Pradhan Mantri Jan Arogya Yojana: Mantri Pradhan Ayushman Bharat Yojana, also referred to as Pradhan Mantri Jan Arogya Yojana, is the government of India’s flagship program. It is essentially a health insurance scheme for the general population as well as the poorer and weaker segments of society.
In the event that a medical emergency requires hospitalization, the program provides financial protection. This page provides comprehensive information about the government health insurance program, including eligibility requirements, features, benefits, and application procedures.
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Contents
What is Pradhan Mantri Jan Arogya Yojana?
Pradhan Mantri Jan Arogya Yojana:Ayushman Bharat Yojana, regarded as one of the largest healthcare programs globally, intends to provide coverage to over 50 crore Indian citizens. Particularly designed for the economically underprivileged areas of the country. Launched in September 2018, the PMJAY offers health insurance policies with a Rs. 5 lakh maximum sum insured.
The government health insurance program pays for the majority of medical treatment costs, prescription medications, diagnostic fees, and pre-hospitalization expenses. Another option is to use the Ayushman Bharat Yojana e-card for cashless hospitalization, which covers medical costs at any authorized facility across the nation. By presenting their PMJAY e-card, program participants can receive hospitalization for necessary medical care.
Pradhan Mantri Jan Arogya Yojana
| Name of the Scheme | Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) or Ayushman Bharat National Health Protection Scheme (NHPS) |
| Type of project | Health Insurance |
| Started By | Prime Minister Shri Narendra Modi |
| Country | India |
| Ministry | Ministry of Health and Family Welfare |
| Launched | 23 September 2018; 4 years ago |
| Total Number of Ayushman Cards Issued Until Now | 21,40,17,608 (as of 21st December 2022) |
| Total Number of Hospital Admissions Until Now | 4,23,59,252 (as of 21st December 2022) |
| Total Number of Registered Families | Over Ten Crore |
| Budget | ₹8,088 crore (US$1.0 billion) (2021–22) [1] |
| Status | Active |
| Website | https://www.pmjay.gov.in/ |
| Helpline Numbers | 1800-111-565 or 14555 |
| Address | National Health Authority of India, 3rd, 7th and 9th Floor, Tower-L, Jeevan Bharati Building, Connaught Place, New Delhi – 110001 |
PM-JAY Eligibility Criteria for Rural and Urban Population:
The PM-JAY program was introduced to assist the nation’s lowest 40% of impoverished and economically disadvantaged citizens. This was predicated on the occupational and deprivation parameters found in the 2011 Socio-Economic Caste Census for both urban and rural areas. Requirements are part of the Ayushman Bharat Yojana Eligibility framework, which ensures that the benefits of the program are limited to the most impoverished members of society.
The PM-JAY program was introduced to assist the nation’s lowest 40% of impoverished and economically disadvantaged citizens. This was predicated on the occupational and deprivation parameters found in the 2011 Socio-Economic Caste Census for both urban and rural areas. The Ayushman Bharat Yojana Eligibility is structured with prerequisites to ensure that the program’s benefits are limited to the poorest members of society.
PMJAY Rural:
One aspect of the Socio-Economic Caste Census 2011 (SECC 2011) is a rating of households based on socioeconomic level. Rating rural families takes into account seven deprivation criteria.The application automatically covers all six categories of deprivation: bonded laborers, alms-dependent households, poor households that scavenge by hand, and primitive tribal groupings.
- households having just one room and Kucha-style roofs and walls.
- There isn’t a single adult participant in the 16–59 age range.
- Not a single adult male in the 16–59 year age range.
- There is one individual with impairment and one without in the house.
- SC and ST
- The primary source of income for households without land is physical labor.
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PMJAY Urban:
The design divides urban households into groups based on the occupation of the family members. Employees who fall into any of the 11 occupational categories below are eligible for the Ayushman Bharat Yojana Scheme:
- Beggar
- household helper
- Angry Picker
- Hawker, Street Vendor, Cobbler, and Additional street-based service providers.
- Mason, Painter, Plumber, Laborer, Welder, Security Guard, and Coolie
- Sweeper, Mali, and Cleaning Employee
- Craftsperson, Tailor, Artist, and Home-Based Employee
- Drivers, transport workers, conductors, pullers of carts or rickshaws, and assistants to drivers and conductors
- Employees in small businesses: shop workers, peons, assistants, attendants, delivery assistants, and waiters
- Repair worker/mechanic/electrician/assembler
- Chowkidar/Man-Washer
What is Covered Under Ayushman Bharat Yojana Scheme?
The Ayushman Bharat Yojana Scheme aims to make secondary and tertiary hospitalization care accessible to the impoverished and needy by providing coverage of up to Rs. 5 lakh per household annually.
