Atal Ayushman Uttarakhand Yojana (AAUY): A Guide

The Atal Ayushman Uttarakhand Yojana (AAUY) is the flagship health coverage scheme of the Government of Uttarakhand. Launched on December 25, 2018, it aims to provide universal health coverage to all resident families of the state. The scheme is a co-branded extension of the national Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PM-JAY).

Before AAUY, the state had the Mukhyamantri Swasthya Bima Yojana (MSBY), which was active since 2016 but offered a lower coverage amount. AAUY replaced MSBY and significantly expanded the scope of health protection. While the national PM-JAY scheme covered about 5 lakh economically vulnerable families in Uttarakhand based on the SECC-2011 census data, AAUY extended this coverage to an additional 18 lakh families, bringing the total to approximately 23 lakh households across the state.

This guide provides detailed information on the scheme's benefits, eligibility criteria, enrolment process, and how to avail cashless treatment at empanelled hospitals.

Atal Ayushman Uttarakhand Yojana at a Glance

The scheme operates on a family floater basis, where the total sum is shared among all family members.

• Health Coverage Amount — ₹5 lakh per family per year
• Scheme Launch Date — December 25, 2018
• Implementing Agency — State Health Authority, Uttarakhand
• Official Helplines — 14555, 155368, 104

Rates shown are as per the State Health Authority, Uttarakhand (2024) and are subject to periodic revision. Always verify the latest approved rates on the official source.

What Does the Atal Ayushman Uttarakhand Yojana Cover?

The AAUY scheme provides significant financial protection against hospitalisation expenses for secondary and tertiary care treatments. The benefits are designed to be comprehensive, covering the entire cycle of care for listed procedures.

Key features of the coverage include:

• **Health Cover:** A sum of ₹5 lakh is provided per family per year on a family floater basis. This means the entire amount can be used by one or more members of the family for treatment during the policy year.
• **Treatment Packages:** The scheme covers over 1,500 medical and surgical procedures, following the Health Benefit Package (HBP) list of the national PM-JAY scheme.
• **Hospitalisation Expenses:** Coverage includes expenses for up to 3 days of pre-hospitalisation care (such as diagnostics and consultations) and up to 15 days of post-hospitalisation care (including medicines and follow-ups).
• **Pre-existing Conditions:** All pre-existing diseases are covered from the very first day of enrolment. There is no waiting period for any illness.
• **No Restrictions:** There is no cap on family size, age of the members, or gender to be eligible for the scheme's benefits.

Who is Eligible for the AAUY Scheme?

The primary goal of AAUY is to provide universal health coverage to the residents of Uttarakhand. Eligibility is therefore broad and includes nearly all permanent resident families of the state. A valid ration card or an entry in the family register can be used as proof of residence.

However, certain categories of individuals are excluded from the state-funded portion of the scheme, as they are typically covered by other government-funded health plans:

• Beneficiaries already covered under other central government health schemes like the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), and Employees' State Insurance (ESI).
• State government employees and pensioners, who are covered under the separate State Government Health Scheme (SGHS).
• The research notes also indicate that income tax payers may not be eligible for the benefit.

How to Enrol and Get the Atal Ayushman Golden Card

To avail the cashless benefits of the scheme, every eligible family member must have an 'Atal Ayushman Golden Card'. This card is the primary identification document required at the hospital.

The enrolment and card generation process is conducted at various locations across the state:

**Where to Enrol:**

**Common Service Centres (CSCs):** Residents can visit their nearest CSC to get the card made.

**Empanelled Hospitals:** All hospitals networked under the scheme have dedicated counters with 'Arogya Mitras' who assist with the card generation process.

**Special Camps:** The government periodically organises special enrolment camps in municipal and rural areas to facilitate card issuance.

**Documents Required:**

To get the Golden Card, individuals typically need to provide proof of identity and residence. The most common documents required are an Aadhaar card and a ration card. The card is issued to each member of the family and is mandatory for accessing cashless treatment.

Relationship with Ayushman Bharat PM-JAY

Atal Ayushman Uttarakhand Yojana is not a separate scheme but a co-branded extension of the national Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PM-JAY). It operates in close alignment with the national framework.

The state scheme adopts the core components of PM-JAY, including the ₹5 lakh coverage amount, the list of over 1,500 treatment packages, and the technology platform. The key difference lies in the beneficiary base. PM-JAY's beneficiaries are identified based on specific deprivation and occupational criteria from the Socio-Economic and Caste Census (SECC) of 2011, which covered approximately 5 lakh families in Uttarakhand.

AAUY expands this coverage to all remaining resident families of the state, an additional 18 lakh households, thereby aiming for universal health coverage for all 23 lakh families. This expansion is funded by the state government.

Using the AAUY Scheme at Hospitals

The AAUY scheme is designed to be completely cashless, meaning beneficiaries do not have to pay for covered treatments at empanelled hospitals. The hospital directly claims the expenses from the State Health Authority.

Beneficiaries can avail treatment at all government hospitals within Uttarakhand and a large network of empanelled private hospitals. In a significant move in March 2024, the state government mandated that all private hospitals in Uttarakhand must treat patients under the Atal Ayushman scheme, widening the network of available facilities.

The scheme also offers nationwide portability. This allows a beneficiary from Uttarakhand to receive cashless treatment at any PM-JAY empanelled hospital across India. For planned treatments at a private hospital, a referral from a government hospital may be required. However, in case of a medical emergency, a beneficiary can go to any empanelled private hospital directly without a referral.

Frequently Asked Questions

What is the Atal Ayushman Uttarakhand Yojana (AAUY)?

AAUY is a health insurance scheme by the Government of Uttarakhand that provides a health cover of ₹5 lakh per family per year for secondary and tertiary care hospitalisation. It is an extension of the national PM-JAY scheme, covering all resident families of the state.

What is the coverage amount under the AAUY scheme?

The scheme provides a health cover of ₹5 lakh per family per year. This is a family floater amount, meaning it can be used by any member of the family for treatment within the year.

How is AAUY different from the national PM-JAY scheme?

While AAUY uses the PM-JAY framework and benefits, its main difference is the expanded beneficiary base. PM-JAY covers families based on the SECC 2011 data, whereas AAUY extends coverage to all resident families of Uttarakhand, aiming for universal health coverage in the state.

Do I need to pay for treatment under this scheme?

No, the scheme provides cashless treatment for all covered procedures at empanelled government and private hospitals. There should be no out-of-pocket expenses for the beneficiary within the coverage limits.

Where can I get my Atal Ayushman Golden Card?

You can get your Golden Card made at Common Service Centres (CSCs), the helpdesks of empanelled hospitals (with assistance from Arogya Mitras), or at special enrolment camps organised by the government.

Are pre-existing diseases like diabetes or heart conditions covered?

Yes, all pre-existing diseases are covered from day one of enrolment in the scheme. There is no waiting period for any condition.

Can I use the AAUY card for treatment outside Uttarakhand?

Yes, the scheme offers nationwide portability. You can receive cashless treatment at any hospital in India that is empanelled under the Ayushman Bharat PM-JAY scheme.

Related

• Government hospital OPD guides in Uttarakhand
• How to find an Ayushman Bharat (PM-JAY) hospital near you
• Government health schemes in India: a guide
• Ayushman Bharat PM-JAY eligibility check

Medical Disclaimer

The information provided in this article is for general informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.