How to apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

126

5 min read

Updated on Jan 18, 2023

The Indian Government has initiated many reasonable schemes and policies lately to secure the health of its people. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is one such scheme that allows health coverage to all. Do you know how to apply for this scheme? Let’s find out!

Visual Stories by PayBima

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) is the Government of India’s flagship health insurance scheme that was launched with the aim of offering universal health coverage to the people of India, especially the economically deprived people. The scheme was introduced as per the recommendations of the National Health Policy 2017. Under this scheme, over 18 crore PM-JAY health cards were issued by the government till March 31, 2022.

With the PM-JAY initiative, the government endeavored to offer a comprehensive health insurance facility by incorporating a holistic approach. Hence, PMJAY offers health prevention and health promotion along with ambulatory care in different levels.

The Ayushman Bharat Scheme has two connected components, such as;

  • Pradhan Mantri Jan Arogya Yojana (PM-JAY)
  • Health and Wellness Centres (HWCs)

Ayushman Bharat Yojana – Target Group

The PM-JAY scheme is mainly targeted at the economically low sections of the society. Hence, the poor and deprived people of rural and urban areas along with some categories of occupational workers in the urban areas are primarily targeted.

With the PM-JAY Scheme, the government wants to cover nearly 50 Crore Indian population including rural and urban families as per the Socio-Economic Caste Census (SECC) data of 2011.

Under the scheme, each family eligible for the plan receives a health cover of INR 5 lakh every year on a family floater basis.

Process to Check for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Online Eligibility

The PM-JAY scheme is applicable for all beneficiaries who are identified under the SECC 2011. Also, the scheme includes the beneficiaries who have been a part of RSBY scheme.  The eligibility for the scheme can be checked via the NHA or National Health Authority Portal. If you are eligible, you can apply for the scheme by following the below process. Here are the steps to Ayushman Bharat Pradhan Mantri Jan Arogya Yojana apply online process:

  • First the applicant needs to log in to the official website of the scheme – mera.pmjay.gov.in
  • Enter your contact number along with the captcha code that you can see on the screen
  • You will receive an OTP in your mobile number. Enter the OTP and you will be redirected to the login screen of PM-JAY
  • Now, you may select the state where you reside and from where you want to apply for the scheme
  • Here, you can check for your eligibility criteria by using details of your Name, Phone number, Ration card number, or RSBY URN number
  • In case you are eligible, your name will feature on the right-hand side of the screen
  • Now, you can click on the ‘Family Members’ tab to check the beneficiary details

How to Check Eligibility Offline for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

Further to this, the eligibility for PM-JAY can also be checked by dialing the Ayushman Bharat Yojana call center number: 1800-111-565 or 14555 or by approaching an EHCP or Empaneled Health Care Provider.

Popular Health Insurance Companies India, 2023

How to register the name for Ayushman Bharat Yojana?

For quick Ayushman Bharat Pradhan Mantri Jan Arogya Yojana registration online, you can follow the below-mentioned steps:

  • First complete the eligibility checking by visiting the PM-JAY official website at https://pmjay.gov.in/
  • The names of the eligible applicants are displayed on the right side of the webpage
  • Fill up the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana online form to proceed with the Ayushman card online registration
  • You might be asked to attach scanned copies to support your documents
  • Now, you have to submit the form together with the attached documents
  • Once done, the relevant authorities will process your application
  • After your application gets approved, you will be issued an online Ayushman card will be issued in PDF, which you can download

Does the PM-JAY work on an entitlement basis?

Ayushman Bharat PM-JAY scheme is an entitlement-based scheme which decides the eligibility criteria on the basis of SECC database.

  • In case of rural areas, the beneficiaries are categorized as D1, D2, D3, D4, D5, and D7 on the basis of deprivation as per the SECC database
  • In case of applicants in the urban areas, the entitlement is determined as per 11 occupational criteria
  • Further, among the applicants also includes the beneficiaries of RSBY or Rashtriya Swasthya Bima Yojna

Let us now take a look at the basic differences between the features of private health insurance policies as compared to Ayushman Bharat Yojana to get better understanding.

