Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a boon for economically weaker families. Under this scheme, eligible families get health insurance of up to Rs 5 lakh per year, which covers the cost of treatment of critical illnesses. But all diseases and expenses are not covered in this plan. Therefore, it is important to understand which services are covered and which you will have to pay for yourself.
Are OPD and general checkup free?
The benefit of Ayushman card is available only on hospitalization. If the illness is normal and limited to OPD consultation or doctor’s advice only, the expenses will have to be borne by you. You will also have to pay for any test or general checkup done without admission yourself. At the same time, if you are admitted to the hospital and get tested as per the doctor’s instructions, the expenses will be covered under the scheme.
Vitamins, tonics and dental treatments
You will have to bear the cost of purchasing simple vitamins or tonics yourself. Vitamin expenses related to illness or injury will be covered under the plan only on the recommendation of a doctor. General dental treatment is not free, but in serious situations like accident, injury, tumor or jaw surgery the treatment is covered under the plan.
IVF, cosmetic and alternative treatments
IVF or other assisted reproductive technologies for infertile couples are not covered. Similarly, aesthetic surgeries, tattoo removal, obesity reduction surgeries, life support and circumcision of children below 2 years of age are not included in the scheme.
Who cannot take advantage?
People working in organized sector, tax payers, ESIC beneficiaries, PF deductees or government employees cannot avail the benefits of Ayushman Yojana. These people will have to bear the treatment expenses from their own pockets.
