Ayushman Bharat and state schemes cover only basic care; for autoimmune diseases, the expensive biologics and regular scans are mostly out-of-pocket. The gaps are in medicine coverage and access to specialists in smaller towns, forcing long trips to Kolkata. A year's out-of-pocket cost for drugs and monitoring can easily reach two lakhs, which is a mountain for families like mine. I know this because my neighbour's son has rheumatoid arthritis, and our village library fund now quietly helps his medicine costs—our small paddy yield could never cover it.
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