Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) scheme
PM-JAY is one of the world's largest healthcare schemes, aiming to provide health insurance coverage to over 50 crore economically weaker citizens of India.
It was launched in September 2018 and provides health insurance plans with a maximum sum insured of Rs. 5 lakh per family per year.
The scheme covers costs related to medical treatment, medications, diagnostics, and pre-hospitalization expenses.
Beneficiaries get an Ayushman card that allows them to access cashless hospitalization services at any empanelled public or private hospital across India.
PM-JAY aims to make secondary and tertiary healthcare completely cashless and accessible for underprivileged sections of society.
The key benefit is that beneficiaries can simply walk into any empanelled hospital and obtain cashless treatment by presenting their Ayushman card.
So in essence, PM-JAY is a ambitious government-backed health assurance scheme designed to protect poor and vulnerable Indians from high out-of-pocket medical expenses and provide them access to quality healthcare services.
key details about the Ayushman Bharat PM-JAY scheme :
It provides an annual health insurance coverage of Rs. 5 lakh per family to help the economically disadvantaged access healthcare services.
The scheme covers 1,400 treatment procedures across secondary and tertiary care.
It covers pre-hospitalization expenses up to 3 days prior and post-hospitalization expenses up to 15 days after discharge.
The official website is pmjay.gov.in where one can find more information.
Helpline numbers 1800-111-565 and 14555 are available for any queries.
The email id ayushmanbharat.csc@gmail.com can also be used for correspondence.
This comprehensive overview lays out the main features, coverage details, and contact points for the PM-JAY scheme aimed at providing affordable healthcare access to India's underprivileged population. The annual Rs. 5 lakh coverage per family for nearly 1,400 procedures is a significant benefit under this flagship health assurance program.
PM-JAY scheme in rural and urban areas:
Rural Eligibility:
The scheme targets 8 crore economically disadvantaged rural families identified from the Socio-Economic Caste Census 2011 data.
Covers households from scheduled castes/tribes, landless labourers, those without able-bodied adults, primitive tribal groups, legally released bonded labourers, families in makeshift single-room houses, manual scavengers, etc.
Also covers families previously enrolled under Rashtriya Swasthya Bima Yojana (RSBY).
Urban Eligibility:
Targets 2.33 crore urban poor/lower income families based on occupational categories from the Socio-Economic Caste Census.
Covers workers like rag pickers, mechanics, electricians, domestic helps, sanitation workers, home-based artisans, cobblers, hawkers, construction workers, transport workers, helpers in small establishments etc.
Also includes families earlier covered under RSBY.
Exclusions:
Those owning vehicles, mechanized farm equipment, decent pucca houses, over 5 acres of land.
Government employees, those with over Rs 10,000 monthly income.
The scheme aims to financially protect around 10 crore underprivileged families (50 crore beneficiaries) who often have to borrow or sell assets for medical treatment. Potential beneficiaries can check their eligibility on the PM-JAY website.
Overall, the criteria focuses on identifying families without healthcare access based on socio-economic, occupational and housing deprivation parameters.
Ayushman Bharat PM-JAY scheme steps to check eligibility online :
What is covered:
Up to Rs. 5 lakh annual coverage per family for secondary and tertiary hospitalization
Medical examination, consultation, treatment
Pre and post hospitalization expenses (up to 3 days before and 15 days after)
Intensive care, medications, diagnostics, implants
Hospital accommodation, food services, treatment complications
What is not covered:
Out-patient department (OPD) expenses
Drug rehabilitation
Cosmetic surgeries
Fertility treatments
Individual diagnostics tests (without hospitalization)
Organ transplants
Eligibility Check Process:
Visit pmjay.gov.in
Go to "Am I Eligible?" section
Enter mobile number, generate OTP
Verify OTP
Provide name, state, age, family, income details
Submit to check if eligible
This comprehensive coverage for nearly 1400 procedures and packages aims to prevent catastrophic out-of-pocket expenditure for the underprivileged. The online eligibility process seems simple and straightforward.
0 Comments