Is Caesarean Section (C-section) delivery covered under Ayushman Card?

Yes, absolutely. The Ayushman Bharat (PMJAY) scheme covers both Normal Delivery and Caesarean Section (C-section) delivery at empanelled hospitals. The package includes all associated costs, so the beneficiary does not have to pay anything.

How long is a newborn baby covered under the mother's Ayushman Card?

A newborn baby is automatically covered under the mother's PMJAY ID from birth for a specified period (often up to 90 days, but can vary). This includes neonatal care, treatment for any complications, and vaccinations administered during the hospital stay. After this period, the child's name should be formally added to the family's card.

Can I choose a private hospital for delivery with my Ayushman Card?

Yes, you can get free and cashless delivery at any private hospital, provided it is empanelled under the Ayushman Bharat scheme and has maternity/obstetrics facilities. You should confirm the hospital's empanelment before admission.

Does the scheme cover pre-delivery consultations and tests?

The Ayushman Bharat scheme primarily covers hospitalization expenses. Regular outpatient (OPD) consultations and tests during the nine months of pregnancy are generally not covered. However, the package does include medical expenses for 3 days prior to admission and up to 15 days after discharge.

Free Delivery & Newborn Care with Ayushman Card (2025 Guide)

Ensuring a Healthy Start: Maternity Care under Ayushman Bharat

Welcoming a new member into the family is a joyous occasion, but the associated medical expenses for pregnancy, delivery, and newborn care can be a significant financial strain. The Ayushman Bharat (PMJAY) scheme provides a comprehensive safety net for expecting mothers and their babies, ensuring that every eligible family can access quality maternal and child healthcare without any cost.

This guide will provide a detailed overview of the maternity and neonatal benefits available under the Ayushman Card in 2025. We will explain what procedures are covered, the benefits for the newborn baby, and the step-by-step process to avail these services completely cashless.

Maternity Benefits Covered for the Mother

The PMJAY scheme has specific, high-value packages for maternity care to cover all aspects of childbirth at an empanelled hospital. This ensures a safe and dignified delivery for the mother. The key covered procedures are:

Normal Delivery: The entire cost of a normal vaginal delivery, including hospital stay, medicines, and doctor's fees, is covered.
Caesarean Section (C-section): If a C-section is medically necessary, the complete cost of the surgery, anaesthesia, and post-operative care is covered under a separate, higher-value package.
High-Risk Pregnancy Management: The scheme has provisions for managing high-risk pregnancies that may require a longer hospital stay or more intensive monitoring.
Pre and Post-Hospitalization: The package covers medical expenses for 3 days before admission and for up to 15 days after discharge, including follow-up consultations and prescribed medicines.

Crucial Benefits for the Newborn Baby

The coverage doesn't stop with the mother. The Ayushman Bharat scheme automatically extends benefits to the newborn child from the moment of birth.

Under the scheme, a newborn is covered under the mother's PMJAY ID for a specific period (usually up to 90 days). This ensures the baby receives immediate medical attention if needed. The key benefits for the newborn include:

Neonatal Care: All essential care for the baby after birth is covered.
Treatment for Complications: If the baby is born with an illness, is premature, or requires admission to a Neonatal Intensive Care Unit (NICU), the treatment is covered.
Vaccinations: Essential vaccinations administered during the hospital stay are included in the package.

After this initial period, it is important to formally add the newborn's name to your family's Ayushman card to ensure continued coverage.

Step-by-Step Process for Cashless Delivery

To avail the maternity benefits smoothly, follow these steps:

Step 1: Choose an Empanelled Hospital
During your pregnancy, identify a nearby government or private hospital that is empanelled under Ayushman Bharat and has a good maternity (Obstetrics & Gynaecology) department.
Step 2: Visit the Ayushman Mitra Desk
When you go to the hospital for admission for delivery, go to the Ayushman Mitra helpdesk. Provide the mother's Ayushman Card and Aadhaar Card.
Step 3: The Pre-Authorization Process
The hospital will verify your identity and submit an online pre-authorization request for the delivery package. In the case of childbirth, this process is treated as a priority.
Step 4: Receive Completely Cashless Care
Once approved, the entire process of admission, delivery, post-natal care for the mother, and neonatal care for the baby will be completely cashless. The hospital will settle the bill directly with the government.

Frequently Asked Questions (FAQs)

Q. Are regular check-ups and ultrasounds during pregnancy covered?

No. Ayushman Bharat is a hospitalization scheme. Regular Outpatient (OPD) check-ups, routine tests, and ultrasounds during the course of the pregnancy are not covered. The coverage begins with hospitalization for delivery.

Q. What if the hospital asks me to buy medicines from outside during my stay?

This is not allowed. All necessary medicines and consumables for both the mother and the newborn during the hospital stay are part of the cashless package and must be provided by the hospital.