The following elements of AB-PMJAY’s health insurance program pay for hospitalization costs for beneficiaries:
- consultation, diagnosis, and medical care.
- before going into the hospital for admission.
- both intense and non-intensive care options.
- prescription drugs and supplies.
- Laboratory and diagnostic services.
- Give in.
- When feasible, provide medical implant services.
- catering services.
- a problem that comes up during treatment.
- expenditures incurred for up to 15 days following hospitalization.
- Treatment for the coronavirus COVID-19.
What is Not Covered Under Ayushman Bharat Yojana Scheme?
The Ayushman Bharat Yojana Scheme includes certain exclusions, just as other kinds of health insurance plans. The proposal does not include the following elements:
- Spending from the Out-Patient Department (OPD).
- drug detoxification.
- surgical cosmetic procedures.
- treatments for fertility.
- personal medical evaluations.
- transplant of organs.
Features of Ayushman Bharat Yojana Scheme:
The following are the salient characteristics and focal points of the PMJAY, or Ayushman Bharat Yojana scheme:
- The Indian government funds one of the largest health insurance schemes globally.
- coverage of up to Rs. 5 lakh per family per year for secondary and tertiary care in both public and private facilities.
- Nearly 50 million beneficiaries, or more than 10 crore qualifying needy and disadvantaged families, are eligible for the program.
- hospital stay without money.
- covers the cost of prescription drugs for up to three days as well as any diagnostic tests required prior to hospital admission.
- covers, for a maximum of 15 days after hospitalization, the cost of prescribed medications and diagnostic testing.
- No restrictions on family size, gender, or age.
- can obtain medical care at any recognized public or private hospital across the country.
- All pre-existing conditions were immediately covered.
- 1,393 are in existence.
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Benefits & Advantages of Ayushman Bharat Yojana Scheme:
The goal of the Pradhan Mantri JAY (PMJAY), also known as the Ayushman Bharat Yojana Scheme, is to assist the weaker and less fortunate segments of the population. The following are PMJAY’s main features and benefits:
- It can pay for all hospitalization expenses for recipients thru cashless transactions.
- Housing whilst a patient is within the medical institution.
- Fees both earlier than and after hospitalization.
- Any troubles that come up while receiving remedy.
- Suitable for all own family individuals to apply.
- Circle of relatives size, age, or gender are all unlimited.
List of Critical Diseases or Illnesses Covered Under Ayushman Bharat Yojana Scheme:
More than 1300 medical packages at nationally affiliated public and private institutions were covered by the medical care program. Some of the serious illnesses that the Ayushman Bharat Yojana covers are listed below:
- Prostate cancer.
- Double valve replacement.
- Coronary artery bypass graft.
- COVID-19.
- Pulmonary valve replacement.
- Skull base surgery.
- Anterior spine fixation.
- Laryngopharyngectomy with gastric pull-up
- Tissue expander for disfigurement following burns.
- Carotid angioplasty with stent.
Who Does Not Qualify For The Ayushman Bharat Yojana Program?
The list of individuals who are not eligible to receive healthcare services under the program is provided below:
- individuals who employ mechanical farming equipment.
- whose car is a two-, three-, or 4-wheel drive vehicle.
- individuals who own a Kisan card.
- employees of the government.
- persons who possess motorized fishing boats.
- anybody earning more than 10,000 rupees each month.
- people who work for non-agricultural government-run companies.
- those who own more than five acres of farmland.
- those who own landlines or refrigerators.
- those who reside in sturdy homes.
PM-JAY Enrollment Process:
The system, an entitlement-based program, was launched by the Indian government for the respected and disadvantaged groups in society. As a result, there is no registration process. The SECC 2011 is followed in selecting beneficiaries who are enrolled in the RSBY scheme. Do the following to see if you are eligible for the program:
Step1: Click the “Am I Eligible” button after visiting the government website for the PMJAY program, https://pmjay.gov.in/.
Step2: Enter your contact details and generate OTP.
Step3: Choose your state.
Step4: You can now search using your ration card number, name, mobile number, or HHD number.
Step5: Depending on the result, you will be notified of your eligibility for the PMJAY plan.
Ayushman Bharat Yojana customer service numbers are 1800-111-565 and 14555, respectively, and you can also get in touch with any Empanelled Health Care Provider (EHCP).
Documents Required to Apply For Ayushman Bharat Yojana Scheme:
The list of documents needed to apply for the PMJAY scheme is provided below:
- Age and Identity Verification (Aadhaar Card/PAN Card)
- information about your home address, email address, and cell phone number.
- Caste certificate
- Income Declaration
- documents certifying your family status as of right now.
How To Apply Online For Ayushman Bharat Yojana?
