Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat Yojana is a health insurance and protection policy that was introduced in 2018. This government initiative aims to provide medical coverage to the economically weaker section of society. Following is a discussion on the features, benefits, eligibility criteria, and other details related to this scheme.
Here are some features and benefits of PMJAY:
Pradhan mantri jan arogya yojana health protection scheme does not provide medical coverage for expenses incurred due to the following:
Here is a list of individuals who can be beneficiaries under the pm jan arogya yojana scheme:
The following category of individuals are eligible for pradhan mantri jan arogya yojana health care coverage:
If you are a beneficiary under Ayushman Bharat Scheme you will get an Aysuhman health card. With this card, you can avail of cashless claims on treatment or hospitalisation under the Ayushman Bharat Yojana. To register for Ayushman Bharat Yojana you have to follow the given steps:
You can also visit your nearest Common Service Center or contact on the helpline numbers 14555/1800-111-565.
These households will not be able to avail benefits of the PMJAY scheme:
In case an individual is not eligible for this health protection scheme, he or she can opt for a health insurance policy from any leading insurance provider in India. Navi Health Insurance offers medical coverage with cashless claims via a network of over 10,000 hospitals across India. Download the Navi app to know more today!
Eligible individuals can gain access to cashless healthcare facilities under the Ayushman Bharat Yojana scheme by using the PMJAY Card. Here’s how they can apply for it:
Beneficiaries, being an individual or family can avail of the benefit of Rs. 5 lakh as provided under PMJAY. This cost is enough to cover the medical or surgical treatments. However, one cannot avail of the cost of surgical and medical treatments simultaneously.
If a beneficiary needs multiple surgeries, the one with the highest cost is paid in the first instance, followed by a waiver of 50% on the second and 25% on the third. The filing for cashless claims is also made possible due to the cost-sharing agreement between the Central Government and state government in the ratio of 60:40.
The Insurance Regulatory and Development Authority has issued notice to all health insurance companies to include COVID-19 treatments under their schemes. Beneficiaries under PMJAY can avail themselves of free treatments and medical facilities for COVID-19 at the empanelled hospitals registered under this scheme.
Eligible applicants must submit these documents to apply for the Ayushman Bharat Yojana scheme:
You should keep in mind the following aspects before investing in the PMJAY scheme:
To file a complaint or grievance you have to follow these steps:
You can also make such complaints offline by dialling the helpline numbers. Alternatively, you can send a letter, email or fax to the official addresses of SHA/NHA or meet the District Grievance Nodal Officer.
The contact information for Ayushman Bharat Yojana is given below:
Healthcare protection schemes such as Pradhan Mantri Jan Arogya Yojana (PMJAY) ensure financial protection against life-threatening illnesses or accidents. The above-mentioned guide about this scheme can help prospective applicants avail of its benefits with ease.
If you’re looking for a comprehensive health insurance plan, sign up for Navi Health Insurance. With Navi Health Insurance, you could get coverage of up to Rs.1 crore. Other benefits include cashless claim settlement in over 10000+ network hospitals, no cap on room rent, EMI facility for premiums, and more. Download the Navi app today and sign up for our policy!
Ans: One can check online by following these steps:
Visit the official online portal of PMJAY
Log in by generating the OTP
Enter the required details such as ration card number, name of the State, etc.
In case the applicant’s family is already covered under the scheme, the results will show his/her name
Ans: No, individuals do not have to pay anything to avail of healthcare protection under the PMJAY scheme.
Ans: As per the new regulations of IRDAI, it’s compulsory for health insurance providers to cover expenses incurred for Covid-19 treatment. Thus, even PMJAY provides medical coverage for Covid-19.
Ans: There aren’t any age-related restrictions in the case of PMJAY. Thus, individuals can avail of medical coverage irrespective of their age.
Ans: To find the CSC nearest to you simply visit any online CSC locator website, fill in details like your state, district, and city and hit ‘Search.’
Ans. No, the PMJAY doesn’t offer maternity coverage.
Ans. Yes, pre-existing diseases are covered under PMJAY and you can get treatment for the same at any of the empanelled hospitals.
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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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