Essential components of comprehensive health coverage
Comprehensive health insurance packages medical security to protect families from catastrophic health expenditures and out-of-pocket medical debt.
Unlike basic accidental or surgical covers, a comprehensive policy encompasses the entire healthcare continuum from pre-hospitalization diagnosis to post-treatment recovery.
- Inpatient hospitalization: Covers room charges, nursing fees, intensive care unit (ICU) charges, and surgeon fees.
- Pre- and post-hospitalization: Reimburses diagnostic tests, medical investigations, and medicines before admission and after discharge.
- Daycare procedures: Covers advanced medical treatments (like cataract surgery and chemotherapy) requiring less than 24 hours hospitalization.
- Pre-existing conditions: Covers chronic ailments following completion of mandatory statutory waiting periods.
Ayushman Bharat PM-JAY national health protection mission
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the world's largest government-funded health assurance scheme, administered by the National Health Authority.
It provides substantial annual cashless health assurance per eligible family per year for secondary and tertiary care hospitalization across empanelled public and private hospitals nationwide.
- Universal portability: Beneficiaries can access cashless treatment at any empanelled hospital across any state in India.
- Zero out-of-pocket payment: Covers all expenses including diagnostics, medicines, surgery, implants, and post-discharge recovery.
- No family size restriction: Covers all family members without caps on family size, gender, or age.
- Senior citizen expansion: Extended health assurance cover specifically catering to all senior citizens aged 70 years and above.
Eligibility verification and Ayushman Card generation
Eligible families are mapped based on deprivation and occupational criteria from the Socio-Economic Caste Census (SECC) and state ration card databases.
Citizens can verify their family eligibility online and generate an official Ayushman Card (Golden Card) for instant cashless hospital admissions.
- Online verification: Check eligibility on the official beneficiary portal beneficiary.nha.gov.in or mera.pmjay.gov.in using Aadhaar or ration card.
- Ayushman Card issuance: Generated online or at Common Service Centers (CSC) and empanelled hospital Ayushman kiosks.
- Hospital helpdesk: Dedicated Ayushman Mitras assist patients with verification, admission, and cashless claim processing at the hospital.
Official source
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Common questions
What is comprehensive health insurance?
It is an extensive health policy covering inpatient hospitalization, pre and post-hospitalization costs, daycare surgeries, and chronic ailments.
What coverage does Ayushman Bharat PM-JAY provide to eligible families?
PM-JAY provides substantial cashless health assurance per family per year for secondary and tertiary healthcare at empanelled hospitals.
How can rural citizens verify their eligibility for government health insurance?
Citizens can check eligibility online at beneficiary.nha.gov.in or visit their nearest Common Service Center (CSC) with their Aadhaar or ration card.
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