Ayushman Bharat Yojana (PMJAY): Health Insurance for All

Ayushman Bharat Yojana is also known as Pradhan Mantri Jan Arogya Yojana (PMJAY) or National Public Health Insurance. Ayushman Bharat Yojana was launched by Prime Minister Narendra Modi on 28 September 2018. PMJAY is a flagship health insurance scheme sponsored by the Government of India. The main objective of Ayushman Bharat Yojana (PMJAY) is to provide medical facilities to those people who are financially weak. Initially, the Pradhan Mantri Jan Arogya Yojana was launched to provide health insurance to over 10 billion poor families, which is equivalent to about 50 billion Indians and about 40% of India's total population.

What is Ayushman Bharat Yojana (PMJAY)?

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) is one of the largest health insurance schemes sponsored by the Government of India. Ayushman Bharat Yojana was launched to provide health cover to over 50 billion Indian citizens and about 10 billion underprivileged families without any limit on family size and age. Ayushman Bharat Yojana (PMJAY) provides medical services with health insurance coverage of up to INR 5 lakh per family per year.

Ayushman Bharat Yojana (PMJAY) provides cashless medical treatment in both public and private hospitals. Pmjay covers hospitalization expenses, cost of medicine, and pre and post-hospitalization expenses for 3 and 15 days respectively.

Standard Health Insurance vs Ayushman Bharat Yojana (PMJAY)

Below mentioned are some of the common differences between standard health insurance and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY):

Standard Health Insurance Vs Ayushman Bharat Yojana

Particular	Standard Health Insurance	Ayushman Bharat Yojana (PMJAY)
Sum Insured Amount	Up to INR 5cr	Up to INR 5 Lakh
Eligibility	Available for everyone	Only Available to lower income group
Annual Health Check-up	Free Annual Health Check-up	No Free Health Check-up
Pre-Hospitalization	60 Days	3 Days
Post-Hospitalization	180 Days	15 Days
Critical Illnesses	Covered	Covered
Domiciliary Treatment	Covered	Not Covered
Premium Amount	Paid by Insured	Paid by the Govt. of India
No Claim Bonus	Available	Not Available
Tax Benefits	Available	Not Available

*Disclaimer: Sum insured amount and other coverage benefits may vary from insurer to insurer.

Features of Ayushman Bharat Yojana (PMJAY)

Below mentioned are some of the key features of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY):

Family Health Insurance Scheme
Sum Insured up to INR 5 Lakhs per year
Designed for low-income group
Cashless Hospitalization in public and private network hospitals
Coverage for Daycare treatments
Covers all pre-existing diseases
No limit on family size, gender, or age

Benefits of Ayushman Bharat Yojana (PMJAY)

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana offers medical services to the underprivileged and vulnerable section of the society. Below mentioned are some of the benefits of Ayushman Bharat Yojana (PMJAY):

Ayushman Bharat Yojana (PMJAY) is free of cost.
Covers 1354 medical & surgical packages.
Covers 50 different types of cancers.
Covers the cost of oncology and chemotherapy
No waiting period for pre-existing diseases
The Ayushman Bharat scheme covers the highest package amount for the first surgery and 50% and 25% respectively for the second and third surgeries in case of multiple surgeries.

Coverage Benefits Under Ayushman Bharat Yojana (PMJAY)

Pm Jan Arogya Yojana (PMJAY) offers various types of coverage benefits. Below mentioned are the coverage benefits under Ayushman Bharat Yojana (PMJAY):

Coverage	Benefit
Doctor’s Consultation Fees	Covered
Pre-Hospitalization	Covered for 3 Days
Post-Hospitalization	Covered for 15 Days
Cost of Medicine	Covered
Medical Consumable	Covered
Hospital Accommodation	Covered
ICU Service	Covered
Medical Implantation Service	Covered
COVID-19 Treatment	Covered
Diagnostic Procedures	Covered
Food Services	Covered

Who Can’t Avail Coverage Benefits Under Ayushman Bharat Yojana (PMJAY)?

