This article is a detailed guide about the PMJAY Ayushman Bharat Yojana Scheme, its eligibility, features, and benefits. The objectives, enrollment process, and how to apply and download for Ayushman Bharat Yojana online are also explained below. The Ayushman Bharat guidelines pdf is available on the official website of PM-JAY along with the policies.
What is PMJAY –Ayushman Bharat Yojana Scheme?
The Pradhan Mantri Jan Arogya Yojna (PMJAY) also known as Ayushman Bharat Yojana Scheme is the National Health Protection Scheme introduced by the Government of India. It is also called ‘Modicare’ which is an ambitious healthcare program aimed at covering over 10 crore poor and vulnerable families and 50 crore individuals based on the Socio-Economic Caste Census database. The program promises to give underprivileged families Rs. 5 lakh every year for medical treatments and hospitalization. Ayushman Bharat scheme details are available on the official website of the PMJAY.
The two main objectives of the PM insurance scheme are as follows:
- It aims at creating a health network and infrastructure across the country to deliver primary health services.
- The scheme also promises insurance coverage to at least 40% of India’s majorly deprived population (This population does not get secondary and tertiary care services).
You can also avail the services using the PMJAY e-card at any empanelled hospitals dispersed in the country. Under this scheme, beneficiaries can get hospitalized for required treatment with the help of the Ayushman Bharat Yojana card.
The Scheme covers
Under this scheme, the beneficiaries can avail of services like medical examination, intensive and non-intensive care, facility of accommodation, medical implants, diagnostic services, covers post-hospitalization expenses for 15 days, Treatment for COVID-19, and any other complication arising during treatment.
The Scheme does not cover
The PMJAY scheme just like other insurance schemes also has some exclusion. Like drug rehabilitation, cosmetic surgeries, organ transplant, fertility treatments, and Out-Patient Department, and individual diagnostics.
Ayushman Bharat Yojana Scheme-Features
- Rs. 5 lakh covered per family every year for tertiary and secondary care in all private and public hospitals.
- Beneficiaries are 50 crores in number.
- Gives cashless hospitalization.
- Pre-hospitalization expenses coverage of 3 days.
- Post-hospitalization expenses coverage of 15 days.
- It has no bar on age, gender, and family-size.
- It covers the pre-existing illnesses from the first day onwards.
- It includes 1393 medical procedures.
10 Benefits of the PMJAY Ayushman Bharat Yojana Scheme That Every Indian Should Know
The benefits of Ayushman Yojana are mentioned below:
- The Prime Minister of India, Mr. Narendra Modi launched the scheme in September 2018 which aims at catering to 50 crore beneficiaries. It provides coverage of Rs. 5 lakh per family every year below the poverty line.
- All families listed in the SECC database are covered under this scheme. Out of the 10 crore beneficiary families, 8 crore families are from the rural areas and 2 crore families of urban India.
- Having an AADHAR card to avail of all the services is not mandatory. The beneficiaries are only required to carry a prescribed ID to receive free treatment.
- There is no restriction on the family size, age, and gender under the Ayushman Bharat scheme. It can be used by all the family members. Priority is given to girl children, women, and senior citizens.
- It gives secondary and tertiary benefits provided by specialists like cardiologists and urologists. It also covers medical treatment for cancer, cardiac surgery, and other diseases.
- It also covers pre-existing diseases and illnesses. It means that individuals who require medical care cannot be turned away.
- The scheme aims at removing the burden of out-of-pocket expenses. The process is cashless and provides paperless registration and administration. The beneficiaries can avail of treatment throughout the country.
- The empanelled private hospitals and public hospitals under this scheme are directed to not charge any extra payment for the medical services given to the PMJAY beneficiaries.
- It encourages the production of more affordable healthcare equipment and drugs to help in the achievement of public health goals.
- It aims at improving the quality of the population especially the weaker sections of society. The main objective is to make more and more Indians having access to healthcare, broadening the health insurance network.
List of Critical Diseases covered under this scheme
- Bypass graft of Coronary artery.
- Surgery of the skull base.
- Double valve replacement.
- Fixation of anterior spine.
- Carotid angioplasty.
- Laryngopharyngectomy along with gastric pull-up.
- Burn injuries corrected with tissue expander (correction of disfigurement).
