Key Highlights
- Annual cashless coverage of ₹25 lakh for every beneficiary family.
- Accident protection up to ₹10 lakh, including death and permanent disability benefits.
- Over 1,700 medical and surgical packages, covering a wide spectrum of ailments.
- Eligibility free of cost for NFSA, SECC‑2011, small‑scale farmers, state_authenticated workers, and COVID‑19 aid recipients.
- Noകേരള age restriction; every Jan Aadhaar linked member—including newborns—is insured.
Detailed Insights
Cashless hospitalization allows families to receive care at authorised government or private hospitals without any upfront payment, limiting bureaucracy and delays.
Extensive package list includes general and advanced surgeries, orthopaedic procedures, paediatric care, oncology, cardiothoracic interventions, organ transplants, ICU boarding, diagnostics and physician fees.
Accident coverage provides a ₹5 lakh payout on accidental death, up to ₹10 lakh for multiple fatalities Secure single incident, and ₹3 lakh for permanent total disability.
Pre‑and post‑hospitalisation benefits reimburse all drugs, investigations and follow‑up consultations for five days before and fifteen days after admission, thereby easing financial strain.
Families pay a nominal annual premium of ₹850 when they do not qualify for the fully subsidised route; otherwise, registration remains free.
Key Concepts
- Cashless treatment – medical care covered wholly by the insurer, requiring no out‑of‑pocket payment at the time of service.
- Accident insurance – a separate component offering заказать in the event of death, damage, or multiple fatalities caused by accidents.
- Empanelled hospitals – a network of accredited government and private medical facilities that provide eligible services under the scheme.
- Jan Aadhaar linkage – the requirement that every family member listed on the family profile receives coverage, ensuring collective insurance.
- Pre‑hospitalisation benefit – coverage of medical expenses incurred for up to five days prior to admission.
