The Ayushman Bharat program was launched by the Government of India to work towards universal health coverage for all citizens. It is designed to meet India's Sustainable Development Goals and the commitment to "leave no one behind."
Ayushman Bharat follows a comprehensive care approach with two interconnected components, one of which is the Pradhan Mantri Jan Arogya Yojana (PM-JAY). PM-JAY stands as the world's largest health assurance scheme, targeting poor and vulnerable groups that constitute 40% of India's population.
PM-JAY provides health insurance coverage of up to Rs.5 lakhs to over 12 crore economically disadvantaged families. It aims to cover hospitalisation costs for secondary and tertiary care.
Read on as we discuss in detail what PM-JAY is, its key features, benefits, eligibility criteria, and the PM-JAY online registration process.
What is PM-JAY?
PM-JAY, also known as Pradhan Mantri Jan Arogya Yojana, stands as a leading healthcare initiative initiated by the Indian Government. Launched in September 2018, this program offers health insurance plans with a maximum coverage of Rs. 5 lakhs.
Its primary goal is to deliver accessible and affordable healthcare to economically vulnerable individuals and families nationwide, focusing particularly on the economically weaker sections of the country.
This government health insurance scheme comprehensively covers medical treatment costs, medicines, diagnostics, and pre-hospitalisation expenses. Moreover, it facilitates cashless hospitalisation services through the Ayushman Bharat Yojana e-card, received after completing the PM-JAY registration.
This e-card allows beneficiaries to access healthcare services seamlessly at any empaneled hospital across the country. To avail themselves of necessary treatment, beneficiaries need only present their PM-JAY e-card during hospitalisation.
Key features and benefits of PM-JAY
PM JAY, the world's largest government-financed health insurance scheme, has several important features:
#1. It offers coverage of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across both public and private hospitals in India.
#2. Beneficiaries get cashless access to healthcare services directly at the hospital.
#3. It covers up to 3 days of pre-hospitalization and 15 days of post-hospitalization expenses, including diagnostics and medicines.
#4. There are no restrictions on family size, age, or gender.
#5. All pre-existing medical conditions are covered from day one.
#6. The services encompass approximately 1,929 procedures, covering all treatment-related costs such as drugs, supplies, diagnostics, physician's fees, room charges, surgeon charges, OT and ICU charges.
What is covered under the PM-JAY scheme?
The Ayushman Bharat Yojana Scheme aims to make healthcare accessible to the poor by providing coverage of up to Rs. 5 lakh per family annually for secondary and tertiary hospitalisation care. The scheme covers various treatment components, including:
- Medical examination, treatment, and consultation
- Pre-hospitalisation
- Medicine and medical consumables
- Non-intensive and intensive care services
- Diagnostic and laboratory investigations
- Medical implantation services (where necessary)
- Accommodation benefits
- Food services
- Complications arising during treatment
- Post-hospitalisation follow-up care for 15 days
However, before proceeding to the Ayushman Bharat registration process, you must know that certain medical components such as Out-Patient Department (OPD) expenses, drug rehabilitation, cosmetic surgeries, fertility treatments, and organ transplants are not covered under this scheme.
PM-JAY eligibility criteria
Beneficiaries applying for this scheme need to fulfill certain eligibility criteria before beginning the PM-JAY registration process. The PM-JAY Scheme categorises beneficiaries into two groups: PM-JAY Urban and PM-JAY Rural. Here's a breakdown of each of them:
PM-JAY urban eligibility criteria
Eligible individuals in urban areas encompass various occupations
- Domestic worker
- Ragpicker
- Beggar
- Home-based Artisans/ Tailor Sweeper/ Handicrafts worker/ Sanitation worker/
- Washer-man/Mason/Plumber
- Construction worker/ Painter/Labour/ Welder/ Security guard/ Coolie
- Transport worker/ Rickshaw puller/ Conductor/ Cart puller/
- Electrician/ Mechanic/ Assembler/ Repair worker
- Street vendors/ hawker / Cobbler
- Waiter/Shop worker/ Assistant/ Peon/Delivery assistant
PM-JAY rural eligibiity criteria
PM-JAY Rural covers individuals and families residing in rural areas of India.
- Families living in a single-room with kucha walls and kucha roof.
- Families without any adult member aged between 16 to 59.
- Households without any adult male member aged between 16 to 59.
- Families with a disabled member and no able-bodied adult member.
- SC/ST households.
- Landless households relying significantly on manual casual labor for a major part of their income
Documents required for PM-JAY registration
For the PM-JAY registration process, the beneficiaries need to submit a few documents. Below is the list of documents required to apply for the PM-JAY scheme:
#1. Identity and Age Proof (PAN Card/ Aadhaar Card)
#2. Details of your mobile number, email address, and residential address.
#3. Caste certificate
#4. Income certificate
#5. Documents stating your current family status.
Steps to follow for PM-JAY enrollment
PM-JAY registration process is quick and hassle-free. Here's a simple guide to follow:
Step 1: Visit the official PM-JAY website.
Step 2: Next, click on the “Am I Eligible” icon.
Step 3: Input your contact details and click on “Generate OTP”.
Step 4: Next step in PM-JAY registration is to choose your state and search using your name, mobile number, HHD number, or ration card number.
Step 5: You can view if you are eligible for the government healthcare scheme.
Step 6: If eligible, proceed with the PM-JAY registration process. Follow the website's instructions and accurately fill in the required information.
Step 7: Upload scanned or digital copies of the necessary documents.
Step 8: Double-check all information and uploaded documents for accuracy and completeness. Submit the application form to complete the PM-JAY registration.
After completing the PM-JAY registration, you'll receive an application reference number or acknowledgment. Keep it for future reference, as you can use this number to track your application status online.
To end
Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a landmark initiative by the Government of India to provide healthcare access to the economically deprived sections of society. With over 12 crore eligible families covered under this scheme, PM-JAY aims to significantly bring down out-of-pocket expenditure on hospitalisation and treatment.
However, if you're not eligible and cannot proceed for the PM-JAY registration, consider exploring other medical loan options, like a personal loan for medical purposes, to ensure financial support during medical emergencies. Tata Capital offers competitive personal loan interest rates, requiring minimal documentation and easy-to-meet eligibility criteria. Additionally, you can use our personal loan EMI calculator to plan monthly installments for better financial management.
09 January 2024
6 mins read
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