Ayushman Bharat scheme consists of the Senior Citizens Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojana (RSBY) and is also known as the PM-JAY scheme. Ayushman Bharat Yojana scheme caters to the needs of not only the poor but also the rural families, which is why it is economically beneficial for the poor families of rural and urban areas.

About PM-JAY Scheme

PM-JAY, also known as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, is one of the largest healthcare schemes sponsored by the Government of India. Prime Minister Narendra Modi launched the Pradhan Mantri Jan Arogya Yojana health care scheme intending to cover more than 50 crore Indian citizens and approximately 10 crore underprivileged families without any limit related to family size and age. Ayushman Bharat Yojana will help these families to avail the best healthcare services with insurance coverage of up to Rs 5 lakh for each family per year for tertiary and secondary hospitalization expenses.

PM Jan Arogya Yojana is paperless and provides cashless hospitalization cover in public hospitals and network private hospitals. Ayushman Bharat health insurance covers hospitalization, pre-hospitalization, medication and post-hospitalization expenses during treatment, which applies to almost all tertiary and secondary care procedures.

Features of PM-JAY: Ayushman Bharat Yojana Scheme

Apart from being a life-saving scheme for lower middle income, other key features of Pradhan Mantri Jan Arogya Yojana are as follows:

  • Ayushman Bharat Yojana is a family floater plan that offers a sum assured of Rs. Rs 5 lakh per family enrolled.
  • This scheme is specially designed for people below the poverty line who have access to the Internet or online health plans.
  • PMJAY scheme provides cashless health facilities to its beneficiaries in any public sector hospital and private network hospital.
  • Apart from this, Pradhan Mantri Ayushman Bharat Yojana also compensates for the transportation cost incurred by the beneficiary during the period before and after hospitalization.
  • Along with medical treatment expenses, the Ayushman Bharat scheme insurance package also covers day-care expenses incurred by the beneficiary.
  • PMJAY scheme also covers some specific pre-existing diseases
  • Medical expenses are to be paid based on a pre-determined package rate by the Government
  • Under the government-supported scheme, an adequate number of health and wellness centres will be set up as per the socio-economic caste census data.

Benefits of the Ayushman Bharat Yojana Scheme

The Ayushman Bharat Yojana scheme insures about 40% of vulnerable and needy families in India. The health services and benefits they can avail of are listed below:

  • Treatment and healthcare facilities under PMJAY are available across India and are free of cost.
  • The Ayushman Bharat scheme offers 25 speciality categories and includes a wide range of 1,354 medical and surgical packages such as neurosurgery, cardiology, etc.
  • The Ayushman Bharat scheme also covers post-hospitalization expenses.
  • In case of multiple surgeries, the cost will be covered with the highest package. For the second and third surgeries, it should be covered by 50% and 25% respectively.
  • This plan covers the cost of oncology treatment and chemotherapy for 50 different types of cancer. However, both the Medical and Surgical packages cannot be availed at the same time.
  • Beneficiaries can also avail of follow-up treatment coverage under the PMJAY scheme.

What is included under the Ayushman Bharat Yojana scheme?

PMJAY covers the following expenses during treatment:

  • Ayushman Bharat Yojana This plan provides coverage for medical tests, treatment and consultation charges.
  • Pre-hospitalization expenses are covered under the Ayushman Bharat scheme policy.
  • Post-hospitalization expenses are covered for 15 days.
  • The policy also covers the cost of medication and medical consumables.
  • Hospital accommodation charges are also included.
  • Non-intensive and ICU services.
  • Expenditures on diagnostic procedures are also included.
  • Medical transplant services are included where necessary.
  • Expenses incurred on complications arising during medical treatment.
  • Food Services.

Ayushman Bharat Eligibility Criteria for Rural and Urban People

The Pradhan Mantri Jan Arogya Yojana allows eligible members to avail of healthcare services across India.

