Pradhan Mantri Jan Arogya Yojana (PMJAY)

Features of the PMJAY(Ayushman Bharat) Scheme

PMJAY scheme makes quality healthcare accessible to the poorest of poor families in India. Hence, the benefits offered by this health insurance plan are massive. Take a look at these features and benefits offered by the healthcare scheme to every family in need:

PMJAY Card Eligibility Criteria Details

PMJAY registration - A simple and easy process to avail of quality healthcare services.

According to the 71st round of the National Sample Survey Organisation, over 85.9% of people in rural areas do not have access to basic healthcare plans. Moreover, 24% of the rural population seeks healthcare facilities by borrowing money.

This is where the Pradhan Mantri Jan Arogya Yojana scheme comes in handy. It helps these people avoid getting into a debt trap and avail health facilities. This scheme is economically beneficial to underprivileged households. Also, the families enrolled under the Rashtriya Swasthya Bima Yojana (RSBY) will be covered under the PMJAY scheme.

Inclusions & Exclusions Under the Ayushman Bharat Yojana

Here’s a breakdown of the Ayushman card benefits and all that is not covered under the Ayushman Bharat Yojana.  

List of Critical Ailments Covered Under PMJAY Scheme

PMJAY scheme provides funding of ₹5 lakh per family annually. The Pradhan Mantri health insurance benefit can be utilised for daycare procedures and even for pre-existing illnesses. Some of the critical illnesses covered in the PMJAY insurance plan 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

• COVID-19 treatment and testing

Ayushman Bharat Yojana Scheme: Medical Packages and Hospitalisation Process

Individuals, as well as families, can utilise the health coverage of ₹5 lakh provided under the Pradhan Mantri Arogya Scheme. This sum is enough to cover surgical treatments and medical expenses in almost 25 specialities that include:

• Cardiology

• Neurology

• Oncology

• Paediatrics

• Orthopaedics

However, you cannot reimburse medical and surgical expenses simultaneously. In the case of multiple surgeries, the surgery with the highest cost is paid in the first instance; then a 50% waiver is offered for the second surgery and a 25% discount on the third.

Additionally, unlike other health insurance plans , PMJAY has no waiting period for pre-existing illnesses. This service comes under a larger umbrella scheme of Ayushman Bharat Yojana. So, in case you or any of your loved ones need immediate medical assistance, you do not have to worry about the expenses incurred. However, make sure that the individual seeking treatment is admitted to a network government or private hospital.

Moreover, this scheme also provides cashless treatment and hospitalisation, primarily because of the 60:40 cost-sharing agreement between the Centre and States. Once you are recognised under the plan, you and your family members will be issued the Ayushman card by professionals identified as Ayushman Mitras. The PMJAY or Ayushman card is an e-card that allows you to avail the benefits of Pradhan Mantri Jan Arogya Yojana at any of the network hospitals.

Check Here: Difference Between Network & Non-Network Hospitals in Health Insurance

How to File a Complaint or Grievance on the PMJAY Portal?

You can lodge a complaint or grievance online on the CGRMS portal of the PMJAY scheme: www.cgrms.pmjay.gov.in

In case you want to lodge a complaint offline, you can do so by:

• Contacting the Ayushman Bharat scheme helpline centre operated by your State/NHA

• Sending a letter, email, or fax to the official addresses of the SHA/NHA

• Directly meeting the District Grievance Nodal Officer (DGNO) of your district where the complaints are formally processed. The DGNO will enter the contents of grievances received via offline mode in the portal.

For additional technical support related to the PM Jan Arogya Yojana, you can head to https://mera.pmjay.gov.in/search/login.

To sum up, the exorbitant medical expenses have made having comprehensive health insurance the need of the hour. However, certain people cannot afford the Health Insurance Plans. The PM Jan Arogya Yojana programme is a measure to help underprivileged families tackle medical emergencies. In the end, health is an essential aspect of our lives. Hence, it should not be ignored, at any cost. Ayushman Bharat online registration can be done in order to get access to quality healthcare under this programme. Thus eventually, every citizen of our country will be able to lead a worry-free healthy life.

Contact Information Regarding Ayushman Bharat Yojana

The PMJAY scheme contact and mailing information is as follows:

Contact Number:

14555 or 1800-111-565 (both toll-free)

Mailing Address:

National Health Authority of India

3rd, 7th and 9th Floor,

Tower-L,

Jeevan Bharati Building,

Connaught Palace,

New Delhi – 110001

You also get easy access to the information related to PM Jan Arogya Yojana with the Ayushman Bharat app. It is available on the Google Play Store for Android users only as of now. The app also offers the facility to check your eligibility for the scheme and search the empanelled hospitals around you.

To Conclude

Pradhan Mantri Jan Arogya Yojana is one of the world’s largest national health insurance schemes. Under this medical insurance scheme, the government has launched several healthcare initiatives like National Health Protection Scheme (NHPS), Rashtriya Swasthya Bima Yojana (RSBY), Senior Citizen Health Insurance Scheme (SCHIS), Central Government Health Scheme (CGHS) and Employees’ State Insurance Scheme (ESIS). Get exclusive insights and details related to all healthcare programs under the AB-PMJAY scheme at Bajaj Markets.

Moreover, since the PM Jan Arogya Yojana scheme was launched recently, a majority of people are unaware of this government initiative. Hence, you can go through these top frequently asked questions (FAQs) about the Ayushman Bharat Yojana Scheme mentioned below.

In case you are not covered under the PMJAY scheme, you can also check out pocket insurance plans available on Bajaj Markets. Each plan focuses on specific healthcare needs and comes for a premium starting at ₹19!

Health Insurance Plans Available at Bajaj Markets

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