonus100% restoration benefits4 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 448/month*
    Single Private A/C Room 20% no claim bonus100% restoration benefits1 year PED waiting period
    View All Features
  • Cover 5 L
    Starting at 396/month*
    No room rent limit Room rent upto 2% of SI Room rent upto 1% of SI No room rent limit
    View All Features
  • Cover 5 L
    Starting at 738/month*
    No room rent limit 50% no claim bonus100% restoration benefits3 yrs PED waiting period
    View All Features
Note: Premium is shown for 18yr old individual of Delhi
Show More
Must BuyMust Buy

Why to Buy Health Insurance Policy Online from InsuranceDekho

  • Tax benefit upto 75,000*
  • Claim support everyday 10AM-7PM
  • 66 Lacs+ happy customers