What is The Ayushman Bharat Yojana or PMJAY Scheme?

PMJAY is also known as the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Scheme, one of the biggest healthcare schemes that are sponsored by the Government of India. Prime Minister, Narendra Modi rolled out the Pradhan Mantri Jan Arogya Yojana healthcare scheme with an aim to cover more than 50 crore Indian citizens and nearly 10 Crore underprivileged families without any limitations pertaining to family size and age. Ayushman Bharat Yojana (PMJAY) will help these households avail the best healthcare services with insurance coverage of up to INR 5 lakh for each family per year for tertiary and secondary hospitalization expenses.PM Ayushman Bharat Yojana scheme is paperless and offers cashless hospitalization cover at public hospitals and network private hospitals. Ayushman Bharat health insurance covers the cost of hospitalization, pre-hospitalization, medication, and post-hospitalization expenses incurred during the treatment, which is applicable to almost all tertiary and secondary care procedures.

Moreover, the Ayushman Bharat Yojana scheme includes nearly 1,400 exorbitant treatments like skull surgery, knee replacements, and the likewise. And the patients can also follow up for the treatments to ensure a full recovery. Read all about (PMJAY) Ayushman Bharat Yojana scheme features, eligibility criteria & application process mentioned below.

Features of PMJAY: Ayushman Bharat Yojana Scheme

 In addition, to be a lifesaver scheme for lower middle income the other key features of Pradhan Mantri Ayushman Bharat Yojana (PMJAY) are as follows:

• Ayushman Bharat Yojana scheme is a family floater scheme with a sum assured of Rs. 5 lakh per family enrolled
• This scheme is specially designed for people below the poverty line who do have access to internet or online health plans
• PMJAY scheme facilitates cashless healthcare services to its beneficiary in any of the public sector hospitals and private network hospital
• Moreover, Pradhan Mantri Ayushman Bharat Yojana also recompenses the transportation cost incurred by the beneficiary during the pre and post-hospitalization period
• Along with medical treatment expenses, the Ayushman Bharat Yojana insurance package also covers the day-care expenses incurred by the beneficiarybeneficiary
• PMJAY scheme also covers some of the specific pre-existing diseases
• The payment for medical expenses is to be made based on the package rate as pre-determined by the government
• Under the government-backed scheme, a considerate number of health and wellness centres will be established as per the Socio-Economic Caste Census data
• Benefits of Ayushman Bharat Yojana SchemeScheme

• Ayushman Bharat Yojana scheme insures almost 40% of the vulnerable and needy families in India. The healthcare services and benefits that they can avail themselves are listed below:

  • The treatment and healthcare facilities under PMJAY are available across India and are free of cost
  • The Ayushman Bharat Scheme offers 25 speciality categories and it covers a wide range of 1,354 medical and surgical packages such as neurosurgery, cardiology, etc.
  • Ayushman Bharat Yojana scheme also covers post-hospitalization expenses
  • In case of multiple surgeries, the cost shall be covered with the highest package. And for second and third surgery it should be covered 50% and 25% respectively
  • The scheme also covers the treatment cost of oncology with chemotherapy for 50 different types of Cancer. However, both medical and surgical packages cannot be availed at the same time.
  • The beneficiaries under the PMJAY scheme can also avail of follow-up treatment coverage

  • What is Covered under Ayushman Bharat Yojana Scheme?

  • PMJAY covers the following expenses during the treatment:

    • Ayushman Bharat Yojana Scheme provides coverage for medical examination, treatment and consultation fee
    • Pre-hospitalization expenses are covered under the Ayushman Bharat Yojana policy
    • Post-hospitalization expenses are covered for 15 days
    • The policy also covers the cost of medicine and medical consumables
    • Hospital accommodation charges are also covered
    • Non-intensive and ICU services
    • The expenses incurred on the Diagnostic procedures are also covered
    • Medical implantation services are covered where required
    • Expenses incurred on complications arising during the medical treatment
    • Food services

    • Who is not entitled to avail coverage under the Ayushman Bharat Yojana?

       

      The following categories of entities are not covered under the Ayushman Bharat Yojana:

      • People who own a vehicle like a two-wheeler, three-wheeler, or a car
      • Government employees
      • People whose monthly income is more than Rs 10,000
      • Those who have farming machinery and types of equipment
      • Those who live in properly build houses
      • Those who hold a Kisan card
      • Those owing a motorized fishing boat
      • Those owing an agricultural land of more than 5 acres
      • People employed in government-run non-agricultural enterprises
      • People who have refrigerators and landline phones in their houses

      • PMJAY Scheme: Eligibility Criteria for Rural

        • Household with no adult/male/ earning member within the age group of 16-59 years
        • Families living in one room with Kuccha Kuccha walls and roof
        • Families with no members within the age group of 16-59 years
        • A household without a healthy adult member and one disabled member
        • Manual scavenger families
        • Landless households earn a major part of their family income from manual labour

        PMJAY Scheme: Eligibility Criteria for Urban

        • Domestic worker
        • Beggar
        • Ragpicker
        • Home-based Artisans/ Tailor Sweeper/ Handicrafts worker/ Sanitation worker/ Mali
        • Construction worker/ Labour/ Painter/ Welder/ Security guard/ Coolie
        • Washer-man/ Plumber/ Mason
        • Electrician/ Mechanic/ Assembler/ Repair worker
        • Transport worker/ Rickshaw puller/ Conductor/ Cart puller/
        • Waiter/Shop worker/ Assistant/ Peon/Delivery assistant
        • Street vendors/ hawker / Cobbler

        How to Register for PMJAY Scheme Online?

