Launched on July 2, 2012, Rajiv Gandhi Jeevandayee Arogya Yojana is a flagship health insurance scheme of the state government of Maharashtra. The scheme was renamed as Mahatma Jyotiba Phule Jan Arogya Yojana on April 1, 2017.
Under the Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY), families that are below poverty line (BPL) and above poverty line (APL) are eligible for free medical care and hospitalization in the state of Maharashtra. The health insurance scheme covers beneficiaries residing in all the 36 districts of Maharashtra.
The Rajiv Gandhi Yojana was launched with the objective to improve access to quality care for low-income families in the state. Under this health insurance scheme beneficiary families in the state will be able to receive free medical services on 30 types of specialties; 971 surgeries, therapies and procedures; along with 121 follow up packages.
Rajiv Gandhi Jeevandayee Yojana covers all hospitalisation costs of the beneficiary family up to a limit of Rs. 1.5 lakh if they undergo treatment in an empanelled hospital. Even if a beneficiary under the Jeevandayee scheme has a pre existing disease, they are covered if the medical procedure is approved.
Rajiv Gandhi Yojana scheme has many valuable features and health insurance benefits for families with valid orange, yellow and white ration cards in the state of Maharashtra.
There is no waiting period for persons with pre-existing diseases under this scheme.
The insurance scheme is similar to a family floater – where any or all members of the family can avail free hospitalisation up to a maximum of Rs. 1.5 lakh.
Beneficiaries don’t have to pay anything if they visit an empanelled hospital from the Rajiv Gandhi Jeevandayee Arogya Yojana hospital list.
For patients undergoing renal transplant surgery, the maximum limit of coverage is up to Rs. 2.5 lakh.
There are close to 500 healthcare providers in the Rajiv Gandhi Jeevandayee Arogya Yojana hospital list where beneficiaries can avail free medical treatment.
Beneficiaries can also avail free follow-up consultations and attend free medical camps.
Unlike traditional health insurance plans, Rajiv Gandhi Yojana also covers plastic surgery procedures.
The state government of Maharashtra allows beneficiaries to undergo 971 surgical procedures, therapies and treatments under this scheme. Out of the 971 procedures, 131 have to be undertaken only in an empanelled government hospital or medical college. It also includes 121 follow-up packages.
Under Maharashtra’s Jeevandayee health insurance scheme, BPL and APL families can get free hospitalisation for 30 specialties such as:
Gynaecology and obstetrics surgery
Cardiac and cardiothoracic surgery
to Maharashtra with a Yellow Ration Card, Antyodaya Anna Yojana Card (AAY), Annapurna Card and Orange Ration Card are eligible to register for Rajiv Gandhi Jeevandayee Arogya Yojana.
Also, farmers from 14 agriculturally distressed districts of Maharashtra holding a white ration card are eligible.
The following documents are required to avail this health insurance scheme:
Yellow, orange or white ration card
Any photo ID including:
Approach the nearest empanelled hospital in your area.
Beneficiaries should furnish the specific ration card or AAY or Annapurna Card before diagnosis and check-ups are done.
The patient is admitted and an E-preauthorization request is sent to the insurance company associated with the scheme. The request is also reviewed by the Rajiv Gandhi Arogya Yojana Society.
Empanelled doctors, specialists and the concerned insurance company will ascertain the validity of the claim and approve if all conditions are met.
Cashless treatment and surgery is provided to the beneficiary.
The beneficiary can avail free follow-up consultations, medicine and diagnostic services up to a period of 10-days from the date of discharge.
You need to following the below steps for registering a patient under the Jeevandayee health insurance scheme:
First, you need to visit a network hospital in your district along with medical reports.
Meet the Arogyamitra in the network hospital who are basically volunteers who help beneficiaries. They will then check your medical reports.
Photo ID and ration card is scanned and sent to RGJAY society.
Copy of the registration is sent within an hour.
Upon successful registration, the patient will be given an OPD appointment.
After some medical exams, the concerned doctor will submit his opinion.
Once the procedure recommended by the doctor is approved by RGJAY society and insurance company, the patient is admitted and surgery or treatment is started by the network hospital.
Rajiv Gandhi Jeevandayee Arogya Yojana is a great scheme run by the government of Maharashtra for underprivileged members of the society. However, if you are not a BPL or APL family, you cannot take advantage of this scheme. If you and your family are not adequately protected by health insurance in a time when contagious diseases such as COVID-19 run amok, you are putting their life and your finances in jeopardy. You can also buy comprehensive family health insurance from Bajaj Allianz, available on Finserv MARKETS today and secure yourself and your loved ones.