PMJAY Scheme: Eligibility Criteria for Rural

  • Household with no adult/male/earning member between the age of 16-59 years
  • The family lives in a room with mud walls and a roof.
  • Households with no members between the ages of 16-59
  • A household without one healthy adult member and one disabled member
  • Scavenger family
  • Landless families earn a large part of their family income from manual labour.

PMJAY Scheme: Eligibility Criteria for Urban

  • Domestic Worker
  • Petitioner
  • Ragpicker
  • Home-Based Artisan/Tailor Sweeper/Handicraft Worker/Sanitation Worker/Gardener
  • Construction Workers/Laborers/Painters/Welders/Security Guards/Porters
  • Washerman/Plumber/Mason
  • Electrician/Mechanic/Assembler/Repairman
  • Transport worker/rickshaw driver/conductor/cart puller/
  • Waiter/Shop Employee/Assistant/Peon/Delivery Assistant
  • Street vendor/hawker/cobbler

How to register online for the PM-JAY scheme?

If you want to register online for PMJAY, you can follow the steps given below:

  • Visit the official government website for the PMJAY scheme
  • You will find the “Am I Eligible” tab, just click on it
  • Submit your mobile number, and captcha code and click on the Generate OTP button
  • Now enter your state and your name, ration card number, house number or mobile number
  • If your family comes under the Ayushman Bharat scheme, your name will be displayed in the results

Documents required to apply for Ayushman Bharat Scheme

  • Age and Identity Proof (Aadhar Card/PAN Card)
  • Contact details (mobile, address, email)
  • Caste certificate
  • Income Certificate (Maximum annual income only up to Rs. 5 lakhs (per annum)
  • Document proof of the current status of the family to be covered (joint or single)

How to check your name in the Ayushman Bharat Yojana scheme list?

There are many ways to check your name in the PM Jan Arogya Yojana -PMJAY beneficiary list. Listed below are some methods you can try:

  • Online Method – Ayushman Bharat Online List can be checked by the beneficiaries. All you have to do is visit the official online site of the National Health Authority for the Ayushman Bharat Scheme.
  • Common Service Center (CSC) – If you are a beneficiary of Ayushman Yojana, you can also visit the nearest Common Service Center. If this is not possible then you can also visit any empanelled hospital to collect the information form. You can check the list of Ayushman Bharat hospitals on their site or in your policy documents.
  • Contact their Helpline Number – You can contact any helpline number given by the Government of India (like 1800111565). And even Ayushman Bharat Scheme Registration.
  • If your name is on the list, then only you will get an Ayushman Bharat card.

Who is not entitled to avail coverage under the Ayushman Bharat Scheme?

The following categories of institutions are not covered under the Ayushman Bharat Scheme:

  • People who have vehicles like two-wheelers, three-wheelers or cars.
  • Government employee.
  • People whose monthly income exceeds Rs 10,000.
  • Those who own agricultural machinery and equipment.
  • People who live in properly built houses.
  • Those who have a Kisan Card.
  • Those who own a motorised fishing boat.
  • Those who have more than 5 acres of agricultural land.
  • People employed in government-run non-agricultural enterprises.
  • People who have refrigerators and landline phones in their homes.

List of critical illnesses covered under PM Jan Arogya Yojana (PMJAY)

PMJAY provides around 1,350 medical packages across private and public network hospitals. Given below are some of the critical illnesses that the Ayushman scheme 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 deformity after burns

How to download the Ayushman Bharat Yojana card online?

Applying for an Ayushman card is important as it includes a dedicated family identification number. AB-NHPM is provided to every beneficiary family. To apply or download your Ayushman Card online you can follow the steps given below-

  • First, go to the official website of the Ayushman Bharat Scheme.
  • Now login with your email ID and generate a password.
  • Enter your Aadhaar number to proceed.
  • Click on the Approved Beneficiary option.
  • It will be redirected to their help centre.
  • Now enter your password and PIN in CSC.
  • It will be redirected to the home page.
  • You will see the download option form where you can download your Ayushman Bharat Golden Card.

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