Ayushman Card: Free treatment will be available this many times in a year, if you do not know these rules then you will have to pay from your pocket!
People are often misled by the Ayushman Card, believing it provides "unlimited" treatment throughout the year. The truth is, while you can visit the hospital any number of times, the limit for free treatment is only ₹5 lakh per year for the entire family. This benefit is only applicable for inpatient and serious illnesses, not for outpatient treatment.
Ayushman Card: The government has taken several major steps to make healthcare accessible to the common man in India, and the Ayushman Bharat Yojana is the most prominent of these.
It is considered one of the world's largest health insurance schemes. People often wonder if obtaining an Ayushman Card will provide free treatment throughout the year.
This question is important because incomplete information can often lead to patient difficulties at the hospital. If you are a beneficiary of this scheme, it is crucial to understand its rules and treatment limits thoroughly.
What is meant by the limit of Rs 5 lakh?
The primary objective of the Pradhan Mantri Jan Arogya Yojana (PM-JAY), launched by the government, is to provide a safety net for economically weaker sections. Regarding the frequency of treatment, the answer is a bit complicated and important to understand.
Technically, you can visit the hospital any number of times per year; there is no set limit. You can be admitted an unlimited number of times, but this benefit applies only up to an annual limit of ₹5 lakh.
This plan works on a 'family floater' basis. This means that the Rs 5 lakh cover is for the entire family, not per individual. For example, if you have a family of six, this Rs 5 lakh amount can be spent on the treatment of one ailing member or divided among all members if needed.
Once your card's wallet balance (the Rs 5 lakh limit) is exhausted, you will have to bear the remaining expenses yourself. Therefore, it is wise to keep the balance in mind while getting treatment.
The card will be useful only in serious illnesses
Many times, people go to the hospital with their Ayushman card for even minor ailments and are disappointed. It's important to clarify that this plan is primarily for serious conditions requiring hospitalization. Its benefits are not available for outpatient (OPD) consultations, X-rays, blood tests, or minor medications.
However, if the case is serious, such as heart valve replacement, prostate cancer, kidney transplant, coronary angioplasty, or neurosurgery, this card is a boon.
In such situations, the patient does not have to pay the hefty hospital bill out of pocket, and the entire procedure is cashless. This plan is designed to protect the patient from the burden of debt.
Get your card made like this sitting at home
Previously, availing benefits of government schemes required numerous visits to government offices, but now the government has made this process completely transparent and digital.
You no longer need to pay any middlemen or agents to get your card. You can do this yourself by downloading the government's 'Ayushman App' onto your smartphone.
Mobile number and Aadhaar are used to log in to the app. Here, you can check your family's eligibility by selecting your state and district.
If a member's name is listed but the card hasn't been generated, an 'Authenticate' option will appear next to their name. Here, e-KYC can be completed using Aadhaar OTP and photo verification. You can download the card from the same app within a week of verification.