In a bid to revolutionize healthcare accessibility in India, the government introduced the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Ayushman card is an aspect of PMJAY, using which the beneficiaries can claim cashless treatment at network hospitals. This ambitious initiative aims to provide health insurance coverage to economically vulnerable families, ensuring they can avail themselves of quality medical services without financial strain.
However, eligibility for the Ayushman Card is subject to specific criteria. In this comprehensive guide, we will explore who qualifies for this scheme and who doesn’t, shedding light on the nuances of Ayushman Card download process and eligibility.
What is the Ayushman Card?
The Ayushman Card, part of the Ayushman Bharat scheme, is a government initiative aimed at providing health insurance coverage to economically vulnerable families across India. Through this scheme, beneficiaries can avail themselves of medical treatment at empaneled hospitals for a wide range of health conditions, without worrying about the financial burden.
The Ayushman Card is a unique identification card issued to beneficiaries under this scheme. It contains essential details such as the beneficiary’s name, age, gender, family details, and a unique identification number. This card facilitates easy identification and verification of beneficiaries when availing treatment at empaneled hospitals. It helps ensure smooth access to healthcare services covered under the Ayushman Bharat scheme.
Eligibility criteria for Ayushman Bharat Yojana
Eligibility criteria for rural families under the Ayushman Bharat Yojana are determined based on six deprivation criteria. These criteria include:
- Families without an earning adult member aged between 16 and 59 years.
- Households headed by female members with no adult male members aged between 16 and 59 years.
- Households residing in single-room dwellings with makeshift walls and roofs.
- Families belonging to Scheduled Castes and Scheduled Tribes.
- Households with disabled members lacking support from able-bodied individuals.
- Landless households relying on manual labor as their primary source of income.
Additionally, certain households are automatically considered eligible, such as:
- Destitute families dependent on alms.
- Families of manual scavengers.
- Households lacking proper shelter.
- Families of bonded laborers.
- Primitive and particularly vulnerable tribal groups.
PMJAY eligibility criteria for urban families
For urban families to qualify for the scheme, they must belong to specific occupational categories, including:
- Street vendors, cobblers, and hawkers.
- Domestic workers.
- Rag pickers and beggars.
- Construction site workers, plumbers, masons, painters, welders, and security guards.
- Coolies.
- Sweepers, sanitation workers, and gardeners.
- Transport workers like conductors, drivers, cart pullers, and others.
- Artisans, home-based workers, handicraft workers, and tailors.
- Washermen and watchmen.
- Electricians, mechanics, repair workers, and assemblers.
- Peons, helpers, shop workers, delivery assistants, attendants, and waiters.
Who does not qualify for the Ayushman card?
While the Ayushman Bharat scheme aims to reach the most economically vulnerable sections of society, certain exclusions exist within the eligibility framework:
- Income threshold exceedance: Individuals or households exceeding the prescribed income threshold may not qualify for the Ayushman Card. This criterion ensures that resources are directed towards those most in need of financial assistance for healthcare expenses.
- Employer-provided health insurance: If you are covered under an employer-sponsored health insurance scheme that offers comprehensive coverage, you may not be eligible for the Ayushman Card. Employees with access to such schemes are expected to utilise their existing healthcare benefits.
- High-income professionals: Individuals engaged in high-income professions, such as doctors, lawyers, and corporate executives, may not qualify for the Ayushman Card. Given their relatively affluent socioeconomic status, they are expected to manage their healthcare expenses through private insurance or out-of-pocket payments.
- Non-Resident Indians (NRIs) and Overseas Citizens: The Ayushman Card is designed for Indian residents, excluding non-resident Indians (NRIs) and overseas citizens. Since NRIs and overseas citizens may have access to healthcare facilities in their respective countries of residence, they are not eligible for enrollment in this scheme.
If you and your family members are enrolled in the Pradhan Mantri Ayushman Bharat Yojana, you will receive an enrollment letter containing a unique QR code and identification number. This letter serves as a vital tool in identifying your family members in the event of a hospitalization claim.
All hospitals that are part of the Pradhan Mantri Ayushman Bharat Yojana are equipped with an ‘Ayushman Mitra’ whose role is to assist insured families in accessing cashless medical treatment. The Ayushman Mitra verifies your eligibility by scanning the QR code provided in the enrollment letter against the data stored in the scheme’s database. If you meet the eligibility criteria, you are entitled to cashless medical treatment under the scheme.
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