Ayushman Bharat Yojana – PMJAY Eligibility Online at pmjay.gov.in

Ayushman Bharat Yojana, which is also called the Pradhan Mantri Jan Arogya Yojana (PMJAY) is a program that seeks to benefit the economically weaker segment of society that require health facilities.

The PMJAY scheme was launched into effect by the PM on 23rd on the 23rd of September, 2018. The health insurance scheme is aimed at approximately fifty crore people in India. Ayushman card has a long list of positive stories to its credit.

About PMJAY (Ayushman Bharat Yojana)

In India one of the largest health insurance programs started by Central Government is know as Ayushman Bharat Yojana is aiming to provide coverage to more than 50 million Indian citizens, primarily those who are economically less fortunate.

It was introduced in September 2018 from the Government of India. PMJAY offers health insurance plans that have a maximum insurance sum of. 5 lakh.

The health insurance plan of the government will cover the majority of medical costs including diagnostics, medicines as well as pre-hospitalisation expenses.

In addition, it provides hospitals that are cashless with the health card Ayushman, that can be used at any hospital with an empanelled facility throughout the nation. Patients can seek hospitalisation for needed treatment by showing their PMJAY electronic card.

The Ayushman Bharat Yojana National Health Protection Scheme has changed its name to Pradhan Mantri Jan Arogya Yojana.

This scheme aims to transform secondary and tertiary health care totally cashless for the poor part of society. The beneficiaries of the PM Jana Arogya Yojana are issued an Ayushman Card to use the services of an empanelled hospital either private or public across the country.

Through the PMJAY scheme you will be able to enjoy the benefits of going to the hospital and getting the treatment you need without having to pay.

Ayushman Bharat scheme and card (PMJAY): Overview

Features	Details
Name of the Scheme	Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) or Ayushman Bharat National Health Protection Scheme (NHPS)
Launch date for PMJAY	September 23, 2018
Coverage (per family)	Rs. 5 lakh/year
Procedures covered	1,400 procedures
Pre-hospitalisation expenses coverage	Up to 3 days
Post-hospitalisation expenses coverage	Up to 15 days
Website	https://www.pmjay.gov.in/
Helpline Numbers	1800-111-565 or 14555
Email Id	ayushmanbharat.csc@gmail.com

PMJAY Health Cover: Eligibility Criteria for Rural and Urban Residents

The PMJAY scheme is designed to impart healthcare to 10 crore families. They are mostly most disadvantaged and those with a low middle incomes. It is the healthcare insurance scheme that covers an amount of Rs. 5 lakh for each family.

The ten crore families include eight crore families from rural areas, and 2.33 crore families in urban areas. Split into smaller units it means that the plan will be aiming at 50 crore beneficiaries.

To be eligible to apply for Ayushman Bharat Yojana, applicants must fall under one of the categories listed: SC/ST, Lower Income Group or EWS. You can check the eligibility of your Ayushman card by using the ‘Am I eligible feature available at the website of Ayushman Bharat Yojana’s official site.

But, the program has certain conditions under which it selects those who are eligible to avail of the health coverage benefits. In rural areas, this list is mainly based on the lack of housing, low income, and other adversities.

PMJAY Rural

The 71st round of National Sample Survey Organisation reveals that 85.9 percent of rural households don’t have access to any health guarantee or insurance.Furthermore 24 percent of rural households access healthcare services through borrowing cash.

Ayushman Bharat Yojana aims to benefit the rural poor by providing each year a sum of the amount of Rs. 5 lakh for each family. The scheme will help economically marginalized families according to data in the Socio-Economic Classe Census of 2011.

In addition, households that are who are enrolled in the Rashtriya Swasthya Bima Yojana (RSBY) will fall under the aegis of the Prime Minister Jan Arogya Yojana.

