The Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) is a Maharashtra State Government-backed plan created to provide health insurance benefits to the economically weaker section. Previously known as the Rajiv Gandhi Jeevandayee Arogya Yojana, it provides access to free medical care and facilities to financially disadvantaged people in Maharashtra. This article discusses the features, benefits, how to apply for Mahatma Jyotiba Phule Jan Arogya Yojana and file a claim. Read on!
The Maharashtra state government established the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) to provide low-income communities with free and high-quality medical care. The service includes free medical treatment through an established network of medical professionals, primarily for specialty services that require hospital stays for counselling sessions, operations, and therapies. With a total insured amount of Rs.1,50,000 per family yearly, the MJPJAY would cover all medical expenses paid by the beneficiary while he or she is hospitalised. A person or a household can obtain Rs.1,50,000 per year of insurance through cashless inpatient treatment.
The primary objective of the Mahatma Jyotiba Phule Jan Arogya Yojana is that the state government has decided to treat the poor people of Maharashtra who are financially distressed, with 14 districts included in this kind of ration card. Under Mahatma Jyotiba Phule Jan Arogya Yojana, highly-priced medical services such as surgery and organ transplants therapy are provided for such poor people in addition to those farmers who are survivors of any natural catastrophe and whose financial assistance is very limited. All of these diseases have been assigned to government hospitals in the state of Maharashtra.
The scheme provides several advantages in the form of 971 procedures. 131 of these procedures are only performed in government hospitals. However, diseases that can be treated in ordinary hospitals or primary-level health centres will not be covered under this plan. The Mahatma Jyotiba Phule Jan Arogya Yojana has many features.
The following documents must be submitted for Mahatma Jyotiba Phule Ja Arogya Yojana:
The enrolling procedure in the Maharashtra MJPJAY scheme is as follows:
Step 1: Individuals or families should visit a nearby Network/District/Women/General hospital and meet with Arogyamitra to begin the scheme application process.
Step 2: If you visit a Government Health Facility, you will be given a referral card that you can present to the Network Hospital along with the clinical assessment made by the physician at the Government Health Facility.
Step 3: The referral card can also be obtained by attending one of the Network Hospital’s Community Clinics.
Step 4: Display the reference card and your Yellow or Orange Card. Users can show your Annapurna or Antyodaya Card instead of a ration card.
Step 5: The analytic and follow-up process will begin after providing the above details.
Step 6: You will be admitted to the Network Hospital based on the diagnosis.
Step 7: The insurance company will receive an E-authorisation request, which the MJPJAY will also review.
Step 8: The medical specialists at the insurance company and MJPJAY will review the authorisation request and approve it if all conditions are met. This authorisation will be finished within a day, and if the authorisation is marked “EM,” it will be finished quickly in the event of an emergency.
Step 9: After your authorisation is approved, you will be able to receive cashless treatment or hospital stays.
Step 10: To settle the claim, the hospital will provide the insurance company with all of the diagnostic reports, original bills, discharge summary, and other relevant evidence.
Step 11: After reviewing the paperwork, the insurance company will approve the claim and pay the hospital.
Step 12: Under the scheme, the network hospital will provide free consultations, tests, and medicines up to 10 days after release.
The Mahatma Jyotiba Phule Jan Arogya Yojana includes 971 therapies, procedures, and surgeries and 30 different categories having follow-up packages of around 121. Here are a few examples:
The Mahatma Jyotiba Phule Jan Arogya Yojana excludes the following from the plan:
Visit your nearby network hospital. and meet with the Arogyamitra or the representative. The representative will verify your documentation and enrolment and would help you get an MJPJAY card.
If you have contacted a Government-run hospital for the same, they will issue you with a referral card for a nearby network hospital. You can also avail a health card by visiting Health Camps conducted by network hospitals from time to time.
The procedure to file a claim for the Mahatma Jyotiba Phule Jan Arogya Yojana scheme is straightforward and is outlined below:
The Maharashtra government intends to establish a call centre through which the Jyotiba Phule Jan Arogya Yojana will be used to provide even better healthcare facilities. The Mahatma Jyotiba Phule Jan Arogya Yojana is undergoing some variations. This could be increased to INR 2 lakh with the inclusion of possibly counting to 1034 different types of treatments or operations under the scheme.
Ans: The turnaround time for the Mahatma Jyotiba Phule Jan Arogya Yojana pre-authorisation is 12 hours.
Ans: No, the beneficiary must bear the ambulance charges under this scheme.
Ans: The Mahatma Jyotiba Phule Jan Arogya Yojana toll-free helpline number is 1800-233-2200/155 388.
Ans: Yes, the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) covers COVID-19, also known as the Novel coronavirus.
Ans: No, the Mahatma Jyotiba Phule Jan Arogya Yojana scheme only covers the cost of appendicular perforation treatment.
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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.
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