Healthcare and health insurance are an indisputable necessity for every Indian family. Considering the astronomical costs of healthcare and rising inflation, it is essential to have a health insurance cover for yourself and your family to counter health risks.
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Healthcare for the vulnerable sections of Indian society
It is a well-known fact that a significant portion of India’s population lives below the poverty line. More than 365 million Indian citizens are living in poverty as of now. Although there has been a huge improvement in this area in the past decade, a lot still remains to be done. One of the efforts of the government towards this end is the Ayushman Bharat Yojana or the PMJAY, which works towards healthcare for the poor.
What is the PMJAY scheme?
Launched in 2018, the Pradhan Mantri Jan Arogya Yojana or Ayushman Bharat Yojana aims to make healthcare accessible and affordable to around 50 crore individuals who are part of the more economically marginalized sections of Indian society.
It does this in the form of an e-card that provides cashless treatment. It provides a cover of Rs.5 Lakhs per year to each registered family. The number of e-cards issued as of September 2019 was more than 10 crores.
Where can one find the list of hospitals under PMJAY?
Since the implementation of the Ayushman Bharat Yojana scheme, a whopping number of hospitals have been empaneled. Current estimates say that over 15,000 hospitals are currently part of this scheme. 50% of the empaneled hospitals are estimated to be private hospitals.
The complete list of hospitals can be found on the government’s official PMJAY website. Here’s how you can find a hospital in your jurisdiction.
Step 1: Visit the following link https://hospitals.pmjay.gov.in/Search/empnlWorkFlow.htm?actionFlag=ViewRegisteredHosptlsNew
Step 2: Select your state and your district
Step 3: Select the type of hospital you’re looking for (public, private and for profit, private and not for profit)
Step 4: Select the medical specialty you need. For example, general, pediatric, neurosurgery, cancer, gynecology, etc.
Step 5: A captcha will appear. Type it in the box below.
Step 6: Click on search.
You can also download the list of de-empanelled hospitals under the PMJAY scheme by clicking on the link below:
What is covered under PMJAY scheme?
- Pre-hospitalization (3 days) and post-hospitalization (15 days)
- Around 1400 procedures
- OT expenses and other related expenses
- Surgical and medical treatment cannot be simultaneously reimbursed
Critical diseases covered under the scheme
- Coronary artery bypass grafting
- Prostate cancer
- Carotid angioplasty
- Skull base surgery
- Double valve replacement
- Pulmonary valve replacement
- Anterior spine fixation
- Laryngopharyngectomy (gastric pull-up)
- Tissue expander (related to disfigurement caused by burns)
Exclusions under the scheme
- Drug rehabilitation
- Fertility related procedures
- Cosmetic related procedures
- Individual diagnostics (evaluation)
- Organ transplants
What is required for Ayushman Bharat registration?
There isn’t a special procedure for Ayushman Bharat registration. You just need to check your eligibility and produce these relevant documents for obtaining an e-card.
- Caste Certificate
- Special Category Certificates
- Age proof
- Contact Information
- Id Proof
- Scanned Copy of Aadhar
- Income Certificate
How to obtain an e-card?
You need to get your documents verified at a PMJAY kiosk. Once verified, you will be issued a PMJAY card.
How to check eligibility for PMJAY scheme?
- Visit the official PMJAY website and click ‘Am I eligible’
- Fill in your contact number
- Enter the captcha and click on ‘generate OTP’
- Select your state
- Enter your name/ ration card number/ HHD number/ mobile number
- Check search results to know if you and your family are eligible
You can also visit an Empaneled Health Care Provider (EHCP) or call 14555 or 1800-111-565.
Who is covered under PMJAY Rural?
- Scheduled tribe and scheduled caste families
- Families without a male member between 16 to 59 years of age
- Homeless individuals
- Families without any members between 16 and 59 years of age
- Families with at least one person who is physically challenged, and without any able-bodied adults
- Landless families who are casual manual laborers
- Tribal communities that are primitive
- Bonded laborers
- Families who live in makeshift one-room houses without proper walls or roofs
- Manual scavengers and their families
Who is covered under PMJAY Urban?
- Washerman /chowkidars
- Rag pickers
- Mechanics, repair workers, electricians
- Domestic help
- Gardeners, sweepers, sanitation workers,
- Artisans based out of home, tailors, handicraft workers
- Drivers, helpers, conductors, rickshaw or cart pullers
- Construction workers, plumbers, welders, masons, painters, porters, security guards
- Hawkers, cobblers, and others who provide services on streets or pavements
- Assistants, shopkeepers, peons working in small establishments, waiters, delivery boys
If you are a working-class individual, you would not be eligible for the PMJAY scheme. However, a health insurance policy would still be a necessity. An option you should definitely check out is Health Insurance, available on Finserv MARKETS. You can easily apply for n Health Insurance on Finserv MARKETS’ Health Insurance App. It comes with a solid customer base of 100+ million across the length and breadth of India, so you can rest assured that the health and wellbeing of you and your loved ones is in sound hands. You can also take advantage of a sum insured of up to Rs. 50 lakhs at nominal premiums, reinstatement benefits and a vast network of 6500+ hospitals in every pocket of India. Download our health insurance app to buy the best medical policies with extensive coverage at affordable premiums.
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