Ayushman Bharat Card Explained: What It Covers, How To Use It, And What You Still Have To Pay For

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is also known as the Ayushman Bharat Card or Ayushman Card. It is one of the biggest government-funded health care schemes in the country. It provides eligible families with cashless treatment for serious medical problems at government and private empanelled hospitals across the country. The scheme provides health cover of up to ₹5 lakh per family every year for secondary and tertiary hospitalization, as per the National Health Authority (NHA).

The scheme was introduced to reduce the financial burden of expensive medical treatments for the economically weaker families. Over the years, it has widened its scope, and now it is benefiting crores of people across the country. In several states, senior citizens aged 70 years and above have also been brought under the scheme irrespective of income category.

Who Is Eligible For Ayushman Bharat?

How To Check Eligibility

People can check eligibility through:

• The official PM-JAY website
• Ayushman Bharat mobile app
• Common Service Centres (CSCs)
• Empanelled hospitals

Usually, an Aadhaar card and mobile OTP verification are required.

How To Make An Ayushman Card

How To Use The Ayushman Bharat Card

Using the card is relatively simple for beneficiaries. A patient needs to visit a government or private hospital empanelled under PM-JAY and present the Ayushman Card along with Aadhaar verification.

The hospital then checks eligibility digitally and selects the approved treatment package. Once authorisation is completed, treatment becomes cashless for the patient under the scheme guidelines. In most approved cases, beneficiaries are not required to pay admission deposits or advance hospitalisation charges.

What Is Covered Under Ayushman Bharat?

The Ayushman Bharat scheme provides hospitalisation coverage of up to ₹5 lakh a year per family. Thousands of treatment packages and medical procedures are included under the program.

Major illnesses and treatments covered include heart surgery, cancer treatment, kidney dialysis, orthopaedic surgeries, neurosurgery, trauma care, maternity services, ICU care, and newborn treatment. The scheme also covers medicines, diagnostics, hospital room charges, doctor consultations during hospitalisation, implants, and food during hospital stay.

Another major feature of PM-JAY is that pre-existing diseases are covered from day one without waiting periods, unlike many private health insurance plans.

What Does Ayushman Bharat Not Include?

While the scheme covers wide hospitalisation, it does not cover all types of medical expenses. OPD (Outpatient Department) consultation without hospitalisation is generally not covered.

Routine health check-ups, regular blood tests, MRI scans, CT scans, and medicines bought outside hospitalisation packages may not be covered either. Cosmetic procedures such as hair transplant, face-lift surgeries and beauty treatments are excluded from the PM-JAY benefits.

Routine dental treatments such as fillings, root canals, and dental implants are generally excluded unless associated with hospitalisation or accidental trauma. Fertility treatments, including IVF procedures, are also excluded under the scheme guidelines.

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