Frequently Asked Questions About Ayushman Bharat Health Account (ABHA)

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July 21, 2023

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Ayushman Bharat Health Account (ABHA) is a health savings account that provides health insurance coverage for all citizens of India. It was launched in 2021 by the Government of India to provide healthcare access to those unable to afford private insurance. It covers a wide range of treatments, including medical and surgical services. First, you should be aware of all the features associated with ABHA, which is why we have compiled a list of frequently asked questions.

FAQs

  • What is ABHA?

Your Ayushman Bharat Health Account (ABHA) Address makes your digital health record unique (self-declared username). The Indian government's Ministry of Health and Family Welfare started the Ayushman Bharat Digital Mission to help people who don't have much money get health care. Check if you are eligible for an ABHA health card, what it can do, and how to get one.

  • How Does the ABHA card work?

ABHA is a 14-digit health ID that may be created using your Aadhaar card or phone number. It enables consumers to exchange digital copies of their health records with hospitals, clinics, insurance companies, and other organisations. Citizens may create their own ABHAs for free. Once created, it can access various healthcare services such as medical treatments, health insurance, and other related services.

  • How is the ABHA card useful?

ABHA health card enables users to exchange digital copies of their health records with hospitals, clinics, insurance companies, and other organisations. Citizens are not required to pay anything to create their own ABHA.

The card also helps keep track of the medical history and records of citizens, which can be accessed anytime by healthcare providers. This is particularly useful for those who travel frequently or suffer from chronic illnesses and need to access their medical records quickly.

The major benefit of ABHA Card is that they assists families by providing access to health care services and assistance with daycare processes, especially for persons with health issues. The plan covers about 1,350 medical plans at networked public and commercial hospitals in India. ABHA also provides health insurance to BPL families up to 5 lakhs per family. It is also very helpful in monitoring citizens' medical history and records, which healthcare providers can access anytime.

  • What are the benefits of the ABHA Health Card?

Use your ABHA number to register for an ABHA address to safeguard the privacy of your sensitive medical information. Establish a connection between your ABHA number and an ABDM ABHA address. The easiest way to communicate health facts to others is via this manner. This makes it easy for healthcare providers to access your health information quickly.

The ABHA card also gives citizens discounts on medicines and treatments and access to government health schemes. It helps citizens save money on medical treatments and allows them to get quick access to healthcare services.

  • Are ABHA and Ayushman cards the same?

No, they are not the same. The Ayushman card is a prepaid cashless card issued to beneficiaries of the Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme. The ABHA card is a digital health identity issued to all citizens of India that enables them to exchange digital copies of their health records with hospitals, clinics, and other organisations. Both cards provide access to healthcare services but have different features and benefits. The ABHA card is free to all citizens, but the Ayushman Card requires registration under PMJAY to avail of benefits.

The Ayushman card will also provide access to cashless health insurance of up to Rs 5 Lakh per family. However, the ABHA card doesn't offer any insurance facility. The ABHA card helps keep track of citizens' medical history and records, while the Ayushman card can be used to avail of cashless hospitalisation services. Both cards are essential for getting access to healthcare services in India.

  • What is PHR in the ABHA card?

PHR Addresses, or Personal Health Records Addresses, are self-declared usernames necessary to sign in to Health Information Exchange and Consent Managers (HIE-CM). Each ABHA number on the card must be linked to a consent manager to facilitate data exchange. Without a PHR address, the ABHA cannot be used for any purpose. The PHR Address is an essential feature of the ABHA Card as it helps to protect the privacy of users' health information. The PHR address also helps healthcare providers access citizens' medical records and other health data quickly. The PHR address is necessary for the secure exchange of medical records and helps to ensure that information remains confidential.  

The ABHA Card, with its PHR address, allows citizens to access their medical records and control who has access to it. It also ensures that the data is securely stored and provides an easy way for citizens to share access with healthcare providers. This helps in providing timely care and treatment for people with health conditions.

  • Is ABHA compulsory?

