Investing in healthcare can have significant and wide-ranging benefits, contributing to the well-being of individuals and the overall development of a society. Our Indian Govt has initiated various schemes, out of which PRADHAN MANTRI JAN AROGYA YOJANA SCHEME is essential for wide-ranging benefits for Indian families.

WHAT IS PRADHAN MANTRI JAN AROGYA YOJANA SCHEME?

Pradhan Mantri Jan Arogya Yojana, a flagship initiative by the Government of India, was launched in alignment with the recommendations of the National Health Policy 2017. This visionary scheme aims to realize Universal Health Coverage (UHC), ensuring that no one is left behind in the journey towards a healthier and more inclusive nation. Ayushman Bharat marks a departure from the traditional, segmented approach to healthcare delivery. Instead, it embraces a comprehensive, need-based healthcare service strategy.

The main aim is to work towards the Sustainable Development Goals (SDGs) by making important changes in healthcare. This includes everything from stopping illnesses to promoting good health. Ayushman Bharat is making big changes in how healthcare is given, starting from basic care all the way to advanced treatments. This is a major move towards a more complete and caring healthcare system.

OBJECTIVE OF THE SCHEME

PMJAY – Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Scheme, is the largest healthcare scheme sponsored by the Government of India. Our Prime Minister Narendra Modi has launched the Pradhan Mantri Arogya Yojana healthcare scheme to help 50 crore Indian citizens & 10 crore underprivileged families without any limitations irrespective of family size. This Ayushman Bharat Yojana (PMJAY) has insurance coverage up to INR 5 lakh for each family per year for all secondary & tertiary hospitalization expenses where the households avail the best healthcare services.

WHAT ARE THE TREATMENT COVERED UNDER PMJAY SCHEME

This Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Scheme covers various benefits such as:
1. Medical examination, treatment, and consultation
2. Pre-hospitalization
3. Medicine and medical consumables
4. Non-intensive and intensive care services
5. Diagnostic and laboratory investigations
6. Medical implantation services (where necessary)
7. Accommodation benefits
8. Food services
9. Complications arising during treatment
10. Post-hospitalization follow-up care up to 15 days

The benefit of INR 5,00,000 is a family floater scheme, where anyone who belongs to the family can avail the treatment, this money can be used by any member of the family, and there’s no limit on how many people is in your family or how old they are. Unlike the earlier RSBY scheme, which had a limit of five members in a family, PM-JAY doesn’t have any restrictions. Also, if someone in your family already has a health issue before joining PM-JAY, they can still get treatment for it right from the first day they join the scheme. This is a change based on what we learned from other similar schemes.

ELIGIBILITY FOR THE PRADHAN MANTRI JAN AROGYA YOJANA

PMJAY health coverage has two main groups:

One for people in rural areas and another for those in urban areas. The goal is to provide healthcare to ten crore families, mainly focusing on poor and lower-middle-income individuals. Each family can get coverage up to Rs. 5 lakh. This includes eight crore families in rural areas and 2.33 crore families in urban areas, totaling 50 crore individual beneficiaries.

To qualify, you must be in specific categories like SC/ST, Lower Income Group, or EWS. You can check if you’re eligible by using the ‘Am I Eligible’ feature on the official website. But, there are certain conditions the scheme considers when deciding who can get the health coverage. In rural areas, it looks at factors such as poor or no proper housing, low income, and facing other hardships under BPL category

HOW TO REGISTER FOR PMJAY SCHEME?
Check Eligibility:
Ensure that you meet the eligibility criteria. Eligibility is often determined based on factors such as socio-economic status, deprivation criteria, and family composition.

Visit the Official Website:
Go to the official website of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. The official website URL may vary, so it’s recommended to check the latest information.

Find “Am I Eligible” Feature:
Look for the “Am I Eligible” or similar feature on the website. This tool helps you determine if you qualify for the scheme.

Online Registration:
If eligible, there might be an online registration portal on the website. Fill in the required details with phone number verification.

Identification Documents:
During the registration process, you may need to provide identification documents such as Aadhaar card, ration card, voter ID, or other relevant documents. If your family is covered under Ayushman Bharat Yojana, then you name will be displayed in the results. DOCUMENTS TO BE HANDY BEFORE APPLYING:
1. Age & Identity Proof (Aadhaar Card/PAN Card)
2. Contact details (mobile, address, email)
3. Caste certificate
4. Income certificate (maximum annual income to be only up to Rs. 5 lakh a year)
5. Document proof the current status of the family to be covered (Joint or nuclear)

HOW TO APPLY FOR PMJAY SCHEME

Online : You can check the official online site of the National Health Authority for Ayushman Bharat Yojana.
Offline : You can visit the nearest Common Service Centers to apply for PMJAY scheme along with registration documents.
Contact : You can connect the India provided helpline numbers – 1800111565 to connect the customer care, seek information on PMJAY scheme.

HOW TO DOWNLOAD PMJAY SCHEME CARD?

To know your dedicated family identification number, it is essential to apply for the Ayushman card. Follow these steps to download your Ayushman card online.

Visit Ayushman Bharat Yojana official website to download your PRADHAN MANTRI JAN AROGYA YOJANA SCHEME CARD. FEATURES OF THE SCHEME

Here are the key features of Pradhan Mantri Jan Arogya Yojana (PMJAY) in detail:

1. Beneficiary coverage: PMJAY aims to provide health insurance coverage of up to Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to over 10.74 crore poor and vulnerable families (approximately 50 crore beneficiaries).
2. Services: The services encompass around 1,929 procedures, covering all expenses associated with treatment. This includes, but is not limited to, costs for medications, supplies, diagnostic services, fees for physicians, room charges, surgeon fees, operating theater (OT), and intensive care unit (ICU) charges.
3. Benefits package: It covers a wide variety of surgeries and therapies including orthopedics, cardiology, cancer treatment, neurosurgery, catastrophic medical expenditure, etc. Pre and post-hospitalization expenses are also covered.
4. Coverage: It takes care of expenses before going to the hospital (up to 3 days) and after leaving the hospital (up to 15 days). This includes costs for tests and medicines.
5. Cashless and paperless access: PMJAY is a completely cashless and paperless scheme. Beneficiaries get a PMJAY e-card that allows them cashless access to healthcare services at any empaneled hospital across India.
6. Hospitals empanelment: Both public and private hospitals can be empaneled under PMJAY based on defined criteria. Over 21,000 public and private hospitals have been empaneled so far.
7. Premiums: No premium is paid by PMJAY beneficiaries. The premium is shared between the central and state governments.
8. Portability: The scheme allows full portability so beneficiaries can access benefits across the country at any empaneled hospital. Aadhaar is used for identification and portability of services.
9. IT infrastructure: PMJAY has created a robust IT infrastructure for rapid transactions between patients, hospitals and insurance companies. This enables a seamless service delivery.

PMJAY provides cashless, paperless health insurance to the poor by empaneling hospitals to deliver quality and affordable care. This is facilitated through a strong IT backbone for identification and transaction smoothness.