• Shruti GOCHHWAL

About The Pradhan Mantri Jan Arogya Yojana

We know very well that “Health is Wealth” Pradhan Mantri Jan Arogya Yojana. In any unforeseen situations like accidents or sudden serious medical illnesses, owning health insurance becomes a mandatory thing. These health insurance schemes may help to cover your huge medical expenses. One such health insurance scheme that is designed for the common man is (PMJAY).

Pradhan Mantri Jan Arokya Yojana

Largest health scheme of the country-PMJAY, Credits: Pexels


What is Pradhan Mantri Jan Arogya Yojana (PMJAY)?

  1. The Pradhan Mantri Jan Arokya Yojana scheme is also called as Ayushman Bharat Yojana scheme. This national health insurance scheme was initiated by the Government of India in September 2018.

  2. The main aim of the scheme is to provide free access to healthcare to rural, poor and some parts of the urban group of the country.

  3. The intention of this healthcare scheme is that the healthcare facilities should reach the lowest strata of the society.

  4. The program is a part of the Indian Government’s National health policy.

  5. It is expected to benefit 50 crore people in the rural and urban parts of India and is considered as the world’s largest government sponsored healthcare program.

Eligibility

The eligibility is determined from the Socio Economic and Caste Census 2011 (SECC 2011). The general eligibility criteria in the SECC include literacy rates, median household income, occupation, type of housing, and sanitation.

The following categories of people are eligible to apply for PMJAY scheme:

  1. SC and ST caste families

  2. Families without a male member (between 16 to 59 years of age)

  3. Individuals without home

  4. Families with at least one person who is physically challenged or have any disabilities

  5. Landless families

  6. Tribal communities

  7. Bonded labour

  8. Scavengers

There are certain exclusions from the SECC beneficiaries like government employees, people owning 5 acres or more of agricultural land, people with two, three or four wheelers, kisan card holders with Rs. 50,000 credit limit, people with refrigerator and landline connections, people with an income of more than 10,000 per month.

How to apply (online)?

  1. No registration fees

  2. No application forms

  3. To avail the scheme, the person can call helpline (14555) or fill the details on the official website. Here is the stepwise procedure.

  4. Log in to the official website (https://pmjay.gov.in/)

  5. Enter the mobile number and captcha and generate OTP

  6. Check your eligibility by entering your name, ration card number.

  7. Select the state and know the eligibility status of your family members.

  8. The required documents to apply for the scheme includes aadhar card, PAN card, income and caste certificate and documents stating your family status.

  9. Once the process is complete, you can get the Ayushman Bharat card.

Application for health insurance scheme

The PMJAY scheme is user friendly to apply, Credits: Pexels


What are the benefits of the scheme?

The benefits of PMJAY scheme

There are innumerable benefits in PMJAY scheme, Credits: Pixabay


  1. Coverage of five lakhs per family per year for medical treatment is offered in both public and private hospitals for secondary and tertiary hospitalization.

  2. Cashless payment and paperless record keeping

  3. No restriction based on the family size, gender or age.

  4. Both pre hospitalization (3 days) and post hospitalization (15 days) expenditure are covered.

  5. Diagnostic care and expenses of medicines are taken care of.

  6. Any history of previous medical conditions is also covered.

  7. The beneficiary can avail treatment in any hospital outside their state and anywhere in the country.

  8. This scheme also provides access to COVID-19 testing.

Some of the other benefits include

  1. Non intensive and intensive care services

  2. Medical implant services

  3. Complications due to treatment

  4. Treatment for COVID

  5. Some of the critical illnesses that are covered in this scheme includes prostate cancer, pulmonary valve replacement, carotid angioplasty with stent and double valve replacement

What is not covered under this scheme?

  1. Out-Patient Department (OPD) expenses.

  2. Drug rehabilitation.

  3. Cosmetic surgeries.

  4. Fertility treatments.

  5. Individual diagnostics.

  6. Organ transplantation.

Take home message

Pradhan Mantri Jan Arogya Yojana is a comprehensive healthcare scheme that provides healthcare facilities to economically weaker sections of the society to avail pre and post hospitalization and surgery free of cost.

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