All Beneficiaries of the Scheme shall have access to cashless and paperless services under the AB PM-JAY CMHIS up to the limit of their annual coverage.
Risk Cover for each Beneficiary Family Unit (BFU) shall include hospitalization and treatment expenses coverage including treatment for medical conditions and diseases requiring secondary and tertiary level of medical and surgical care treatment and including defined day care procedures (as applicable) and follow up care along with cost for pre- and post-hospitalisation treatment.
Sum Insured: As on the date of commencement of the Policy Cover Period, the AB PM-JAY CMHIS Sum Insured in respect of the Risk Cover for each CMHIS (GEN) BFU shall be Rs. 5,00,000 (Rupees Five Lakhs Only) per family per annum on a family floater basis.
Risk cover to be provided on a family floater basis: Risk cover for each BFU shall be provided on a family floater basis covering all the members of the BFU including Senior Citizens, i.e., the Sum Insured shall be available to any or all members of such BFU for one or more Claims during each Policy Cover Period.
All pre-existing conditions/diseases to be covered.
OPD services and standalone diagnostics are not covered
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