Pradhan Mantri Jan Arogya Yojana: Features, Eligibility and Registration Process

Health Insurance

Pradhan Mantri Jan Arogya Yojana (PMJAY), otherwise known as Ayushman Bharat Yojana, is the Indian Government’s flagship health insurance scheme. This policy was launched in 2015 to provide emergency medical expenses to the poor, vulnerable and economically weaker sections of the society. 

PMJAY covers around 10 crores low-income families in India, providing a sum insured of Rs. 5 lakh for each family for a range of medical expenses. To ensure cashless and paperless treatment for beneficiaries, the Government has issued Ayushman Bharat Golden Card. This card contains all necessary information about the patient and is necessary for treatment in empanelled hospitals.

You can apply for the Ayushman Bharat Golden Card online or contact an authorised hospital or public service centre. The following sections will tell you about the public scheme and how (and if) you can get a Golden card for cashless treatments.

What are the Features of the Ayushman Bharat Yojana?

• This Government health insurance is one of the world’s largest health insurance schemes.
• It provides up to Rs. 5 lakh of coverage per family per annum to over ten crore poor and vulnerable families.
• It covers most of the medical expenses, including treatment, diagnostics, medicine, etc. 
• Ayushman Bharat provides paperless and cashless facilities for easier access to treatment.
• The scheme covers up to 3 days of pre-hospitalisation and 15 days of post-hospitalisation expenses, including medical tests and medicine costs.
• Coverage includes costs of diagnostic services, room rent, doctor’s fees, surgeon’s fees, drugs, ICU (Intensive Care Unit) charges, and OT (Operation Theatre) charges.
• People eligible for this scheme can avail of these services from any empanelled public and private hospitals.
• PMJAY provides priority care to a girl child, women and senior citizens. 

Who Can Apply for Ayushman Bharat Yojana?

To be eligible for PMJAY, one will need to have his/her name listed in the SECC (Socio-Economic Caste Census) of 2011. People applying for the scheme will need to have the RSBY (Rashtriya Swasthya Bima Yojana) card and check their names on the SECC database. 

The following categories of individuals from rural areas can also apply for Ayushman Golden Card:

• Households without any members between 16 to 59 years of age
• People living in one room kutcha houses lacking proper walls and roof
• Households with one disabled member and no healthy adults
• Families without land earning money via manual casual labour
• Those in SC and ST categories
• Beggars and those living on charity
• Primitive tribal groups

Under the PMJAY Urban scheme, the following people can apply for PMJAY Golden Card:

• Domestic workers
• Hawkers, street vendors, cobblers
• Washermen, chowkidars, construction workers, coolies, labourers
• Mechanics, masons, plumbers, electricians
• Transport workers, conductors, cart pullers 
• Waiters, shop workers, delivery assistants
• Ragpickers
• Beggars

Who is Excluded from the Ayushman Bharat Yojana?

The following is a list of people not entitled to healthcare services under PMJAY:

• Those who own mechanised farming equipment
• Government employees
• People owning a two, three or four wheeler vehicle
• Those who have a Kisan card
• People earning over Rs. 10,000 per month
• Landowners with over 5 acres of agricultural land
• People residing in decently built houses
• Those who own a motorised fishing boat
• Workers at non-agricultural government enterprises
• Households having landline phones and refrigerators

How Can You Apply for the Ayushman Bharat Yojana?

PMJAY does not have an enrolment process for beneficiaries as they are already identified by SECC 2011 and are part of RSBY. To check if you are eligible for the scheme, follow the given steps:

1. Visit the official website and click on ‘Am I eligible’.
2. Then, enter your contact details and click the ‘Generate OTP’ button.
3. Next, select your state and the search by criteria (name, HHD number, mobile number and ration card number)
4. The results will tell you if your family has coverage.

Alternatively, you can contact any Empanelled Health Care Provider (EHCP) or Ayushman Bharat via the helpline numbers – 14555 and 1800-111-565. You can also visit the nearest PMJAY Common Service Centre (CSC) to check your eligibility.

How Can You Register for the Ayushman Bharat Golden Card Online?

All families covered by Ayushman Bharat get a Golden Card issued to them. These cards are now made available to all public CSC and empanelled private hospitals and district hospitals. The PMJAY e-card contains all required information and is necessary for treatment at an empanelled hospital.

The online registration process for the Ayushman Bharat Golden card is given below:

1. First, visit PMJAY’s website and log in using your registered contact number.
2. Afterwards, enter the captcha code and click on ‘Generate OTP’.
3. Opt for HHD Code and enter this code to the CSC of PMJAY.
4. A PMJAY representative (Ayushman Mitra) will check and verify the details. 
5. Pay Rs. 30 to complete the registration process.

You can also visit the nearest registered Government or private hospital with all the necessary documents. The hospital staff will check your name in the list of Jan Arogya Yojana and give you the card if it is present there.

How to Download the Ayushman Bharat Golden Card?

If you cannot get the original card, you may download and print its soft copy for treatment at an empanelled hospital. To get the PMJAY Golden card, follow these steps:

1. Visit the official website of Ayushman Bharat Yojana.
2. On the homepage, click on the ‘login’ option.
3. On the login page, enter your email ID and password and click on ‘Sign In’.
4. Enter your Aadhaar number and verify your thumb mark to log in to CSC Connect.
5. Click on the ‘Approved Beneficiaries’ to get the list of all people with an approved golden card.
6. On the next page, choose your name from the given list and click on the ‘Confirm Print’ option. 
7. You will be redirected to the Jan Seva Kendra wallet. 
8. Enter your password and then the Valet PIN to view the AB-PMJAY Card.
9. Click ‘Download Card’ and take a printout.

Final Word

PMJAY is the biggest health insurance scheme providing essential support for the medical needs of our country’s economically weaker sections. It also provides free treatment to poor people in both rural and urban areas through empanelled hospitals. Hence if you are eligible for this scheme, ensure to apply for the Ayushman Bharat Golden Card online or via CSC.

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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.