Despite Ayushman Card, not getting free treatment for diseases? ‘These’ facilities are outside the scheme; Know the rules beforehand

Ayushman Bharat Yojana: ‘Ayushman Yojana’ has emerged as a relief scheme for poor families. ‘Ayushman Bharat Pradhan Mantri Jan Arogya Yojana’ is considered as one of the largest health schemes in the country. The main objective of this scheme is to protect economically weaker families from the financial burden caused by expensive medical treatment. Under this initiative, eligible families are provided ‘cashless’ medical treatment up to Rs 5 lakh per annum. Especially when it comes to critical illness and hospitalization, this plan is of great help. The benefits of this scheme can be availed in government hospitals as well as private hospitals affiliated to the scheme. But though the scope of this scheme is very broad, certain limitations are fixed in it; Let us understand what these limitations include.

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of OPD and routine diagnostic tests

Many people think that once they get an ‘Ayushman Card’, every visit to the doctor is completely free; However, the reality is not like that. The scheme prioritizes only those treatments that require hospital admission. If a person only goes for a doctor’s consultation and is not admitted to a hospital thereafter, the OPD expenses related to that visit are not covered under the scheme. Similarly, the plan does not cover only the cost of getting diagnostic tests done; Of course, the situation may be different if the doctor has specified that certain tests should be done during the treatment of a hospitalized patient. Because of this, patients often find that upon reaching the hospital, they have to pay certain expenses out of their own pocket.

Not for vitamins, tonics and regular medicines

The main objective of ‘Ayushman Yojana’ is to provide financial assistance for critical illnesses and essential medical treatment. Consequently, the cost of vitamins, tonics and supplements which are primarily used to treat general weakness, fatigue or improve overall health are not covered under this scheme. But if the doctor finds it necessary to administer these drugs during the treatment of a serious illness or injury, the situation may be different. According to experts, the scheme is primarily designed to cover the cost of life-saving treatment and specialized medical treatment provided in hospitals; Hence, regular medicines of daily use are not covered under the scheme.

Facilities like routine dental treatment and IVF

Under this plan, expenses on regular dental cleanings, fillings or general dental check-ups are not covered. Dental treatment costs are covered only in cases of serious accidents, jaw injuries or serious illnesses such as tumors or cysts. Additionally, treatments related to IVF and other assisted reproductive technologies are not covered under this scheme. Procedures like cosmetic surgery, tattoo removal, weight loss surgery and neck lift are also not included in the list of free treatments. The government is of the view that the main focus of the scheme should be on essential and critical healthcare; Consequently, cosmetic or elective procedures are not included.

Who can get Ayushman card?

This scheme is specially designed for the economically weaker sections of the society. As a result, not everyone qualifies for this scheme. Government employees, citizens paying income tax, employees availing of ESIC and people working in organized sector whose provident fund amount is deducted are generally not covered under this scheme. According to experts, before starting medical treatment, it is very important to understand in detail which expenses are covered under this scheme and which are not. By doing so, it helps to avoid future financial stress and confusion. As the coverage of health plans expands, ‘accurate information’ is considered to be the greatest security.

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