You are here
Home > Schemes

Ayushman Bharat Bima Yojana: PMJAY Scheme

Ayushman Bharat Bima Yojana is also referred to as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY). Ayushman Bharat Bima is one of the largest government-supported health plans in India. 

Prime Minister Narendra Modi launched the Pradhan Mantri Jan Arogya Yojana health plan intending to cover more than 50 crore citizens of Indian and around 10 crore disadvantaged families without family and age restrictions. 

Ayushman Bharat Yojana (PMJAY) will help these families benefit from health services with insurance coverage of up to INR 5 lakh per family per year for tertiary and second hospital expenses.

The program is part of the Indian government’s national health policy. It was started in September 2018 by the Health and Family Welfare ministry. 

The ministry then set up the National Health Authority as an agency to administer the program. It is a centrally supported program co-funded by the central and state governments. [1]

Features of Ayushman Bharat Bima Yojana

Apart from being a life-saving scheme for lower middle income, other main features of Pradhan Mantri Ayushman Bharat Yojana are:

  • The Ayushman Bharat Yojana plan is a family plan with an absolute sum of Rs. 5 lakhs per registered family.
  • This program is specifically framed for people who are living below the poverty line, who have access to the Internet or online health plans.
  • The plan provides cashless health care services for its users in any hospital in the public and private sectors.
  • In addition, Pradhan Mantri Jan Arogya Yojana covers the transportation costs incurred by the user in the period before and after the hospitalization.
  • In addition to the cost of treatment, the Jan Arogya insurance Yojana scheme also provides the day-care costs incurred by the subscriber.
  • Also, the Ayushman Bharat Yojana covers some pre-existing illnesses.
  • Medical expenses are paid based on the price of the package, which is determined in advance by the government.
  • A reasonable number of health and wellness centers will be established, as per the data from the socio-economic census, as part of a government-sponsored program.

Ayushman Bharat Yojana Scheme Benefits

Nearly 40% of needy and vulnerable families in India are covered by the Ayushman Bharat Yojana program. Following are the benefits and health services that these families can enjoy from this program:

  • The Pradhan Mantri Jan Arogya Yojana (PMJAY) healthcare facilities are available free throughout India.
  • 25 specialization categories are offered under the Ayushman Bharat Yojana and the scheme covers a range of 1354 medical and surgical packages like neurosurgery, cardiology, etc.
  • Also, Ayushman Bharat Yojana covers after hospitalization costs.
  • In the event of multiple operations, the costs will be covered by the highest package. And it covers 50 percent and 25 percent respectively for the second and third operations.
  • The program covers the costs of chemotherapy for the treatment of tumors for 50 different types of cancer. However, it is not possible to benefit from a medical and surgical package at the same time.
  • Ayushman Bharat healthcare scheme beneficiaries are entitled to follow-up treatment.

Also Read: SBI Health Insurance Scheme

Eligibility Criteria of Ayushman Bharat Yojana for Rural and Urban Population

To enjoy the benefits of Ayushman Bharat Yojana’s health insurance plan, all people must check their name in the 2011 socio-economic caste census data. This will determine if their family is eligible to cover under Ayushman Bharat Yojana. 

Both families and active RSBY cardholders listed in the socio-economic cast data (SECC) database are eligible for PMJAY benefits. Ayushman Bharat Jan Arogya Yojana facilitates eligible citizens to enjoy healthcare services throughout India.

Eligibility Criteria of PMJAY for Rural People

  • Family without an adult/male / earning member in the age group of 16 to 59 years
  • Families living in a room having kaccha walls and roof
  • A family without a healthy adult and a member with a disability
  • Family doing manual scavenger 
  • Families without land, who earn a large portion of their family income through manual labor

Eligibility of PMJAY Scheme for Urban People

  • Home craftsmen / Tailor, cleaner / Craftsman / Sanitary worker 
  • Domestic Worker
  • Ragerpicker
  • Beggar
  • Painter, Security guard, Labor, Construction worker, Welder, Coolie
  • Mason, Washer-man, Plumber
  • Mechanic, Electrician, Fitter, Repairer
  • Workers in Transport, Driver, Rickshaw puller, Trolley puller
  • Store Worker, Peon, Waiter, Delivery Assistant, Assistant
  • Shoemaker, Hawker, Street vendors

How to Register Online Yourself for Ayushman Bharat Jan Arogya Yojana?

Enrolling in the PMJAY program is very easy. The scheme applies to all the citizens identified in the 2011 SECC list and to those who are part of the Rashtriya Swasthya Bima Yojana (RSBY) plan. If you want to register online for PMJAY, you can follow the steps given below:

  • To register under PMJAY online you can visit the official government website for this plan.
  • You simply have to click on Am I eligible tab to check your eligibility. 
  • Enter your mobile phone number, solve the CAPTCHA code and click Generate OTP.
  • Enter your name, your state, household number or mobile no., and ration card number. 
  • If your family is under Ayushman Bharat Bima Yojana cover, your name will appear in the results.

What Documents are Needed to Apply for Ayushman Bharat Yojana?

  • Aadhaar Card/PAN Card (for age and Identity proof)
  • Contact details (Email, Mobile Number) 
  • Caste certificate
  • Income certificate (annual minimum income should not be more than Rs. 5 lakhs).  
  • Document proof of current family status to be covered (joint or nuclear)

Critical Diseases that are Covered Under Jan Arogya Yojana

PM Jan Arogya Yojana offers approximately 1350 medical packages in any of the private hospitals and all public hospitals. Some of the critical ailments that Ayushman Yojna covers are mentioned below: 

  • Skull base surgery
  • Tissue expander for disfigurement following burns
  • Pulmonary valve surgery
  • Prostate cancer
  • Double valve replacement surgery
  • Coronary artery bypass grafting
  • Anterior spine fixation

Toll-Free Numbers and Address of Ayushman Bharat Yojana

Applicants of the Ayushman Bharat scheme can call on 14555 and 1800111565 toll-free numbers for any grievance.

7th and 9th Floor, Tower-L, Jeevan Bharati Building, Connaught Place, New Delhi – 110001 is their address. 

Conclusion

Ayushman Bharat Bima scheme is a National Healthcare Scheme, which will provide cover more than 100 million vulnerable poor families (approx. 50 crore beneficiaries) covering up to 5 lakh rupees per family per year for secondary and tertiary care hospitals.

The National Health Mission has defined coverage benefits of Rs. 5 lakhs per family per year. The program benefits are available nationwide, and beneficiaries covered by the program will be able to take cashless health benefits from any public / private hospital throughout the country.

Similar Articles

Leave a Reply

Top