- Ayushman Bharat Yojana provides up to ₹5 lakh per family annually for cashless treatment but excludes several diseases.
- Outpatient treatments, dental procedures, cosmetic surgery, and infertility treatments are not covered under this scheme.
- Certain groups like organized sector employees, ESIC beneficiaries, and government employees cannot avail benefits.
Ayushman Bharat Yojana (also known as Pradhan Mantri Jan Arogya Yojana) is a flagship health insurance scheme launched by the Government of India. It aims to offer cashless medical treatment up to ₹5 lakh per family per year to economically vulnerable families across India.
However, it is important to understand that Ayushman Bharat Yojana does not cover every type of disease or medical service. Recently, the government excluded around 196 diseases from its coverage, making it essential for beneficiaries to know which ailments are covered and which are not.
Diseases and Treatments Excluded from Ayushman Bharat Yojana Coverage
Outpatient Treatment (OPD)
If a patient visits a doctor only for consultation or general check-up without hospital admission, no benefits from the scheme are available.
Hospital Admission Solely for Tests
Admission to hospital only for diagnostic tests or purchasing supplements like vitamins is not covered.
Dental Treatments
Dental procedures primarily for cosmetic purposes such as braces, root canals, implants, or cavity treatments are excluded. However, dental care required due to accidents or tumors is covered.
Infertility Treatments
Procedures like In-Vitro Fertilization (IVF) are not part of the scheme.
Cosmetic Surgery
Surgeries related to beauty enhancement, anti-aging treatments, tattoo removal, or weight reduction are not covered under this scheme.
Diseases and Treatments Covered by Ayushman Bharat Yojana
The scheme covers many serious and life-threatening ailments, including:
- Heart diseases (Cardiology)
- Neurosurgery and neonatal care
- Cancer treatment (Oncology)
- Orthopedic and plastic surgery
- Emergency medical care
- Cesarean and other maternity services
- Mental health disorders and psychiatric care
- Pediatric surgeries
- Eye, ENT surgeries
- Organ transplants
- Communicable diseases
Who Is Not Eligible for Ayushman Bharat Yojana?
Certain categories of people are not eligible for benefits under this scheme, such as:
- Employees working in organized sectors
- Beneficiaries of ESIC (Employee State Insurance Corporation)
- Government employees
How to Register for Ayushman Bharat Yojana?
Registration for Ayushman Bharat Yojana can be done easily online by following these steps:
- Visit the official website www.pmjay.gov.in
- Enter your mobile number to begin the registration process
- Keep essential documents handy like Aadhaar card, ration card, and RSBY URN number
Ayushman Bharat Yojana is a blessing for India’s economically weaker sections. However, beneficiaries should carefully understand its coverage limits and terms before availing treatment to maximize benefits effectively.