Is Treatment with the Ayushman Bharat Card Cashless?
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Yes, any treatment under Ayushman Bharat (AB-PMJAY) is completely cashless and paperless for all eligible beneficiaries. However, you still need individual health insurance in addition to the Ayushman Bharat scheme.
The government scheme has a limited cover of up to ₹5 lakh per family per year. It also has fewer network hospitals and does not cover certain treatments.
Why are Individual Health Insurance Plans More Necessary than AB-PMJAY?
1. Higher Cover Limit
AB-PMJAY caps your family’s protection at ₹5 lakh per year. Treatments like cancer, heart surgery, or transplants can easily cross that amount. A private health insurance plan lets you choose ₹25 lakh, ₹50 lakh, or more, so one big illness can not drain your savings.
2. Wider Hospital Choice
Not every top private hospital accepts the Ayushman card. With individual insurance, you access a much larger network across India. You can pick the doctor and hospital you trust without worrying about empanelment.
3. Covers Everyday Health Needs
AB-PMJAY only pays for hospital stays at approved centres. It skips OPD visits, regular tests, pharmacy bills, and health check-ups. Many private health insurance policies include these, so you save on routine care too.
4. Better Speed and Features
Private health insurance usually processes cashless claims faster and approves modern treatments such as robotic surgery or advanced cancer drugs. Government package rates often don’t include these newer options.
What are the Core Features of Private Health Insurance Plans?
Wide-Ranging Coverage
The plan pays for hospital stays, tests and doctor visits before and after admission, daycare surgeries that don’t need 24-hour admission, and emergency air ambulance costs when needed.
Sum Insured Restoration
If you use up your full cover in a year, the insurer automatically refills the basic sum insured. You can use the restored amount for a different illness, and some plans even allow it for the same illness once.
Pre-existing Disease Cover
Insurers cover existing health issues after you finish a waiting period of 2 to 4 years. You can often shorten this wait by paying extra for a PED buy-back rider.
Maternity and Baby Cover
Select plans pay for pregnancy care, delivery costs for both normal and C-section births, and medical expenses for your newborn from day one. A waiting period usually applies.
Add-on Covers
You can boost your policy with extras like bariatric surgery, cancer care, critical illness benefits, or OPD cover.
Final Words
Are you confused between Ayushman Bharat and private insurance? Both aim to improve your access to healthcare, but they serve different needs. Ayushman Bharat acts as a solid safety net for basic treatments if you qualify.
For big hospital bills, more hospital choices, and added benefits, a private health plan works better. Use Ayushman Bharat as your base and add private insurance to cover costly emergencies and gaps.