Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana is a national public health insurance fund of the Government of India that aims to provide free access to health insurance coverage for low income group in the country. PM JAY plans to make secondary and tertiary healthcare completely cashless for the underprivileged sections of society. The beneficiaries get an e-card that can be used to avail services of Rs.5 Lakhs at an empanelled hospital, public or private, anywhere in the country.
PM JAY subsumes the Senior Citizen Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojna (RSBY).
Who is eligible?
Government-run health insurance program for the Indian poor. The scheme aims to provide health insurance coverage to all those who qualify under the 2011- Socio-Economic Caste Census (SECC).
What are the benefits?
It provides a cover up to Rs. 5 lakhs per eligible beneficiary family, per year for secondary and tertiary hospitalization through a network of empanelled hospitals. All pre-existing conditions are covered. Services under this scheme will be cashless, paperless and available across the country. All eligible family members will be covered, with no cap on number, age and gender. RSBY card holders are also eligible.
What are the documents to be submitted?
- Age & Identity Proof (Aadhaar Card/PAN Card/Ration Card)
- Contact details (mobile, address, email)
- Caste certificate
- Income certificate
How to check eligibility?
- Visit the official government website for PMJAY scheme
- You will find ‘Am I Eligible’ tab, simply click on it
- Submit your mobile number, CAPTCHA code, and click on Generate OTP button
- Now enter your State and your name, ration card number, household number, or mobile number
- If your family is covered under Ayushman Bharat Yojana, then you name will be displayed in the results
What are the areas covered under this?
PMJAY covers the following expenses during the treatment:
- Provides coverage for medical examination, treatment and consultation fee
- Pre-hospitalization expenses are covered under Ayushman Bharat Yojana policy
- Post-hospitalization expenses are covered for 15 days
- The policy also covers the cost of medicine and medical consumables
- Hospital accommodation charges are also covered
- Non-intensive and ICU services
- The expenses incurred on the Diagnostic procedures are also covered
- Medical implantation services are covered where required
- Expenses incurred on complications arising during the medical treatment
- Food services
PMJAY Patient Card Generation
You can apply for an e-card once you find out your eligibility for Ayushman Bharat yojana scheme. But before you get this e-card, you will have to go through an identity verification at one of the PMJAY kiosk based on your documents like Aadhaar card or ration card. Even your family identification can be furnished including the RSBY card, or a govt. certified list of members. After this verification is done, you patient e-card is printed along with your Ayushman Bharat ID, which can be used for future references. This can be done online with the aid of CSCs.