5 min read
Updated on Jan 18, 2023
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 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.
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:
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.
For quick Ayushman Bharat Pradhan Mantri Jan Arogya Yojana registration online, you can follow the below-mentioned steps:
Ayushman Bharat PM-JAY scheme is an entitlement-based scheme which decides the eligibility criteria on the basis of SECC database.
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.
|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|
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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.
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.
The health services allowed under PM-JAY include:
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.
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.
At the time of hospitalization, the beneficiary needs to carry a ration card or Aadhaar card or any other government recognized photo identity document.
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.
PMJAY benefits are applicable across the country. You can avail the services by simply calling the toll-free helpline number 14555.
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.
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