Rural and Urban Population- Eligibility Criteria
Economically weaker sections and downtrodden persons of the society fall under the PMJAY scheme. The eligibility criteria are formulated with pre-requisites to protect the underprivileged of society.
PMJAY Scheme for Rural
- Families with a single room having a Kutcha roof and walls.
- No male adult member between the 16-59 age groups.
- SC and ST.
- No-abled-bodied adult member and disabled member of the family.
- Landless families who earn from casual labor given manually.
PMJAY Scheme for Urban
- Domestic worker.
- Sweeper/sanitation worker.
- Construction worker/plumber/painter/security guard and other head load workers.
- Cobbler/hawker and other persons providing service on streets.
- Electrician/mechanic/repair worker/assembler.
- Shop worker/delivery assistant/attendant/waiter/helper/peon in establishments.
- Driver/conductor/transport worker/cart puller/rickshaw puller.
- Home-based worker/artisan/tailor/handicrafts worker.
Individuals who cannot avail the PMJAY Scheme?
No registration or application form is required and the eligible individuals will get a letter. The transport allowances are also provided to the beneficiaries of the scheme.
Enrollment Procedure of PMJAY
There is no procedure of enrollment but on the basis of the SECC 2011, the beneficiaries are picked. To know whether you fall under the eligibility criteria for the scheme, you need to follow the steps given below:
- You need to visit the official website for the PMJAY scheme and select “Am I Eligible” option.
- Enter your required contact details to generate OTP.
- Then select your state.
- Search by entering your name, contact number, HHD number, or your ration card number.
- You will know your eligibility for the scheme after the result is displayed.
Documents needed for applying for Ayushman Bharat Yojana Scheme
- Age and identity proof (PAN/AADHAR card).
- Required details like your contact number, email id, and home address.
- Caste certificate.
- Certificate of Income.
- Family’s current status stating your documents.
Online Application of Ayushman Bharat Yojana?
To avail the Ayushman Bharat benefits, you will have to apply for the scheme through online mode. The following steps mention the procedure to apply online:
- You need to visit the official website of PMJAY and select “Am I eligible” option, to check your eligibility.
- Then enter your required contact details to generate OTP.
- Choose your state and continue to search by name, phone number, HHD code, or ration card number.
- You can now view whether you fall under the eligibility of the healthcare scheme.
Download procedure of Ayushman Bharat Yojana Card
The beneficiaries can avail the Ayushman Bharat Yojana Golden Card to ensure portable transactions through the PMJAY scheme. The Ayushman Bharat card download can be done by following the steps mentioned below:
- You need to visit the official PMJAY website and login using the registered contact number.
- Your OTP will be generated after entering the “Captcha code”.
- Choose HHD code option.
- Then enter the HHD code in the (CSC) Common Service Centre.
- The Ayushman Mitra will proceed to complete the process.
- To download the Ayushman Bharat card, you will need to pay Rs. 30.
How can I check my name in PMJAY List 2020?
The PMJAY 2020 list can be checked through different methods:
- Common Service Centre
- Helpline numbers
Individuals and families can avail about 25 specialities include:
Ayushman Bharat Scheme’s Hospitalization Process (PMJAY)
The hospitalization process is cashless and the centre and state do cost-sharing in a 60:40 ratio. One of the main benefits of the Ayushman card as per the scheme is that beneficiaries can get cashless hospitalization and further treatment. With the help of the golden card, beneficiaries can make use of benefits at any empanelled hospitals be it private or public.
PMJAY Hospital List
To find the PMJAY hospital list, you need to follow the steps mentioned below:
- You need to visit the PMJAY official website.
- Then enter your state along with district.
- Choose either private or public hospital as per your preference.
- Select the required medical speciality.
- After giving the “Captcha code”, click on search.
A new webpage will appear with the PMJAY Hospital list along with their address, contact details, and website. List of Suspended Hospitals can also be browsed by using the same link given.
Address and Toll-free Number of PMJAY
Address of PMJAY: National Health Authority of India
3rd, 7th, and 9th Floor,
Tower-L, Connaught Place, New-Delhi- 110001(Landmark-Jeevan Bharati Building).
Toll-free number of PMJAY is 14555/1800-1110565.