The Indian government developed the program to address the healthcare requirements of the population’s most vulnerable groups. The program does not have an enrollment procedure in accordance with its fundamental requirements. To submit an online application for the Ayushman Bharat Yojana, you must first determine if you qualify for the program. The procedure to ascertain your eligibility for the Ayushman Bharat Yojana Registration is as follows:
- Step1: Go to the PMJAY-only website (https://pmjay.gov.in/) and select the “Am I Eligible” button.
- Step2: After entering your contact information, select “Generate OTP.”
- Step3: Now select your state and conduct a search with your phone number, ration card number, HHD number, or name.
- Step4: You can check if you qualify for the public health insurance program.
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How To Apply Online For Ayushman Bharat Yojana?
The Indian government developed the program to address the healthcare requirements of the population’s most vulnerable groups. The program does not have an enrollment procedure in accordance with its fundamental requirements. To submit an online application for the Ayushman Bharat Yojana, you must first determine if you qualify for the program. The procedure to ascertain your eligibility for the Ayushman Bharat Yojana Registration is as follows:
- Step1: Go to the PMJAY-only website (https://pmjay.gov.in/) and select the “Am I Eligible” button.
- Step2: After entering your contact information, select “Generate OTP.”
- Step3: You can now search by your name, mobile number, HHD number, or ration card number after selecting your state.
- Step4: You can check your eligibility for the government health insurance program.
How To Download Ayushman Bharat Yojana Card Online?
The Ayushman Bharat Yojana Golden Card will be given to beneficiaries in order to guarantee cashless, paperless, and portable transactions through the PM-JAY plan. Every piece of information needed about the patient is on the PMJAY e-card. This card must be presented in order to receive treatment at the hospital that has been accredited.
To obtain this PMJAY Golden Card, go to the steps listed below:
- Step1: Enter the registered mobile number on the PMJAY website (https://mera.pmjay.gov.in/search/login) to log in.
- Step2: To generate the OTP, enter the “Captcha Code.”
- Step3: Opt for the HHD code.
- Steo4: Give the Common Service Center (CSC) the HHD code so they may verify it along with other information.
- Step5: The remaining steps will be carried out by the CSC representatives, or Ayushman Mitra.
- Step6: It will cost you thirty rupees to obtain the Ayushman Bharat card.
How To Check The Name in the PMJAY List 2024?
There are various ways to find out if your name is on the PMJAY list 2020. They are as follows:
- Central Common Service Center: Get in touch with the nearby CSCs or any authorized hospital to see if you are eligible for the healthcare plan.
- Helpline Numbers: You can call the PMJAY helplines to find out if you qualify for the programme. You can reach out to 1800-111-565 or 14555.
- Online: Check your eligibility for the program by going to the official website (https://www.pmjay.gov.in/).
Medical Packages:
Families and individuals can get approximately 25 specialities as program beneficiaries, including:
- Cardiology
- Oncology
- Neurology
- Paediatrics
Note that reimbursement for both medical and surgical costs cannot be received at the same time. Additionally, if there are several procedures, the most expensive procedure will be covered first. You will be paid 50% for the second, and 25% for the third. Pre-existing conditions are not taken into account by the PMJAY program because it is a part of the expansive program that the Indian government implemented.
PMJAY Hospital List:
To acquire both the Ayushman Bharat hospital list and the PMJAY hospital list, complete these procedures:
- step1: To acquire both the Ayushman Bharat hospital list and the PMJAY hospital list, complete these procedures:
- Step2: Select your state and the district.
- Step3: Now choose between public, private, for-profit, or private without a profit hospital types.
- Step4: Select the desired medical specialization.
- Step5: After entering the “Captcha Code,” select “Search.”
You will be taken to a list of Ayushman Bharat Yojana hospitals, complete with their address, website, and phone number. Using the aforementioned URL, you may also view the “Suspended Hospital List.”
PMJAY Toll-free Number and Address:
| Toll-Free Number | 14555 / 1800-111-565 |
| Address | National Health Authority of India, 3rd, 7th and 9th Floor, Tower-L, Jeevan Bharati Building, Connaught Place, New Delhi – 110001 |
| Grievance Portal | PMJAY Grievance |
FAQs
Q: What services are offered under the Ayushman Bharat Scheme?
Ans: Medical care services such pre- and post-hospitalization, daycare procedures, newborn child services, etc. are included under the plan.
Q: Will recipients of the PMJAY Ayushman Bharat initiative receive an ID card?
Ans: Eligible families will receive a PMJAY ecard at the time of hospitalization in addition to a special ID card.
Q: What is the HHD number in PMJY?
Ans: Household identification numbers, or HHD numbers in PMJAY, are distinct 25-character codes that are used to identify households.
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