         

        It is quite simple to register for the PMJAY scheme. It is applicable to all beneficiaries who are identified under the SECC 2011 list and those who are a part of the RSBY scheme. However, if you want to register for PMJAY online, you can follow the steps given below:

      • • Visit the official government website for the PMJAY scheme
        • You will find Am I Eligible tab, simply click on it
        • Submit your mobile number, CAPTCHA code, and click on Generate OTP button
        • Now enter your State and your name, ration card number, household number, or mobile number
        • If your family is covered under Ayushman Bharat Yojana, then your name will be displayed in the results

        Documents Required to Apply For Ayushman Bharat Yojana Scheme

         

        • Age & Identity Proof (Aadhaar Card/PAN Card)
        • Contact details (mobile, address, email)
        • Caste certificate
        • Income certificate (maximum annual income to be only up to Rs. 5 lakh a year)
        • Document proof of the current status of the family to be covered (Joint or nuclear)

        How to Check your Name in Ayushman Bharat Yojana Scheme List?

         

        There are various methods to check your name in the PM Jan Arogya Yojana -PMJAY beneficiary list. Listed below are some of the ways that you can try:

        • Online Method- Ayushman Bharat online list can be checked by the beneficiaries. All you need to do is visit the official online site of the National Health Authority for Ayushman Bharat Yojana.
        • Common Service Centres (CSC)- If you are a beneficiary of Ayushman Yojna you can also visit the nearest Common Service Centres. If it is not possible to do so you can also visit any of the empanelled hospitals to collect the information form. You can check the Ayushman Bharat hospital list on their site or in your policy documents.
        • Contact their Helpline No.- You can call on any of the government of India provided helpline numbers (e.g. 1800111565) to contact their customer care and seek the information about PMJAY Scheme, Ayushman card/e-card, Ayushman card apply, Ayushman card download and even Ayushman Bharat Scheme registration.

        If your name is there on the list, then only you will get the Ayushman Bharat Card.

        List of Critical Diseases covered under PM Jan Arogya Yojana (PMJAY)

         

        • PMJAY offers nearly 1,350 medical packages at any of the private network hospitals and all the public hospitals. Below are some of the critical illnesses that Ayushman Yojna covers:
        • Carotid angioplasty with stent
        • Prostate cancer
        • Coronary artery bypass grafting
        • Skull base surgery
        • Pulmonary valve surgery
        • Double valve replacement surgery
        • Anterior spine fixation
        • Tissue expander for disfigurement following burns

        How to Download your Ayushman Bharat Yojana Card Online?

         

        It is important to apply for the Ayushman card as it consists of a dedicated family identification number. AB-NHPM is provided to every beneficiary household. Below are the steps that you can follow to apply for or download your Ayushman card online-

        • Firstly, visit Ayushman Bharat Yojana’s official website
        • Now login with your email id and generate a password
        • Enter your Aadhaar number to proceed further
        • Click on the approved beneficiary option
        • It will be redirected to their help centre
        • Now enter your password in CSC and the pin number
        • It will be redirected to the home page
        • You will see the download option form where you can download your Ayushman Bharat golden card

        • PMJAY Patient Card Generation

           

          You can apply for an e-card once you find out your eligibility for the Ayushman Bharat Yojana scheme. But before you get this e-card, you will have to go through an identity verification at one of the PMJAY kiosks based on your documents like an Aadhaar card or ration card. Even your family identification can be furnished including the RSBY cars or a govt. certified list of members. After this verification is done, your patient e-card is printed along with your Ayushman Bharat ID, which can be used for future references.

        • COVID-19 Treatment Covered under Ayushman Bharat Yojana Scheme (PM-JAY)

           

          As per the IRDAI’s regulation, all the health insurance providers are covering COVID-19 hospitalization expenses. Even the Government-backed Ayushman Bharat scheme also offers coverage against the Global pandemic COVID-19. The beneficiary can avail of medical test facilities at any of the panel hospitals without any money being charged as per the NHA’s announcement. Ayushman Bharat scheme also covers the isolation and quarantine expenses.

          All the empanelled hospitals under this policy are well-equipped to carry out Coronavirus testing, treatment, and quarantine facilities. It is a great initiative to offer protection to the poor and needy families against the impact of the deadly COVID-19.

          As this policy is for people below the poverty line, those in the higher income groups who can pay premiums on their own should also get adequate health cover. Considering the ongoing medical inflation, a health cover of a minimum of Rs. 10 lakhs is recommended that can go up to of Rs. 1 Crore & more as per your requirement. This is required to avail the best possible treatment for emergency medical treatment including life-threatening diseases like cancer, organ transplant, heart surgeries, etc.