Ayushman Bharat Yojana - Pradhan Mantri Jan Arogya Yojana

What is Ayushman Bharat Yojana

Ayushman Bharat Yojana scheme also known as Pradhan Mantri Jan Arogya Yojana is a flagship scheme of the government of India that aims to help the economically weaker sections of society who need healthcare facilities. The scheme is announced by Prime minister Narender Modi in his independence day speech in 2018 with an aim to cover more than 50 crore Indian citizens and nearly 10 Crore underprivileged families without any limitations regarding family size and age.

It has two inter-related components – Health and Wellness Centers (HWCs) and Pradhan Mantri Jan Arogya Yojana (PM-JAY). Ayushman Bharat Yojana scheme caters the needs of the poor and rural families, which is why it is economically beneficial to the poor and destitute households in rural and urban areas.

Features of PMJAY: Ayushman Bharat Yojana Scheme

The world’s largest health insurance scheme is completely financed by the government.
This scheme is specially meant for people below the poverty line who do not have access to internet or online health insurance plans.
The scheme provides eligible families an insurance cover of Rs.5 lakh per annum per family. This amount is projected to cover all secondary and tertiary care expenditures incurred.
PMJAY scheme facilitates cashless healthcare services to its beneficiary in any of the public sector hospitals and private hospitals.
In addition to medical treatment expenses, Ayushman Bharat Yojana insurance package also covers the daycare expenses incurred by the beneficiary.

Ayush: Health and Wellness Centers (HWCs)

Health and wellness centers are being made by converting the present primary health centers and subcentres. They offer comprehensive primary health care (CPHC) which includes child and maternal health services, non-communicable diseases, diagnostic services, and free essential drugs.

Primary healthcare plays an important role in avoiding many disease conditions. Providing CPHC decreases morbidity and mortality at a reduced cost and greatly reduces the requirement for secondary and tertiary care.

Services offered by HWCs

Pregnancy care, Child birth, and infant Healthcare services.
Childhood and adolescent healthcare services.
Family planning and reproductive healthcare services.
Screening, Prevention, Control and Management of communicable diseases.
Care for common ENT problems.
Basic oral healthcare.
Elderly Healthcare services.
Emergency medical services.
Screening and Management of Mental health ailments.

Documents required to apply for Ayushman Bharat Yojana

Proof of Age/Identity(Aadhar /Pan card)
Contact details
Caste certificate.
Income certificate
Document proof of the current status of the family to be covered.

Steps to check your name in Ayushman Bharat Yojana List

Online Method- .Ayushman Bharat online list is available on the official website of the National Health Authority for Ayushman Bharat Yojana. Beneficiaries can easily check their name by visiting the website.
Common Service Centres (CSC)- Beneficiary can also check their name by visiting the nearest Common Service Centres or you can also visit any of the empanelled hospitals to collect the information form.
Contact their Helpline No.- call on any of the government-provided helpline numbers (e.g. 1800111565) to contact their customer care and seek the information about PMJAY Scheme, Ayushman card/e-card, Ayushman card download, and even Ayushman Bharat Scheme registration.

What is covered under Ayushman Bharat Yojana?

Ayushman Bharat Yojana provides coverage for medical check-ups, treatment, and consultation fees.
Pre-hospitalization costs are covered.
Post-hospitalization costs are covered for 15 days.
The scheme also covers the cost of medicine.
Hospital accommodation charges are also covered
Non-intensive and ICU services.
Diagnostic procedures expenses are also covered.
Medical implantation services are covered if required.
Complications arising during the medical treatment

PMJAY Scheme: Eligibility Criteria for Rural

Households headed by females with no adult male earning member in the age bracket of 16-59 years.
Families living in one room with Kutcha walls and roof.
Families with no adult members within the age group of 16-59 years.
Households without a healthy adult member and one disabled member.
Manual scavenger families.
Landless households earning a significant part of their family income from manual labor.

