Ayushman Bharat Yojana Scheme | Pradhan Mantri Jan Arogya Yojana (PM-JAY) – Prime Minister Narendra Modi introduced Ayushman Bharat Yojana, or “Healthy India,” as part of the National Health Policy 2017 in order to accomplish the aim of Universal Health Coverage (UHC). This effort has been created to meet the SDGs and their overarching aim to “leave no one behind.”
Ayushman Bharat is an attempt of a transition from a commercial and divided strategy to a broad, need-based health care system. At the primary, secondary, and higher levels, Ayushman Bharat aims to implement ground-breaking programs to effectively address health (covering prevention, promotion, and ambulatory care).
Brief Info about Ayushman Bharat Yojana
|Scheme Name||Ayushman Bharat Yojana (PM-JAY)|
|Introduced By||Prime Minister Shri Narender Modi|
|Scheme Department||Ministry of Health and Family Welfare|
|Launch Date||September 2018|
|Eligible Person/Family||Poor Households of the Nation|
|Insurance Cover||Rs. 5 Lakh|
Ayushman Bharat Scheme uses a continuum of care method that consists of two interconnected components:
- Establishing a Health and Wellness Program
- Pradhan Mantri Jan Arogya Yojana (PM-JAY)
According to the latest Socio-Economic Caste Census (SECC) data, the Jan Arogya Yojana (PM-JAY) would give financial security (Swasthya Suraksha) to 10.74 crore impoverished, underprivileged rural households and designated occupational categories of urban workers’ families (approx. 50 crore beneficiaries). It will provide a benefit cover of Rs. 500,000 per year per family (on a family floater basis).
PM-JAY will cover nearly all secondary care and most tertiary care treatments, as well as medical and hospitalization costs. PM-JAY has created 1,350 medical packages that include surgery, medical, and day-care treatments, as well as medications, diagnostics, and transportation.
There will be no restriction on family size or age in the Mission to guarantee that no one is left out (particularly girls, women, children, and the elderly). The plan will
Benefits of Ayushman Bharat Yojana Scheme
The majority of government-sponsored medical insurance plans only cover up to Rs 3 lakh. However, the Ayushman Bharat Yojana (PM-JAY) provides users with coverage of up to Rs 5 lakh as well as cashless medical treatment in both public and private hospitals in India. This sum insured is available to every family in India who meets the Ayushman Bharat Yojana qualifying criteria for defined secondary and tertiary medical problems.
- Medical evaluation, treatment, and consultation
- Every year, the beneficiary family is eligible for a cover of up to Rs.5 lakh.
- Primary, secondary, and tertiary healthcare services can all be obtained through the plan.
- The scheme’s benefits are available at any government or privately accredited hospital.
- Based on the Socio-Economic Caste Census (SECC) 2011 data, beneficiaries were targeted towards impoverished, underprivileged rural families and selected occupational category of urban workers’ families.
- Payments will be made via the package model. The package will be defined by the responsible government in terms of total cost payment, specific services, and procedures.
- For effective cooperation between the central and state governments, an Ayushman Bharat National Health Protection Mission would be developed.
- About 40% of the population is covered by the scheme.
- During the hospitalization, the beneficiary’s out-of-pocket expenses will also be reimbursed.
- The costs incurred prior to and after hospitalization will be compensated.
- The insurance allows for cashless hospitalization.
- The scheme covers the costs of daycare therapy.
- All pre-existing medical issues are covered under the insurance plan. Medical examinations are also covered for up to 15 days to confirm that the patients have fully healed.
Eligibility for Ayushman Bharat Yojana
While the Ayushman Bharat scheme promises to help over ten crore households, totaling over 50 crore people, there are differing eligibility criteria for urban and rural residents. Ayushman Bharat Yojana eligibility criteria for Urban and Rural Residents as following:
Ayushman Bharat Yojana Eligibility in Rural Areas
The key challenge for rural healthcare institutions is accessibility, which is becoming increasingly difficult as the cost of medical care rises. People frequently slip into debt traps in order to pay off large medical expenditures. In rural locations, the PMJAY is offered to the following sorts of people:
- Families having no male members between the ages of 16 and 59.
- Families with no adults between the ages of 16 and 59.
- No able-bodied adult members in a family with a disabled member.
- Households from Scheduled Caste (SC) and Scheduled Tribe (ST) communities.
- Landless families who rely on physical labor for the majority of their income.
- Families sharing a single room with makeshift walls and roofing.
- Working as manual scavengers as a family.
- Families who do not have a home.
- Tribal groups from the past.
- Bonded labor that has been legalized.
- Those who are extremely poor or rely on alms.
Ayushman Bharat Yojana Eligibility in the Urban Area
The Ayushman Bharat scheme will benefit the following categories of people in urban areas, with a 5 lakh insurance cover per household.
