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.
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:
Under the PMJAY Urban scheme, the following people can apply for PMJAY Golden Card:
The following is a list of people not entitled to healthcare services under PMJAY:
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:
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.
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:
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.
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:
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.
However, if you do not qualify for PMJAY, you can still get an affordable health insurance plan from Navi. Download the Navi app from Google Play Store and get support from over 10,000 hospitals and other benefits at a premium starting as low as Rs. 241 per month.
Ans: The following are the documents you will need to carry to apply for PMJAY:
• Proof of age and identity (PAN card, Aadhaar card)
• Contact details
• Income certificate
• Documents stating the current family status
• Caste certificate
Ans: Yes. Patients afflicted with Covid-19 can get free treatment through the PMJAY scheme.
Ans: Yes. As a beneficiary of Ayushman Bharat, you will not need to pay anything if you get treatment from empanelled hospitals. The entire process is cashless since the centre, and state governments share the treatment costs.
Ans: No. PMJAY does not cover a few medical procedures. These are:
• OPD (Out-Patient Department) expenses
• Cosmetic surgeries
• Organ transplant
• Fertility treatments
• Drug rehabilitation
• Individual diagnostics
Ans: PMJAY covers hospital-related expenses, intensive care services, critical illness, medical consumables, medicines, consultation, food services, diagnostics and more. It also covers food services, room rent and costs of complications arising out of treatments.
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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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