My wife and I have been advised to consider IVF treatment. We have Ayushman Bharat cards. Can we use the scheme to cover the costs of this infertility treatment?
No, the Ayushman Bharat (PM-JAY) scheme does not cover the costs of infertility treatments such as In Vitro Fertilization (IVF) or Intrauterine Insemination (IUI). These types of procedures are currently on the list of general exclusions for the health insurance scheme.
Infertility Treatment is on the Scheme’s Exclusion List
My friend was exploring his options for fertility treatment and asked me if his family’s Ayushman card would be of any help. I had to check the official PM-JAY guidelines for him and confirmed that treatments that are specifically for correcting infertility, including IVF and IUI, are not included in the list of covered medical packages.
Why These Treatments Are Not Covered
I was discussing the scope of the scheme with a public health expert. He explained that the primary focus of Ayushman Bharat is to provide a financial safety net against catastrophic expenses from life-threatening diseases, acute illnesses, and essential surgeries. He said that while infertility is a significant health and social issue, its treatment is not currently classified under the curative care packages that the scheme prioritizes.
A Key Distinction: Maternity Care is Still Covered
The expert did, however, point out a very important and positive distinction. He clarified that if a couple conceives through IVF (by paying for the treatment themselves) and the woman is an eligible Ayushman beneficiary, then all of her subsequent maternity care and the hospital expenses for the delivery are fully covered by the scheme. The exclusion is only for the fertility treatment itself, not for the pregnancy and childbirth that follows.
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