Aayushman Bharat Pradhanmantri Jan aarogya Yojana is a public health insurance fund of Government of India. It helps to provide free access to health insurance coverage for low income earners. It is a National Health protection scheme. It provides a service to create a healthy and capable new India. It provides a network of Health and Wellness infrastructure across the nation to deliver Primary Health Care Services. And it provides insurance coverage to 40% of the Indian population. It provides an annual health coverage of up to Rs 5 lakh to beneficiaries. This benefit covers RS 5 lakhs per family per year. It is portable across our country.
The beneficiaries covered under Aayushman Bharat scheme will be allowed to take cashless benefits from public or private hospitals in our country. The payment for treatment will be done at a package rate. States would need to have SHA to implement the scheme. This facility covers almost secondary and tertiary hospitalization. It helps to get increased access to quality health and medication. It helps to get unmet needs of population which remained hidden due to lack of money. It helps to get timely treatment ,patients satisfaction, improvement in efficiency and productivity etc.
It is always known as Pradhan Mantri Jan Arogya Yojana scheme. It helps the economically weaker section of the society who need Healthcare. The beneficiaries get an e card that can be used to avail services at private or public hospitals anywhere in our country. They will get cashless treatment from the hospitals.
It includes three days of pre hospitalisation and 15 days of post hospitalisation expenses. And it includes 1400 procedures with all related costs. Their aim is to provide health care to 10 crore families like poor,lower middle income people. According to the 71 st National Sample Survey organisation, 85% of rural households do not have access to any Healthcare insurance. And 24 % of rural families access healthcare facilities by borrowing money from others. So PMJAY helps this sector avoid debt trap and provide services by yearly assistance of up to Rs 5 lakhs per family.
Eligibility in rural areas
- Families with no male members between the age of 16 to 59 years.
- Landless household who work as casual manual labourers.
- Manual Scavenger family
- Primitive tribal community
- Scheduled caste and Scheduled tribe household
- Legally released bonded labourers
- Family having at least one physically challenged member
- Family living in a one room house with no proper walls.
According to the National Sample survey organisation 82 % of urban households do not have a Health Insurance. PMJAY helps these households providing funding of up to Rs 5 lakh per family per year.
Eligibility in urban areas
- Delivery boys
- Shop keepers
- Helpers of transport
- Cart,rickshaw pullers
- Security guards
- Construction workers
- Domestic helpers
- Repair workers
- Sanitation workers
- Handicraft workers
People not entitled to the health coverage under PMJAY
- Those who have own two,three ,four wheeler vehicles.
- Those who have kisan cards with credit limit Rs 50000
- Those who have own 5 acres land
- Those who have refrigerators,landlines
- Those who have decent built houses.
- Those who have monthly income Rs 10000.
- Government employees
Eligible beneficiaries will get Rs 5 lakhs per family per year. It is enough to cover the medical and surgical treatments including orthopedics, pediatrics,cardiology, oncology,neurosurgery, etc.if multiple surgeries are necessary, highest package is paid for in the first instance, followed by 50% waiver for second and 25% discount for third.
It has no waiting period for pre-existing diseases.The cashless treatment is available due to 60:40 cost sharing agreement between centre and states.It is valid for day care procedures. Prostate cancer, tissue expander for disfigurement, laryngopharyngectomy, skull base surgery, Anterior spine fixation, pulmonary valve replacement, double valve replacement ,coronary artery bypass grafting, carotid angioplasty with stent are covered under this scheme.
Health insurance policies are helpful for medical treatment without suffering any financial issues. Most of the people borrow money informally to pay medical bills. But PMJAy helps to avoid the risk
of debt trap.Now you can’t apply for this scheme. you can check if you are eligible to be a beneficiary of PMJAY.
How to find your name in Ayushman arogya insurance
- Visit the official portal of PMJAY.
- Click on Am I eligible option
- Enter mobile number
- Enter captcha code
- Click on generate OTP option.
- Select your state
- You can search by your name/HHD number/ration card number/mobile number
- You can verify your status.
- Other wise call Ayushman Bharat Yojana call center number 14555 or 1800111565
- You can see all members of your card eligible for this scheme
- You can see the eligible hospitals through this site.
How to download the ID Card
- Visit the official website of PMJAY
- Click the menu option
- Select Beneficiary Identification System
- Click on download Ayushman card option
- Select aadhar card
- Select PMJAY scheme
- Select state
- Enter aadhar number
- Generate OTP
- enter OTP number
- Download the card