Ayushman Bharat is a revolutionary healthcare scheme developed and launched by the Government of India in 2018 to provide financial protection against high healthcare costs to vulnerable sectors of society.
The scheme, which covers more than ten crore families across the country, aims to provide healthcare benefits to the beneficiaries. This article will discuss the list of diseases covered under the Ayushman Bharat scheme and other crucial information. So, let’s dive deep into the article to know more about it.
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What is Ayushman Bharat Scheme?
The Ayushman Bharat scheme is a significant step towards achieving universal healthcare coverage in India and improving the population’s health outcomes. Ayushman Bharat scheme, also known as Pradhan Mantri Jan Arogya Yojana (PM-JAY), is a health insurance scheme established by the Government of India in September 2018. The scheme intends to safeguard needy households from excessive healthcare expenditures by offering annual health insurance coverage of up to INR 5 lakh per family.
The scheme covers the cost of hospitalisation, treatment, surgery and other related expenses. The Ayushman Bharat scheme also includes a Health and Wellness Centre (HWC) component, which aims to offer comprehensive primary healthcare services to the people, especially those living in rural areas.
Medical Facilities under Ayushman Bharat Yojana
Ayushman Bharat Scheme cover all the secondary and tertiary hospitalisation expenses and aim to provide cashless and paperless access to the beneficiaries. Under the Ayushman Bharat scheme, beneficiaries can avail of various medical facilities such as hospitalisation, daycare procedures, and surgeries. The plan also covers pre-existing conditions and critical illness. Beneficiaries can use these medical services at any empanelled hospitalisation across the country. The scheme also provides coverage for medicines, diagnostics, and transport.
The plan comprises 1393 defined packages, one tentative surgical package, and 24 fields of specialisations. Ayushman Bharat will now include Non-Communicable Diseases (NCDs), Mental Health, ENT, Ophthalmology, Oral Health, Geriatric & Palliative Health Care, and Trauma Care in addition to the existing services for Reproductive and Child Health (RCH), and infectious diseases. The Ayushman Bharat Health and Wellness Centres (AB-HWCs) will also provide free diagnostic and drug services to expand the range of medical tests and treatments available.
Disease Covered under Ayushman Bharat List
The Ayushman Bharat scheme covers various diseases and medical conditions. The scheme provides coverage for various surgical and medical procedures. Individuals and families that qualify for the Ayushman Bharat Yojana can choose from approximately 25 specialities. Including the disease list covered under the Ayushman Bharat Scheme, package information, and cost:
Inclusion of PM-JAY Critical Illness Coverage
PM-JAY or Pradhan Mantri Jan Arogya Yojana is a flagship scheme of the Government of India. One of the essential aspects of PM-JAY is the critical illness coverage it offers to its beneficiaries. This coverage includes a wide range of critical illnesses that are expensive to treat and can cause significant financial burdens on families. Ayushman Card is a must-have to avail the benefit of the Ayushman Bharat Yojana.
The critical illness coverage under PM-JAY includes medical conditions such as:
- Cancer
- Kidney diseases
- Heart diseases
- Liver diseases
- Respiratory diseases
- Neurological disorders
- Mental illnesses
- Burn injuries
- Neonatal diseases
- Congenital disorders
- Communicable diseases (such as tuberculosis and malaria)
- Daycare procedures and surgeries
These diseases are often associated with high treatment cost and can cause significant financial strains on low-income households. With PM-JAY critical illness coverage, eligible beneficiaries can receive cashless treatment for certain illnesses at any of the empanelled hospitals or healthcare facilities. The scheme has also been extended to cover daycare procedures and surgeries, making it more comprehensive in terms of its coverage.
In addition to the above illness, PMJAY also includes:
- Pre-hospitalisation
- Consultation, Medical examination, and treatment
- Medicine and medical supplies
- Non-intensive and intensive care services
- Diagnostic and laboratory testing
- Medical implant services (if necessary)
- Accommodation
- Food services
- Complications that occur during treatment
It’s important to note that this list is not exhaustive, and there may be additional conditions and diseases covered under PM-JAY, depending on the specific guidelines and policies of the scheme. Additionally, the availability of specific treatments and procedures may vary depending on the empanelled hospital or healthcare facility and the specific details of the individual case.
Diseases Excluded under Ayushman Bharat List
While the Ayushman Bharat scheme covers a wide range of ailments and medical procedures, certain diseases and medical conditions are excluded from the Ayushman Bharat Scheme. Some of these diseases and medical conditions are:
- Outpatient department (OPD) consultations and procedures
- Fertility-related treatments such as in-vitro fertilisation (IVF)
- Cosmetic surgeries and procedures
- Dental treatments and procedures
- HIV/AIDS treatment
- Drug and alcohol rehabilitation
The Ayushman Bharat scheme is a significant step towards providing universal healthcare coverage to the vulnerable sectors of the society. The policy protects against high healthcare expenditures and covers various diseases and medical conditions. While certain diseases and medical conditions are excluded from the scheme’s coverage, the beneficiaries can avail of coverage for most surgical and medical procedures. The Ayushman Bharat scheme has the potential to transform the healthcare sector in India and provide access to quality healthcare to the beneficiaries.