- Rag Pickers
- Domestic Workers
- Street vendors, cobblers or hawkers or other individuals providing services on the pavements.
- Construction workers, plumber, Laborer, painters, welders, security guards
- Sweepers and sanitation workers
- Individuals who offer transport services like drivers, conductors, helpers, cart or rickshaw pullers along with head load workers.
- Home-based workers, artisans including tailors and handicraft workers.
- Shopworkers, assistants or peons in small establishments, delivery boys, and waiters.
- Washer-men or Watchman
Critical Illnesses Covered by the PMJAY Program
Over 1300 medical packages are available under this scheme at any of the mentioned private hospitals as well as all government health centres and hospitals. The following are some of the critical illnesses covered by PMJAY:
- Cancer of the prostate
- Stent-assisted carotid angioplasty
- Surgery on the cranium
- Bypass grafting of the coronary arteries
- Fixing the anterior spine
- Pulmonary Valve Replacement
- Double valve replacement surgery
Who is not eligible for the Ayushman Bharat Yojana’s coverage?
The Ayushman Bharat Yojana does not cover the following types of entities:
- People who own a two-wheeler, three-wheeler, or automobile.
- Government workers
- People who earn more than Rs 10,000 each month
- Those who own agricultural machines and equipment
- Those who live in properly build houses
- Those who hold a Kisan card
- Those owing a motorized fishing boat
- Those owing an agriculture land of more than 5 acres
- People employed in government-run non-agricultural enterprises
- People who have refrigerators and landline phones in their houses
Ayushman Bharat Yojana Registration Online| PMJAY Registration
Registration for the PMJAY scheme is simple. It applies to all beneficiaries recognised on the SECC 2011 list as well as those who are enrolled in the RSBY scheme. If you want to register for PMJAY online, you can do so by following the procedures below:
Step 1 – Visit the PMJAY scheme’s official government website.
Step 2 – Simply click on the Am I Eligible tab to get started.
Step 3 – Enter your mobile number and CAPTCHA code, then press the Generate OTP button.
Step 4 – Now provide your state as well as your name, ration card number, address, or phone number.
Step 5 – If your family is eligible for the Ayushman Bharat Yojana, your name will appear in the results.
Documents Required for Ayushman Bharat Yojana Application
- Age and proof of identity (Aadhaar Card/PAN Card)
- Contact information (mobile, address, email)
- Certificate of Caste
- Certificate of Income (maximum annual income to be only up to Rs. 5 lakh a year)
- Proof of the family’s current situation is required (Joint or nuclear)
How to Download Ayushman Bharat Yojana Card PDF Online
It is critical to apply for an Ayushman card since it has a unique family identification number. Every beneficiary home receives AB-NHPM. The processes to apply for or get your Ayushman card online are outlined below. –
- To begin, go to the official Ayushman Bharat Yojana website and create a password using your email address.
- To continue, enter your Aadhaar number.
- Select the selection for an approved beneficiary.
- It will be forwarded to their support centre.
- Now, in CSC, enter your password and pin number.
- It will be taken to the main page.
- You will be sent to a download page where you may obtain your Ayushman Bharat golden card.
Generation of PMJAY Patient Cards
Once you’ve determined your eligibility for the Ayushman Bharat Yojana, you can apply for an e-card. However, before receiving this e-card, you must undergo identification verification at a PMJAY kiosk using your credentials such as your Aadhaar card or ration card. Even your family identity, such as RSBY automobiles or a government-certified list of members, can be provided. Following this, your patient e-card is printed, along with your Ayushman Bharat ID, which can be used for future reference.
Useful Links for Pradhan Mantri Jan Arogya Yojana (PM-JAY)
|Check Eligibility for PMAJY||Click here|
|Apply Online for Ayushman Bharat Yojana||Click here|
|Official Website||Click here|
|Other Insurance Schemes||Click here|
FAQs for Ayushman Bharat Yojana 2022
What is the Ayushman Bharat Card?
Ans. Those who are eligible to avail PMJAY benefits can apply for an Ayushman Bharat e-card. This card can be used as proof to avail healthcare benefits in the future.
How do I update my Ayushman Bharat Yojana data?
Ans. Beneficiaries can update their information by calling 14555 or 1800-111-565, or by visiting the common service center.
Is the PMJAY scheme offering coverage to farmers?
Ans. PM-JAY programme provides coverage to low-income people in both urban and rural locations.
What should be done if a hospital management refuses to treat a beneficiary insured by the PMJAY scheme?
Ans. In this scenario, the recipient must register a complaint, and the issue will be resolved by the grievance redressal committee within 30 days.
Is there a fee that beneficiaries must pay in order to receive insurance coverage?
Ans. No. Under the AB-NHPM, every eligible beneficiary can get free secondary and tertiary hospital care services at all public and empanelled private hospitals.