No, acquiring an ABHA Number is not a prerequisite for becoming a citizen in this country. So, one has no civil obligation to possess Health Card ABHA. One may get an ABHA Number if they want to take part in the Ayushman Bharat Digital Mission and if they want their records to be accessible online. Furthermore, they can also use the ABHA Number to get discounts on treatments and access government health schemes. One may obtain an ABHA number of their own free will.

  • Why is the ABHA Card necessary?

Getting an ABHA card may dramatically increase the number of medical facilities you can access. It will assist you in locating health centres and medical specialists and make it simple to exchange your medical data with physicians anywhere in India. It will also help you access government health schemes and immunisation programs, such as the PMJAY insurance. With an ABHA card, healthcare providers will have easier access to your medical records, which can improve the quality of care you receive.

Finally, an ABHA card will allow you to keep track of medical expenses and important immunisation dates. You will have access to better healthcare services by having an ABHA card. In short, the ABHA card is a necessary identity to ensure access to healthcare services and related government schemes.

  • What is the difference between PMJAY and ABHA?

The government has begun many different projects to address this issue. These programmes aim to provide low-income individuals access to high-quality medical treatment. One programme that falls under this category is the Pradhan Mantri Jan Arogya Yojana (PMJAY). It tries to enhance the lives of persons from economically disadvantaged sectors and give security to them at the same time.

On the other hand, the Ayushman Bharat digital mission initiative Abha project aims to persuade individuals to build electronic medical records for themselves. It also provides a secure platform that organises an individual's medical information and enables them to share it with healthcare providers. The two programmes are very different but have the same goal – providing access to high-quality healthcare services. Therefore, both PMJAY and ABHA are important initiatives that can significantly impact the lives of India's population.

Ayushman Bharat is an overall health plan with two parts: Pradhan Mantri Jan Arogya Yojana (PM-JAY) and Health and Wellness Centres (HWCs). It makes people eligible for health insurance and primary health care.

The Pradhan Mantri Jan Arogya Yojana (PM-JAY) offers health insurance coverage to economically disadvantaged families and individuals. In addition, this scheme provides cashless benefits for hospitalisation in both public and private hospitals.

Health and Wellness Centres (HWCs) are primary care facilities in rural and urban areas. These centres provide essential health services, including diagnosis, treatment and preventive care for common health issues such as malaria, diarrhoea, tuberculosis and respiratory diseases. In addition, the HWCs also provide maternal health services, newborn care and health education. HWCs aim to provide comprehensive primary care closer to people's homes.

  • What is the income limit for an Ayushman Card?

The PMSBY programme runs for a full calendar year, commencing on June 1 and ending on May 31 each year. For participants to be eligible to continue receiving the programme's benefits beyond May 31 of each year, the programme must be renewed. The income limit for the Ayushman Bharat card is an average per capita income of Rs. 10,000 per month or less. Applicants must also have a valid Aadhar card to be eligible for the scheme.

Those with an income of Rs 10,000 per month or less are eligible for the scheme, regardless of gender, religion, caste, or economic background. The scheme provides health insurance coverage of Rs 5 lakh per family year for secondary and tertiary care hospitalisation. This scheme is designed to provide financial protection against catastrophic health expenses.

  • What is the validity period of the Ayushman Card?

The PMSBY programme lasts over a calendar year, beginning on June 1 and winding down on May 31 of every year. Therefore, the programme must be renewed for members to be eligible to continue enjoying the programme's advantages beyond May 31 of each year. The validity period of the Ayushman Bharat card is one year. This means the card needs to be renewed after one year for the individual to continue enjoying the scheme's benefits. The renewal process is simple and does not require additional documentation or verification from the concerned person.

ABHA is a 14-digit health ID that may be created using your Aadhaar card or phone number. It enables consumers to exchange digital copies of their health records with hospitals, clinics, insurance companies, and other organisations. Citizens are not required to pay anything to create their own ABHA. The 14-digit ABHA number comprises two parts - the first 8 digits are a unique health ID, while the last six digits represent the mobile or Aadhaar number of the individual. This unique health ID is used to store, share and access a person's medical records securely on the ABHA platform.

  • Is health ID and ABHA the same?

The Ayushman Bharat Card offers insurance of up to 5 million Indian Rupees to low-income segments. The primary, intermediate, and tertiary care levels are all covered by this card.

