India has been making remarkable progress in the healthcare sector over the last few years, which is a great achievement for the country. However, there are still many people who are unable to access or afford medical facilities due to financial constraints. In order to address this issue, the Indian government launched the Ayushman Bharat scheme in 2018, which aims to provide healthcare coverage to the economically weaker sections of the society.
Ayushman Bharat consists of two components – Pradhan Mantri Jan Arogya Yojana (PM-JAY) and Health and Wellness Centres (HWCs). PM-JAY provides financial protection to vulnerable families against catastrophic health expenditure and offers cashless and paperless access to services for the listed medical procedures at PM-JAY empanelled hospitals.
The Ayushman Bharat scheme has been a huge success and has benefitted millions of people across the country, giving them access to quality healthcare services. One of the key components of the Ayushman Bharat scheme is the Ayushman Card, which is issued to the eligible beneficiaries and can be used for availing free healthcare services at the empanelled hospitals. In this article, we will discuss who is eligible for the Ayushman card and who is not.
What is the Ayushman card?
The Ayushman Card is an essential part of the Ayushman Bharat Scheme, which aims to provide health coverage to financially weaker sections of the society. The card is issued to eligible beneficiaries and can be used to avail of free healthcare services at empanelled hospitals across the country. The card contains the beneficiary’s demographic details and other relevant information such as the beneficiary’s household information, ration card details, and mobile number. The card also has a unique QR code that can be scanned at the empanelled hospitals to get access to free healthcare services.
Who is eligible for the Ayushman card?
The Ayushman card is issued to eligible beneficiaries under the Ayushman Bharat Scheme. The eligibility criteria for the Ayushman Card are as follows:
1. Socio-Economic Caste Census (SECC) database:
The eligibility for the Ayushman Card is determined based on the SECC database. Only households identified under the SECC database are eligible for the Ayushman Card. The SECC database is the most comprehensive database of rural and urban households and includes information on the social, economic, and caste status of the households.
2. Deprivations parameters:
Apart from the SECC database, the Ayushman Card eligibility is also determined based on deprivation parameters under the SECC database. 7 deprivation parameters are considered for Ayushman Card eligibility:
– Households without shelter
– Destitute households
– Manual scavenger households
– Households without adult members between 16 to 59 years
– Female-headed households with no adult male member between 16 to 59 years
– Households with a disabled member and no able-bodied adult member
– SC/ST households
3. Family size:
The family size also plays a critical role in determining Ayushman Card eligibility. The families having up to 5 members are eligible for Ayushman Card. However, there are some states where the family size is extended to 7 members. The average family size is estimated by considering the age and gender composition of the family.
4. No age limit:
There is no age limit for Ayushman Card eligibility, and all members of the eligible households are covered under the scheme.
5. No income limit:
The Ayushman Bharat Scheme is not based on the income limit of the household. Therefore, even if the household has a relatively higher income, they would still be eligible under the SECC database and deprivation parameters.
Who is not eligible for the Ayushman card?
There are certain groups, unfortunately, who are not eligible for Ayushman card. They are as follows:
1. Families without the exclusive right over their house or land:
Families without the exclusive right over their house or land, i.e., those who live in rented accommodation or on government land, are not eligible under the Ayushman Bharat Scheme.
2. Government employees and their families:
Government employees and their families are not eligible under the Ayushman Bharat Scheme since they are covered under the existing health benefits provided by their employers.
3. Families with higher income:
Although the Ayushman Bharat Scheme is not based on income, the families with higher income that do not fall under the SECC database or deprivation parameters are not eligible for the scheme.
4. Those who have their own health insurance:
If the beneficiary already has health insurance, they are not eligible under the Ayushman Bharat Scheme. The Ayushman Bharat Scheme provides cover to the beneficiaries who do not have health insurance.
Benefits of the Ayushman Card
The Ayushman Card comes with several benefits for eligible beneficiaries, with its primary purpose being to provide access to quality healthcare services. Below are some of the benefits of the Ayushman Card:
1. Coverage of medical expenses:
The Ayushman Card entitles the beneficiaries to cashless treatment of up to Rs. 5 lakh per year for listed medical procedures at the empanelled hospitals. Beneficiaries can avail of free medical services at any of the empanelled hospitals across the country.
2. No additional expenses:
The beneficiaries do not have to pay anything extra at the empanelled hospitals. Apart from the Aushman card, the beneficiaries do not require any other documents or paperwork to avail medical services at empanelled hospitals.
3. Digital transactions:
The Ayushman Card facilitates digital payments at the empanelled hospitals, and beneficiaries can use the card to pay for services such as diagnostics, drugs, and other consumables that are not covered under the scheme.
4. Comprehensive coverage:
The Ayushman Card provides comprehensive coverage to the beneficiaries, including pre and post-hospitalisation expenses. The scheme covers almost all major illnesses and medical procedures.
The Ayushman Card is an integral part of the Ayushman Bharat Scheme, and eligible beneficiaries can avail of free medical services at empanelled hospitals without any additional costs. The card comes with several benefits that are especially important for economically weaker sections of society. Although not everyone is eligible for the card, the scheme has made significant progress towards providing accessible and affordable healthcare services across the country. Besides the Ayushman Card, family health insurance is another essential safety net that one must explore to provide comprehensive health coverage to their loved ones. Combining Ayushman Bharat with family health insurance can provide not only financial security but also peace of mind for families.