In the rural areas, the PMJAY health cover is available to:

• People who live in scheduled castes or scheduled tribe households
• Beggars and those who rely on alms
• Families without any members aged from 16 to 59
• Families that have at minimum one member physically challenged with no adult who is physically challenged
• Landless families who earn money by working as temporary manual laborers
• Primitive tribal communities
• Legally released bond workers
• Families living in tiny houses without walls or roof
• Manual scavenger families

PMJAY Urban

As per the National Sample Survey Organisation (71st round) 82 percent of households in urban areas don’t possess health insurance. Furthermore 18 percent of Indians living in urban areas have paid for health expenses by taking out loans in one way or the other.

Pradhan Mantri Jan Arogya Yojana assists these families to avail healthcare services by granting funds that can reach up to the amount of Rs. 5 lakh for each family per year.

PMJAY will benefit urban residents families that belong to the job category identified in the Socio-Economic Census of 2011. Additionally, any family that is that is enrolled in the Rashtriya Swasthya Bima Yojana program will benefit of the Prime Minister’s Jan Arogya Yojana.

In the urban areas, those who can avail of the government-sponsored scheme consist mainly of:

• Watchmen/washerman
• Rag pickers
• Repair workers
• Domestic benefit
• Sanitation workers, gardeners, sweepers
• Handicraft workers or tailors
• Cobblers, hawkers and other types of services are available on roads or pavements
• Plumbers masons builders, port workers welding, painters and security guards
• Transport workers, such as conductors, drivers, helpers carts or rickshaw pullers
• Assistants, peons and assistants in smaller establishments, delivery men shopkeepers, waiters and assistants

Health care providers who do not have the right to provide protection in the Pradhan Mantri Jan Arogya Yojana

• Anyone who owns one of the three, two or four-wheeler as well as an electric fishing boat
• People who own mechanised farming equipment
• People who own Kisan cards that have an amount of credit that is Rs. 50000
• The employees of the government
• People who work for non-agricultural businesses managed by the government
• Earners who earn a monthly income that is greater than the amount of Rs. 10000
• Landlines and refrigerators owned by those who have landlines and refrigerators.
• People who have decent, well constructed homes
• Landowners who own at least 5 acres land for agriculture

Covered under Ayushman Bharat Yojana Scheme or PMJAY

To provide affordable healthcare for the economically challenged Ayushman Bharati Yojana Scheme, which includes the AB-PMJAY and the Ayushman card that provide an extensive coverage of up to the amount of Rs.5 lakh for a family (per year) for hospitalisations of secondary and tertiary healthcare.

Health insurance under AB-PMJAY comprises a range of elements that include the medical exam, consult and treatments, pre-hospitalisation including intensive and non-intensive care, medications and consumables such as diagnostic and laboratory tests, lodging and medical implants when needed and treatments-related complications, food services and post-hospitalisation costs for as long as 15 days.

Not covered under Ayushman Bharat Yojana Scheme or PMJAY

Like the other insurance plans for health, Ayushman Bharat Yojana Scheme includes exclusions. The following components aren’t included in the scheme:

• Out-Patient Department (OPD) expenses
• Drug rehabilitation
• Cosmetic surgeries
• Fertility treatments
• Individual diagnostics
• Organ transplant

How to check Ayushman Bharat Yojana eligibility online

Here’s a step-by-step for the guide on how to check your eligibility for the Ayushman Bharat Yojana online:

Step 1: Visit the Official Website

• Go to the official Ayushman Bharat Yojana website at https://pmjay.gov.in.

Step 2: Navigate to the Eligibility Check

• On the homepage, look for the “Am I Eligible” option.

Step 3: Enter Your Details

• You will be prompted to enter your mobile number and captcha code.
• After entering these details, click on the “Generate OTP” button to receive a One-Time Password (OTP) on your registered mobile number.

Step 4: Verify OTP

• Enter the OTP you received on your mobile phone into the provided field.
• Click on the “Submit” button to proceed.

Step 5: Search by Criteria

• Once the OTP is verified, you will be directed to a new page where you can search for your eligibility using one of the following criteria:
  • Mobile Number: Enter the mobile number linked to your ration card or other government records.
  • Ration Card Number: Enter your ration card number.
  • SECC Name: Search using your name as per the Socio-Economic Caste Census (SECC) data.

