Ayushman Card Limit: There is a big update for Ayushman Card holders. Under the central government’s ambitious Ayushman Bharat (PM-JAY) initiative, impoverished families across the nation are entitled to free and cashless medical treatment up to Rs 5 lakh each year. However, many beneficiaries have inquired whether the free treatment ceases once the Rs 5 lakh cap is reached within a financial year. It’s important to note that the Rs 5 lakh coverage under the Ayushman Bharat scheme is allocated to the entire family, not to individual members.
Does treatment stop when the limit is reached?
According to the Ayushman Bharat scheme, a health coverage limit of Rs 5 lakh is established for each family annually. If the total Rs 5 lakh is utilized for the treatment of one or more family members within a financial year, the free treatment via the Ayushman card will halt for the rest of that financial year. Nevertheless, this limit is not permanent; it resets automatically with the commencement of a new financial year.
Can you receive assistance even after the limit is exhausted?
If the Rs 5 lakh limit has been reached and the patient needs additional urgent treatment or surgery, some states allow for special permission to be sought from the district health department or State Health Agency (SHA) for critical conditions like cancer, transplants, or cardiac care. After a review at the Chief Medical Officer (CMO) level, further government support may be granted.
In cases where the Ayushman limit is depleted, patients can seek financial aid from the Rashtriya Arogya Nidhi or the Chief Minister’s Relief Fund of their respective state.
What are the most important things to keep in mind?
As long as the balance of Rs 5 lakh remains, beneficiaries can be hospitalized any number of times per year for treatment. Benefits are available only at government and private hospitals empanelled under the Ayushman Bharat scheme. Before starting treatment, ensure the remaining balance on your card is checked with the Ayushman Helpdesk at your hospital.