The ABHA facilitates easy access to healthcare documentation. With the help of ABHA, patients may assemble the pieces of their healthcare puzzle. However, health ID can only access doctors electronically if patients consent. ABHA, on the other hand, is a 14-digit health ID associated with an individual's Aadhaar card or mobile number.

  • Who is eligible for the ABHA card?

One of the requirements for participating in this abha health card registration is that the yearly income of the individual's family must be less than 2.5 lakhs. Within the confines of this yojana, there will be no category bars. Consequently, this yojana is open to applications from people in any category, including General, SC, ST, and OBC. Additionally, those who are already availing benefits under the Rashtriya Swasthya Bima Yojana (RSBY), Pradhan Mantri Jan Arogya Yojana (PMJAY), or the Central Government Health Scheme (CGHS) can also apply for this scheme. Lastly, the applicant must have a valid Aadhaar card to be eligible for this scheme.

  • Is the Ayushman Card and golden card the same?

Ayushman card and golden card are different. The Ayushman Bharat card is a health insurance scheme offered by the Government of India to provide financial protection against catastrophic medical expenses. It provides health insurance coverage of Rs 5 lakh per family year for secondary and tertiary care hospitalisation.

The golden card is the physical copy of an individual's Ayushman Bharat beneficiary identity card. It is issued by the National Health Authority (NHA) and allows individuals to access their health insurance benefits. The Ayushman Bharat card provides access to health insurance, while the Golden Card is a physical representation. The two are distinct from each other.

  • Can an Ayushman Card be made on an Aadhar card?

Yes, an Ayushman Bharat card can be made with an Aadhaar card. To avail of the scheme, one must register on the AB-PMJAY portal or visit any empanelled hospital.

In the Ayushman Bharat Yojana programme, services such as drug rehabilitation, fertility therapy, and organ transplant are not covered. Moreover, medical expenses related to pre-existing illnesses or conditions are not covered. Additionally, the scheme does not cover cosmetic surgeries or other non-essential treatments.

Furthermore, any medical expense related to childbirth carried out at home is not covered under the scheme. Lastly, procedures such as bone marrow transplants, knee replacement, and coronary artery bypass grafts are partially covered. However, these procedures have a predetermined cap on the reimbursed amount.

  • How to claim ABHA's Health insurance?

If your Aadhaar number is linked to your mobile phone number, you can utilise that number to register for an ABHA ID card. This is necessary to authenticate using OTP. You may ask for help from a facility participating in the Ayushman Bharat Digital Mission if your cell number is separate from your Aadhaar record. Once you have registered, the things to keep in mind while claiming your insurance are:

  1. Keep your health card with you at all times.
  2. Make sure all medical bills are presented to the hospital at discharge.
  3. Contact your local ABHA enrollment centre if you experience any issues.
  4. Submit the duly filled-in Claim Form along with all medical bills and other necessary documents to your insurance provider for reimbursement.
  5. Your insurance provider will investigate the claim and inform you of their decision.
  6. Once approved, your reimbursement will be processed according to the terms and conditions of your policy.
  7. Keep track of all medical bills and other documents related to your claim for future reference. This will help you file a complaint in case of any dissatisfaction.
  • What is the use of the ABHA number?

The ABHA number is a unique identification number assigned to beneficiaries of the Ayushman Bharat Yojana scheme. It is used for identification and authentication purposes, as well as for tracking claims and availing the benefits provided under the plan. With the ABHA number, members can access their health insurance benefits and services at any of the empanelled hospitals. In addition, it helps streamline the process of insurance claims and reimbursement.

  • Is Ayushman a card for a lifetime?

ABHA Card is a plan for a single payment, although it does give a lump amount upon completion. On the other hand, a comprehensive health insurance plan provides coverage for hospitalisations, including those necessary for treating severe diseases, throughout the policyholder's whole lifetime. Though the Ayushman Bharat scheme provides a lump sum benefit, it is not considered a lifetime health insurance plan. It offers only one-time coverage for medical expenses. Therefore, it is not considered to be a viable option for long-term health insurance.