Read More: Pradhan Mantri Ayushman Bharat Yojana Benefits, Features, Inclusions and Exclusions Under PMABY

Differences between Private Health Insurance V/S the Ayushman Bharat Yojana

Features Private Health Insurance Ayushman Bharat Yojana
Health check-up Free periodic health check-up allowed No free health check-up allowed
Sum insured Up to INR 3 Crore (Max) Up to INR 5 lakh (Max)
Pre and post hospitalization coverage 60 days pre-hospitalization and 180 days post-hospitalization coverage allowed 3 days pre-hospitalization and 15 days post-hospitalization coverage allowed
Coverage of critical illness Allow coverage of up to 20 critical diseases Allow coverage for 9 critical diseases
OPD expenses and home treatment OPD coverage and home treatment OPD and home treatment not covered
Premiums Normal premium Government pays premium on behalf of the applicant
NCB or No Claim Bonus You get NCB for every claim-free year No NCB benefit is offered
Tax Benefits Tax deduction can be claimed under section 80D No tax benefit is allowed

Footer Paragraph

Found this post informational?

Browse PayBima Blogs to read interesting posts related to Health Insurance, Car Insurance, Bike Insurance, Term Life Insurance, and Investment section. You can visit PayBima to Buy Insurance Online.

Also, check out the PayBima’s Guide and Glossary section –

 

Related Articles:

 

 

View this post on Instagram

 

A post shared by paybima (@paybima)

FAQs on Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

What is the PM-JAY enrollment process? Is there any time duration for enrollment?

The PMJAY is an entitlement-based health policy with no specific enrollment procedure. Families that are identified under the scheme are done on the basis of deprivation and occupational criteria. The scheme utilizes the SECC census data to determine the beneficiaries under the rural and urban criteria.

What benefits can be received from the PM-JAY Scheme?

The benefits received under Ayushman Bharat Yojana include a family floater health insurance coverage for a sum insured of up to INR 5 lakh per year. Under this scheme, all the pre-existing illnesses are covered without any waiting period.

What are the health services allowed under PM-JAY?

The health services allowed under PM-JAY include:
Hospitalization
Daycare surgeries
Follow-up care
Newborn childcare etc.

A detailed list of the services available under the Ayushman Bharat Yojana can be seen on the official website of the scheme.

Do I need to pay a premium to get coverage under the PM-JAY scheme?

No. the eligible applicants under the PM-JAY scheme do not require to pay a premium. They can avail the benefits offered under the plan without making any payments, including cashless treatment.

What documents does a beneficiary must bring to the hospital in case of getting hospitalized?

At the time of hospitalization, the beneficiary needs to carry a ration card or Aadhaar card or any other government recognized photo identity document. 

How does the Claim Submission process work under Ayushman Bharat Yojana?

Once the patient is discharged from the hospital, he/she can initiate the claim submission process. This can be done by raising a request on the online portal along with submitting the treatment summary and other documents. The hospital submits the documents within 24 hours of discharge.

What happens if a beneficiary falls sick while traveling or when the person is out of the home district or state?

PMJAY benefits are applicable across the country. You can avail the services by simply calling the toll-free helpline number 14555.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana how to apply?

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is a simple online process. However, kit can also be done offline by calling at the Ayushman Bharat Yojana call center number: 1800-111-565 or 14555.

Jan 16, 2023
SHARE THIS ON
Author Bio
Author Image

PayBima Team
PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

Related Blogs

Would love to hear from you

Share your candid feedback. Your email address won’t be published, we promise!

All fields are required

Find your suitable insurance plan

Speak to our advisor

Corporate Office : Mahindra Insurance Brokers Ltd ( A Mahindra Group Company ) Sadhana House, Ground Floor, 570 P. B. Marg, Behind Mahindra Towers, Worli, Mumbai 400018.

Licenced by IRDAI License No. 261; License Validity : 17-05-2025; Category : Composite Broker; CIN : U65990MH1987PLCO42609 Member of Insurance Brokers Association of India (IBAI).

Insurance is the subject matter of solicitation.

For a seamless experience, use the latest version of Chrome/Firefox/Internet Explorer.

Copyright © 2023 Mahindra Insurance Brokers. All Right Reserved.

Get A Call Back
Get A Call Back