Below mentioned are the people who are not covered under Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat Yojana:

People having a two-wheeler vehicle, three-wheeler vehicle, and car
People with government jobs
People having a monthly income of more than 10K INR
People who own farming machines and equipment
People who live in properly built houses
People who hold a Kisan Cards
People who own motorized fishing boats
People who have agricultural land of more than 5 acres
People working in government-run agricultural enterprises
People with landline phones and refrigerators in their homes

Eligibility Criteria for PMJAY or PM Ayushman Bharat Yojana

Below mentioned are the eligibility criteria for both Rural and Urban people:

Eligibility Criteria For Urban People

Under Ayushman Bharat Yojana (PMJAY) categorized 11 occupational categories who are eligible for this scheme.

Beggars
Domestic workers
Hawkers, Street vendors, Cobblers, Ragpickers
Sweepers, Mali, and Sanitation workers
Conductors, Drivers, Helpers of drivers and conductors, Rickshaw pullers, Cart pullers
Construction worker, Coolie with a Security guards, Welders, Painters, Labours, Mason, and Plumbers
Artisan, Home-based workers, Handicraft workers, and Tailors
Chowkidars and Washer-man
Delivery boys, Shop worker, Peon in small establishments, Waiters, Attendants
Mechanics, Electricians, Repair worker, Assembler

Eligibility Criteria For Rural People

Below mentioned are the eligible members to avail the coverage benefits under Pradhan Mantri Jan Arogya Yojana:

Families with no adult/ male/ earning member of between 16-59 years of age
Families living in a one-room house with a kaccha roof and walls
Families come under SC/ST category
People living in alms or extremely poor conditions
People working as a manual scavenger
Legally released bounded labor
Primitive tribal group
Families with at least 1 physically challenged member
Families with landless households whose primary source of income is manual labor

How to Register Online for Ayushman Bharat Yojana (PMJAY)?

To register under Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat Yojana is quite simple and hassle-free. Beneficiaries who identify under the list of SECC 2011 or are a part of the RSBY scheme. Below mentioned are the steps to check if you are eligible for the Ayushman Bharat Yojana or not:

Visit the official website of Ayushman Bharat Yojana (PMJAY) and click on the “AM I Eligible” tab.
Enter your mobile number and create OTP.
Enter OTP and then go to the next tab.
Enter your name, state, ration card number, and household number.
You can check your registration based on the search result.

Documents Required to Apply For Ayushman Bharat Yojana or PMJAY

Below mentioned are the required documents to apply for PM Ayushman Bharat Yojana or PMJAY:

ID Proof
Age Proof
Contact Details (mobile number, email address, residential address)
Caste Certificate
Income Proof
Document Proof showing the status of the family (Nuclear or Joint)

Document required for Ayushman Bharat Yojana or PMJAY

Ayushman Bharat Card Online

A Ayushman Bharat Golden Card will be issued to all the beneficiaries under PMJAY. Pmjay e-card contains all the information of the beneficiary. It is mandatory to show this PMJAY e-card at the time of hospitalization at the network hospital. Follow the below-mentioned steps to get this PMJAY e-card or PMJAY Golden Card:

Step 1. Visit the official website of the Ayushman Bharat Yojana or PMJAY

Step 2. Login with your registered mobile number

Step 3. Enter “Captcha” and generate OTP

Step 4. Provide HHD code to the common service center (CSC).

Step 5. The CSC representative (Ayushman Mitra) will verify the details and complete the further process

Step 6. You just have to pay INR 30 to get the Ayushman Bharat e-card.

Critical illnesses covered under Ayushman Bharat Yojana (PMJAY)

Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat Yojana covers about 1,350 medical packages in their public and private network hospitals. Some of the critical diseases covered under Ayushman Bharat Yojana are mentioned below:

Skull base surgery
Anterior spine fixation
Double valve replacement surgery
Tissue expander for disfigurement following burns
Pulmonary valve surgery
Coronary artery bypass grafting
Prostate cancer
Carotid angioplasty with stent
COVID-19

COVID-19 or Coronavirus Coverage Under Ayushman Bharat Yojana (PMJAY)

Ayushman Bharat Yojana (PMJAY) covers the testing and treatment cost of covid-19. PMJAY offers free testing of covid-19 in private labs and free hospitalization for covid-19 in network hospitals. To avail of these coverage benefits, beneficiaries need to show their e-card at the network hospitals at the time of hospitalization along with some other required documents such as ID proof, Aadhaar Card, etc.