PMJAY Scheme: Eligibility Criteria for Urban

Domestic worker/Beggar/Rag picker
Home-based Artisans/ Tailor Sweeper/ Handicrafts worker/ Sanitation worker/ Mali
Construction worker/ Labour/ Painter/ Welder/ Security guard/ Coolie
Washer-man/ Plumber/ Mason
Electrician/ Mechanic/ Assembler/ Repair worker
Transport worker/ Rickshaw puller/ Conductor/ Cart puller/
Waiter/Shop worker/ Assistant/ Peon/Delivery assistant
Street vendors/ hawker / Cobbler

Who isn’t allowed to avail coverage under the Ayushman Bharat Yojana?

People who own a vehicle like a 2-wheeler, 3-wheeler, or car/Government employees.
People whose monthly earnings are more than Rs 10,000.
Persons who have motorized fishing boats, farming machinery, and equipment.
Individuals who live in appropriately build houses.
Those who hold a Kisan card.
Those owing agriculture land of more than 5 acres.
People employed in government-run non-agricultural enterprises.
People who have fridge and landline connections in their houses.

Diseases covered under PM Jan Arogya Yojana (PMJAY)

PMJAY scheme has nearly 1,350 medical packages at any of the private hospitals and all the public hospitals. Some of the critical illnesses that Ayushman Yojana covers:

Carotid angioplasty with stent
Prostate cancer
Coronary artery bypass grafting
Skull base surgery
Pulmonary valve surgery
Double valve replacement surgery
Anterior spine fixation
Tissue expander for disfigurement following burns

Ayushman Bharat registration: How to Register for PMJAY Scheme Online?

Go to the official government portal “PMJAY”.
Click on “Am I eligible” tab.
Enter your mobile number, captcha code and click on “Generate OTP”.
Select your State and Enter your name, ration card number, household number, or mobile number.
If your family is covered under the scheme then your name will be displayed in results.

Steps to download Ayushman Bharat Yojana card online

Go to the PMJAY website and log in with your registered mobile number.
Enter the ‘Captcha Code’ to generate the OTP.
Click on the HHD code.`
Present the HHD code to the Common Service Centre (CSC), where they will check the HHD code and other details.
The CSC representatives or Ayushman Mitra will complete the remaining process.
Beneficiary will have to pay Rs.30 to get the Ayushman Bharat card.

Ayushman Bharat health card: PMJAY Patient Card Generation

People who are eligible under PMJAY can apply for an e-card. This card will be used as proof to avail healthcare benefits by beneficiaries. At PMJAY kiosk, first the beneficiary’s identity is verified then the card is issued. The process is done with the help of documents like a ration cards or Aadhar card. After the verification process is done, the e-card is printed along with the unique AB-PMJAY ID.

Ayushman Bharat Scheme Hospitalization Process

Ayushman Bharat Yojana scheme provides health insurance cover to beneficiaries without any premium cost, treatment cost during and after the hospitalization process. Ayushman Bharat scheme covers both pre and post-hospitalization costs across PAN India. The complete method of hospitalization is cashless and there is a 60:40 cost-sharing between the centre and the state, respectively. After enrolling in the scheme, the beneficiary will receive an Ayushman health card through which he/she can avail cashless treatment and hospitalization at any of the empanelled public and private hospitals.

All the empanelled hospitals under PMJAY Scheme would have appointed Ayushman Mitra’s who will assist the patient and coordinate with the beneficiary and the hospital. Ayushman Mitra has their help desk where they will verify the eligibility criteria, documents, and the enrolment to the scheme. They provide letters to the beneficiaries with individual QR codes. This QR code is scanned to verify the eligibility for people to gain Ayushman Bharat Yojana benefits.

Benefits of Ayushman Bharat Yojana Scheme

Ayushman Bharat Yojana covers almost 40% of the vulnerable and needy families in India. The healthcare services and benefits that they can easily avail themselves are:

The scheme is available across India and is free of cost. It covers all hospitalization expenses with cashless transactions.
The scheme can be availed by all members of the family regardless of family size, age or gender.
Ayushman Bharat Yojana scheme also covers pre and post-hospitalization costs.
If there are multiple surgeries, the expenses shall be covered with the highest package. And for second and third you will get 50% an 25% respectively.
The treatment cost of oncology with chemotherapy for 50 types of Cancer is also covered under the scheme. However, both medical and surgical package cannot be used at the same time.
The beneficiaries under the PMJAY scheme can avail follow-up treatment expenses.