What is PMJAY Scheme or Ayushman Bharat Yojana?
The Pradhan Mantri Jan Arogya Yojana (PMJAY) Scheme was announced in August, 2018 by Indian Prime Minister, Shri Narendra Modi. Ayushman Bharat Yojna now renamed PMJAY is one of the world’s largest health insurance schemes funded by the Government of India. The scheme offers a health insurance plan of up to ₹5 lakh annually per family covering all senior citizens above the age of 70, regardless of their income. Here’s everything you need to know about PMJAY.
PMJAY was launched to offer better healthcare services to crores of underprivileged Indian citizens. This health insurance scheme is paperless and offers cashless hospitalization expenses at public hospitals and private empanelled hospitals. (Empanelled hospitals are private hospitals established for inpatient medical care with facilities that are sufficient for treating diseases and to perform surgeries). To sign up for the Ayushman Bharat Yojana or PMJAY Scheme, this is the PMJAY portal – Official Website Ayushman Bharat | PMJAY | National Health Authority
What is Covered Under PMJAY?
The PMJAY scheme covers all consultations and hospitalization costs. It also covers
daycare treatment expenses and medications during the course of treatment of tertiary and secondary care procedures. Tertiary care is a higher level of specialized care within a hospital, while secondary care refers to care under a specialist like oncologists, cardiologists or endocrinologists. As far as medical conditions are concerned, the PMJAY scheme covers nearly 1400 procedures including knee replacement surgery, skull surgery, neurosurgery, heart diseases, kidney diseases, cancer, congenital disorder, burn injuries, mental illness, etc to name a few.
Here’s some important information about PMJAY / Ayushman Bharat Yojana
Features | Details |
|---|---|
Name of the Scheme | Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PMJAY) or Ayushman Bharat National Health Protection scheme (NHPS) |
Launch Date of PMJAY | September 23, 2018 |
Coverage (Per Family) | ₹5 Lakh Annually |
Procedures Covered | 1,400 |
Pre-hospitalization Expenses Coverage | Up to 3 Days |
Post-hospitalization Expenses Coverage | Up to 15 Days |
Website | |
Toll-free Helpline Numbers | 1800-111-565 / 14555 |
Email ID | ayushmanbharat.csc@gmail.com |
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Eligibility Criteria Under PMJAY Scheme
All Indian citizens whose names appear in the Socio-Economic Caste Census-2011 (SECC) database are eligible to avail benefits under PMJAY health insurance programme. However, to access free healthcare services, one must have an Ayushman Bharat Card, which serves as a key document in this process. Also, senior citizens who are covered under private health insurance policies or the Employees’ State Insurance scheme are also eligible to benefit from PMJAY.
Process For PMJAY Registration
Here are some steps to follow to register for the PMJAY scheme online
1. Visit the official PMJAY portal for the PMJAY scheme: https://pmjay.gov.in/
2. Click the ‘Am I Eligible’ tab on the right-hand side of the page
3. Submit your mobile number, CAPTCHA code and the OTP
4. Enter your state, scheme, district and family ID / Aadhar Number or PMJAY ID
5. Depending on the option you choose, if your family is covered under PMJAY or Ayushman Bharat Yojana, your name will show up.
Documents Required to Apply For PMJAY Scheme
The following documents are required to apply for PMJAY:
1. Age & identity proof (Aadhaar Card/PAN Card)
2. Contact details (mobile, address, email)
3. Caste certificate
4. Income certificate
5. Document proof of the current status of the family to be covered (Joint or nuclear)
Frequently Asked Questions
PMJAY, also known as Ayushman Bharat is a government-sponsored healthcare scheme in India that provides financial assistance for medical treatment to eligible beneficiaries.
The eligibility criteria for PMJAY varies slightly from state to state, but generally, people belonging to families with a household annual income below a certain threshold are eligible. Specific eligibility criteria can be checked on the official PMJAY portal.
PMJAY covers a wide range of treatments, including hospitalization, surgeries and medical procedures. The exact list of covered procedures can vary but it typically includes treatments for common ailments, critical illnesses and diseases.
Enrollment in PMJAY can be done through various channels, such as government health centers, common service centers or online portals. The specific process may vary depending on your state.
Yes, there is a limit on the amount covered under PMJAY. However, the exact limit may vary, which is sufficient to cover the cost of most treatments.
While PMJAY covers a significant portion of the treatment cost, there may still be some out-of-pocket expenses, such as charges for consumables, diagnostics or private rooms.
No, you cannot choose any hospital for treatment under PMJAY. The scheme has a network of empanelled hospitals where beneficiaries can avail treatment.
The process for filing a claim under PMJAY typically involves submitting necessary documents to the empanelled hospital where the treatment was received. The hospital will then verify the claim and process the reimbursement.
If you face any problems or grievances related to PMJAY scheme, you can reach out on the state-level helpline no: 1800-111-565 / 14555 or file a complaint on the official PMJAY portal: https://pmjay.gov.in/
Yes, you can avail PMJAY benefits in any state across India. However, the specific procedures and eligibility criteria may vary.
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