PMJAY – Pradhan Mantri Jan Arogya Yojana
Hey Guys! The Pradhan Mantri Jan Arogya Yojana (PM-JAY), also known as Ayushman Bharat, is the world’s largest government-funded health insurance/assurance scheme that provides a cover of ₹5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India. in this page, you will know a complete details about PMJAY Scheme. So Keep Reading.
Pradhan Mantri Jan Arogya Yojana Benefits
As of 2024, Indian government has extended health insurance coverage to over 10 crore (100 million) impoverished and vulnerable families across India. This ambitious program now benefits approximately 50 crore (500 million) citizens, ensuring they receive essential healthcare services.
The initiative encompasses both rural and urban families listed in the Socio-Economic Caste Census (SECC) 2011 database. Eligibility for this coverage is determined based on deprivation criteria in rural areas and occupational criteria in urban regions. This targeted approach aims to uplift the health standards of those most in need, offering a safety net against medical expenses for millions of Indians.
PMJAY Scheme Key features
Benefits Covered: The scheme covers 1,949 medical procedures across 25 specialties, including oncology, cardiology, and nephrology. So, It also includes up to three days of pre-hospitalization and 15 days of post-hospitalization expenses. Additionally, Beneficiaries enjoy cashless and paperless access to services at public and private hospitals across India.
Implementation and Funding: The initiative is fully financed by the Government of India, with the cost shared between the Central and State/Union Territory governments in a 60:40 ratio, and 90:10 for North-Eastern states and three Himalayan states. Additionally, The National Health Authority (NHA) provides technical assistance and capacity-building support to states for effective implementation.
Overall, the PM-JAY scheme aims to provide accessible and affordable healthcare to India’s poor and vulnerable population, significantly reducing their out-of-pocket medical expenses.
What are the eligibility criteria for PM-JAY
Eligibility Criteria for Pradhan Mantri Jan Arogya Yojana (PM-JAY)
Rural Beneficiaries
Families in rural areas that meet at least one of the seven deprivation criteria (D1 to D7) from the Socio-Economic Caste Census (SECC) 2011 database are eligible for PM-JAY. The deprivation criteria include:
- D1: Households with only one room, kucha walls, and a kucha roof.
- D2: Households with no adult member between ages 16 to 59.
- D3: Households with a disabled member and no able-bodied adult member.
- D4: SC/ST households.
- D5: Landless households deriving a major part of their income from manual casual labor.
- D6: Households with no adult member able to read and write.
- D7: Households with any member suffering from a serious indicator disease.
Families meeting automatic inclusion criteria, such as destitute/living on alms, manual scavenger families, primitive tribal groups, and legally released bonded labor, are also eligible.
Urban Beneficiaries
In urban areas, eligibility is based on 11 occupational criteria from the SECC 2011 database. Families belonging to the following occupational categories are eligible:
- Ragpicker
- Beggar
- Domestic worker
- Street vendor/cobbler/hawker/other
- Construction worker/plumber/mason/labor/painter/welder
- Sweeper
- Home-based worker/artisan/handicrafts worker/tailor
- Transport worker
- Shop worker/assistant/peon in small establishments/helper/delivery assistant/attendant
- Electrician/mechanic/repairman
- Washer-man/chowkidar
Other Criteria
The benefits are provided on a family floater basis to the listed beneficiary families. There is no cap on family size or age of members, and pre-existing diseases are covered from the very first day. To check eligibility, beneficiaries can visit the official PM-JAY website, enter their details, and search if their name is included in the database. Assistance is also available by calling the helpline number 14555. You want similar government scheme like Pradhan Mantri Awas Yojana, PMJDY, and other click scheme tag in bottom of this page.
Document Required
Key Documents for Verifying Eligibility for Pradhan Mantri Jan Arogya Yojana (PM-JAY)
Based on the search results, the essential documents required to verify eligibility for the PM-JAY scheme include:
- Identity and Age Proof: Aadhaar Card or PAN Card
- Contact Details: Mobile number, email address, and residential address
- Caste Certificate: To verify eligibility under the SC/ST category
- Income Certificate: To verify income criteria for urban beneficiaries
- Family Documents: Documents stating the current family status
How can I get an Ayushman Bharat card at a Common Services Center
How to apply an Ayushman Bharat card or Pradhan Mantri Jan Arogya Yojana online
Eligibility Verification Process
- Beneficiaries can check their eligibility by visiting the official PM-JAY website (https://pmjay.gov.in/) and using the “Am I Eligible” feature.
- By entering details such as name, mobile number, and ration card number, beneficiaries can check if they are included in the SECC 2011 database.
- Eligibility verification and obtaining the Ayushman Bharat health card can also be done at the nearest Common Service Center (CSC) or empanelled hospital.
- Eligibility is determined based on deprivation criteria for rural areas and occupational criteria for urban areas as per the SECC 2011 database.
- There is no income criteria for eligibility, and pre-existing diseases are covered from the first day.
How to Obtain an Ayushman Bharat (PM-JAY) Health Card at a CSC
- Follow these steps to obtain an Ayushman Bharat health card at a CSC:
- Visit Your Nearest CSC: Inform the CSC staff that you want to apply for the Ayushman Bharat health card. You can locate your nearest CSC using the CSC locator tool on the official website here.
- Provide Necessary Documents: Present the required documents to verify your eligibility, as mentioned in the previous paragraph.
- Eligibility Verification: The CSC staff will check your eligibility by entering your details on the official PM-JAY website. They will confirm if your name is included in the SECC 2011 database based on the deprivation criteria for rural areas or occupational criteria for urban areas.
- Application Assistance: Once your eligibility is verified, the CSC staff will assist you in filling out the application form and obtaining the Ayushman Bharat health card on the spot.
- Issuance of Health Card: The health card will be issued to the head of the family, covering all family members. There is no cap on family size or age of members.
- Using the Health Card: You can start using the card immediately to avail of cashless treatment at any empanelled public or private hospital across India for secondary and tertiary care procedures covered under the scheme.
In Finally, visit your nearest CSC, provide the required documents, get your eligibility verified, and obtain the Ayushman Bharat health card to access free healthcare services under the PM-JAY scheme.