Step 6: View Eligibility Status

• After entering the required information, click on the “Search” button.
• If you are eligible, your details will be displayed on the screen, including your family members who are also eligible for the scheme.

Step 7: Download or Print Eligibility Details

• If you find that you are eligible, you can download or print the eligibility details for future reference.

Step 8: Contact for Assistance

• If you encounter any issues or need further assistance, you can contact the Ayushman Bharat Yojana helpline at 14555 or visit the nearest Common Service Center (CSC) for help.

By following these steps, you can easily check your eligibility for the Ayushman Bharat Yojana online.

Ayushman Bharat Scheme (PMJAY): Medical Packages and Hospitalization Process Explained

Individuals in specific and families, in general, can benefit from the Rs. 5 lakh insurance cover provided by the Pradhan Mantri Jan Arogya scheme. This lump sum is enough to cover the medical and surgical treatments in 25 specialities: cardiology, neurosurgery, oncology, paediatrics, orthopaedics, etc. However, medical and surgical expenses cannot be reimbursed simultaneously.

If multiple surgeries are necessary, the highest package cost is paid for in the first instance, followed by a 50% waiver for the second and a 25% discount for the third. Unlike other health insurance schemes, there is no waiting period for pre-existing diseases under the PMJAY scheme, which comes under the larger umbrella scheme of Ayushman Bharat Yojana. Should any beneficiary or anyone in their family require hospitalisation, they need not pay anything, provided they are admitted in any empanelled government or private hospital.

The cashless treatment and hospitalisation are possible due to a 60:40 cost-sharing agreement between the centre and states. Once identified as a genuine beneficiary, you or your family member will be issued a health card by specially trained Ayushman Mitras. They manage kiosks in hospitals for those unaware of the PMJAY scheme.

PMJAY Illness Coverage: Know the Diseases Covered Under PM Jan Arogya Yojana

PMJAY aids families to access secondary and tertiary healthcare through a grant of up to the amount of Rs. 5 lakh for each family per year. This aid is applicable to child care procedures, and is even applicable to existing conditions. PMJAY provides coverage for more than 1,350 medical services at accredited private and public hospitals.

Some of the illnesses under critical health insurance are as follows:

• Prostate cancer
• Coronary artery bypass grafting
• Double valve replacement
• Carotid angioplasty with stent
• Pulmonary valve replacement
• Skull base surgery
• Laryngopharyngectomy with gastric pull-up
• Anterior spine fixation
• Tissue expander for disfigurement following burns

Benefits of Ayushman Bharat Yojana (PMJAY)

Here are the benefits of Ayushman Bharat Yojana (PMJAY) listed out:

1. Free Healthcare Services: Provides free treatment at empaneled public and private hospitals for eligible families.
2. Extensive Coverage: Offers health coverage up to ₹5 lakh per family per year, covering both secondary and tertiary care.
3. Wide Network of Hospitals: Access to over 23,000 empaneled hospitals across India, ensuring widespread availability of medical services.
4. Cashless and Paperless: The scheme is entirely cashless and paperless, simplifying the process for beneficiaries.
5. Comprehensive Medical Services: Covers a broad range of medical treatments, including surgeries, medications, and diagnostics.
6. Covers Pre-existing Conditions: All pre-existing conditions are covered from the first day of enrollment, ensuring no exclusions for prior health issues.
7. Transportation Allowance: Provides financial assistance for transportation costs during hospitalization, easing the burden on families.
8. No Age or Gender Restrictions: The scheme is available to all eligible families regardless of age, gender, or family size.
9. Portable Across India: Beneficiaries can avail of healthcare services at any empaneled hospital across the country, ensuring flexibility.
10. Focus on Rural and Urban Poor: Targets economically vulnerable families in both rural and urban areas, making healthcare accessible to those in need.

These benefits make PMJAY a crucial initiative for providing essential healthcare services to millions of underprivileged families in India.

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