Govt using AI to check for frauds under Ayushman Bharat health insurance; Features, benefits of Pradhan Mantri Jan Arogya Yojana
This program is a component of the government's ambition to guarantee that all of its residents, particularly the underprivileged and vulnerable populations, have access to high-quality hospital care without suffering any financial hardship as a result of accessing those services.
Key Features of PM-JAYIt provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India.
PM-JAY provides cashless access to health care services for the beneficiary at the point of service, that is, the hospital. It covers up to 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines. There is no restriction on the family size, age or gender. All pre–existing conditions are covered from day one. Beneficiary can visit any empaneled public or private hospital in India to avail cashless treatment. Services include approximately 1,929 procedures covering all the costs related to treatment, including but not limited to drugs, supplies, diagnostic services, physician's fees, room charges, surgeon charges, OT and ICU charges etc. Public hospitals are reimbursed for the healthcare services at par with the private hospitals. What benefits are available under PM-JAY?Each qualified household is provided cashless coverage of up to INR 5,00,000 year by PM-JAY for the aforementioned secondary and tertiary care problems. All pre-existing conditions are covered starting on the first day when PM-JAY is implemented in the relevant States/UTs. The following costs related to the treatment are all covered by the scheme's insurance.
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