Pradhan Mantri Jan Arogya Yojana (PMJAY) - An Overview

 The Uncertainties in life have led to the growth of the health sector in India. There has been a subsequent rise in the demand for health insurance plans over the past three decades. The government of India is keen on providing its citizens with better healthcare services to battle medical contingencies.

Due to the sole motive of providing financial assistance during a medical emergency, the Prime Minister of India has introduced Pradhan Mantri Jan Arogya Yojana (PMJAY). However, it is primarily known as the Ayushman Bharat Scheme amongst a majority of people. Ayushman Bharat offers financial protection to the poor in case of unannounced medical exigency. 

 

What is the PMJAY Scheme?

The PMJAY Scheme or Ayushman Bharat is divided into two halves:

  1. The first half of the scheme was launched on the birth anniversary of Dr Babasaheb Ambedkar on April 14th. It was introduced in Bijapur district of Chhattisgarh.

  2. The Indian Government has introduced the second half of the scheme. It was launched on 23rd September, only two days before the birth anniversary of Deendayal Upadhyay in Ranchi.

 

The primary aim of Ayushman Bharat is to provide health coverage to approximately 50 crore citizens of India. Moreover, it offers beneficiaries with an average coverage amount of Rs. 5 Lakh. The coverage covers a majority of investigations, medicines, and pre-hospitalization illnesses and expenses. In addition to this, the cashless, as well as paperless services, work in the favour of the nominees at any given point of time in their lives.

 

Identifying the key features of every policy plays a significant role while purchasing a suitable plan. Moreover, every buyer must understand the crucial elements to make informed decisions in the future. Here are the top five features of the PMJAY Scheme. 

Features of PMJAY Scheme

  • Services

    Under the PMJAY Scheme, the private hospitals provide their services at large. Moreover, the beneficiaries can avail the services of primary, tertiary and secondary hospitals.

  • Paperless

    With PMJAY Schemes, one can ensure paperless and scalable health insurance plans. The paperless transaction is possible under the leadership of the National Institution for Transforming India (NITI) Aayog.

  • Premium

    The health insurance premiums are a significant aspect for the continuance of the policy in the long run. Since the State health agencies of India fix the premium, it is affordable.

  • Families

    The benefits of PMJAY plans are provided to either over 10.74 vulnerable families or approximately 50 crore beneficiary families.

 Ayushman Bharat Scheme protects the families in India. Hence, the benefits offered by the Ayushman Bharat plan is massive. Take a look at these advantages provided to every needy family in India:

 

The benefits of Ayushman Bharat Scheme

 

  1. It handles all the uncovered hospital expenses with ease.

  2. It provides a cashless facility to its beneficiaries.

  3. It covers the transport allowances of the beneficiary during the pre-hospitalization and post-hospitalization period.

  4. It covers the day-care expenses within the insurance package.

  5. It also covers the pre-existing ailments of the beneficiary, which are included under the PMJAY plan.

  6. It makes provisions for the follow-up treatments to ensure the complete recovery of the patient.

 

The Ayushman Bharat Yojana has specific criteria requirements. The criteria depend on the data collected under the Socio-economic caste census conducted in the year 2011. Under the Ayushman Bharat Yojana, the eligibility criteria are divided between the rural and the urban sectors of India. Take a look below:

 

The Eligibility criteria of PMJAY Plan

 

RURAL SECTOR

URBAN SECTOR

Bonded laborers

Rag pickers and beggars

Scheduled caste and Scheduled tribes

Domestic workers

Landless households

Street vendors

Manual scavengers

Construction works, plumbers, security guards, and so on

Primitive and Particularly Vulnerable Tribal Groups (PVTG)

Shop workers, peons, helpers, etc.

 

 

All we need from you…

Eligibility criteria
  • Visit the website of the Government of India
  • Select the ‘Am I Eligible Section?’ on the website
  • Enter your mobile number to obtain an OTP number
  • Submit the OPT number in the provided slot to verify it
  • Enter either your mobile number or your ration card number to check if you’re a part of the SECC database.
  • Receive a text message on your phone along with the Rashtriya Swasthya Bima Yojana (RSBY) unique registration number (URN) to check the search results.
Documents Required
  • A certified document confirming your age and identification.
  • Existing contact details of the buyer
  • Income certificate
  • Caste certificate
  • A document stating the current family status.
Since the Ayushman Bharat Yojana is recently launched, a majority of people are unaware of this government initiative. All first-time buyers have multiple queries regarding the PMJAY Scheme.Hence, go through these top seven frequently asked questions (FAQs) about the Ayushman Bharat Yojana Scheme mentioned below.

 To sum up, the exorbitant medical expenses have made health insurance the need of the hour. However, certain people cannot afford the premiums of health insurance plans. The Ayushman Bharat Yojana Scheme is to help the underprivileged families to 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 Yojana, also called as Pradhan Mantri Jan Arogya Yojana (PMJAY), is one of the world’s largest national health insurance schemes. Under this umbrella medical insurance scheme, the Government has launched several healthcare initiatives like National Health Protection Scheme, Rashtriya Swasthya Bima Yojana, Senior Citizen Health Insurance Scheme and Employees’ State Insurance Scheme. Get exclusive insights and details related to all healthcare programs under the PMJAY scheme at Finserv Markets. 

Manage All Your PMJAY Scheme Queries here

  • When was the PMJAY Scheme launched?

    The PMJAY Scheme was formulated by the Prime Minister of India, Narendra Modi on September 25, 2018.

  • What services can be availed under the Ayushman Bharat Yojana Scheme? Under the Ayushman Bharat Yojana Scheme, the following health care services are covered:

    • Follow-ups • Pre and post hospitalization expenses • Daycare surgeries • Newborn expenses and services

  • What is the Ayushman card?

    The Ayushman card consists of a dedicated number for family identification. AB-NHPM is provided to every eligible family in India. Moreover, a family can obtain an e-card at the time of hospitalization. However, the beneficiaries do not receive the Ayushman card.

  • How to avail the cashless facility?

    Here is the process of availing the cashless benefit under PMJAY Scheme: • Register at the helpdesk in a network hospital • Validate your health card at the help desk • Admit the patient after the registration. • Obtain a pre-approval via emails or any other online medium. However, the pre-authorization is processed after the patient is admitted.

  • Is the beneficiary charged with any fee?

    The beneficiaries need not pay any fee since the services are free of cost. In case of any doubts, they can contact the helpline number.

  • Is there any cap on the family size or the age of the family members?

    There is no restriction on the age limit or the size of the family under the Ayushman Bharat Yojana Scheme. The PMJAY scheme is open to all the vulnerable families of India.

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