How to Find PMJAY Network Hospitals List?

Below mentioned are the steps to find the list of network hospitals under Ayushman Bharat Yojana:

Step 1: Visit the official website of the PMJAY

Step 2: Go to the “Hospitals list” section

Step 3: Select your state name and district.

Step 4: Choose the type of hospital between public and private

Step 5: Pick the “medical specialty” you are looking for.

Step 5: Enter the “Captcha” and then click on search.

Hospitalization Process in Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat Yojana

Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat Yojana provides health insurance without any premium to the people of low-income group. It provides coverage benefits like pre and post-hospitalization, ICU services, ambulance charges, and all expenses related to medicines and medicinal consumables.

The entire hospitalization process is cashless for the beneficiary at all the impaneled hospitals. There are Ayushman Mitras there in the hospitals to help the beneficiaries regarding their documents verification, enrollment process, etc. You have to show your Ayushman Health Card to the Ayushman Mitra to avail of cashless hospitalization at the network hospitals.

Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat Yojana Contact Information

Address: 9th Floor, Tower-l, Jeevan Bharati Building, Connaught Place, New Delhi - 110001

Toll-Free No.: 14555

Email Address: pmjay@nha.gov.in

FAQs

Question: - What is an Ayushman Bharat Card?

Answer: - If you are eligible for Ayushman Bharat Yojana or PMJAY benefits, then you can apply for Ayushman Bharat Card. This card can be used as an identification in future to get health benefits. After verifying the beneficiary's identity at the PMJAY kiosk, this card is issued. Identity cards like your Ration card or Aadhar card are used for this. A list of family members with government authentication, a PM letter, and an RSBY card are used as family identification documents. The e-card and unique AB-PMJAY ID are generated after the verification is over.

Question: - Does PMJAY or Ayushman Bharat Yojana Offer Coverage for Diabetes?

Answer: - Ayushman Bharat Yojana or PMJAY covers diabetic patients from day one. Ayushman Bharat scheme also covers diabetes if it is a pre-existing disease from day one. But, this is only for in-patient hospitalization and OPD expenses will not be covered.

Question: - Does PMJAY or Ayushman Bharat Yojana Covers Maternity Expenses?

Answer: - Yes, PMJAY or Ayushman Bharat Yojana cover the normal and labour delivery, c-section and high-risk delivery.

Question: - Is cancer covered under Ayushman Bharat Yojana or PMJAY?

Answer: - Yes, cancer is covered under Ayushman Bharat Yojana or PMJAY.

Question: - How to update data in Ayushman Bharat Yojana or PMJAY?

Answer: - The beneficiaries can update their data by calling on the Ayushman Bharat Yojana or PMJAY helpline numbers i.e. 14555 or 1800-111-565 or by visiting the Common Service Centre (CSC).

Question: - Does Ayushman Bharat Yojana or PMJAY offer coverage to senior citizens?

Answer: - Yes, Ayushman Bharat Yojana or PMJAY covers senior citizens as it does not have any upper age limit.

Question: - Does Ayushman Bharat Yojana or PMJAY covers the pre-existing diseases?

Answer: - Yes, Ayushman Bharat Yojana or PMJAY covers pre-existing diseases from day one.

Question: - Does Ayushman Bharat Yojana or PMJAY covers Rural people?

Answer: - Yes, Ayushman Bharat Yojana or PMJAY covers people belongs from both urban and rural areas.

Question: - Does Ayushman Bharat Yojana or PMJAY offer coverage for Orthopaedics treatment?

Answer: - Yes, Ayushman Bharat Yojana or Pmjay offer coverage for Orthopaedics treatment but upto a specified limit.

Question: - How I can find my Household ID number for Ayushman Bharat Yojana or PMJAY?

Answer: - The Household ID (HH ID) number is of 24 digits and is provided to the families who are identified under the SECC.

PMJAY: Ayushman Bharat Yojana Eligibility & Registration Online