PMJAY Scheme – Ayushman Bharat Yojana Eligibility Criteria and the Online Registeration Process

Prime Minister Shri Narendra Modi launched the (PMJAY) Ayushman Bharat Yojana in his year 2018 Independence Day speech. Pradhan Mantri Jan Arogya Yojana (PMJAY) may be a flagship National Health Protection Scheme funded by the govt. of India. Ayushman Bharat Yojana subsumes the Senior Citizen health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojna (RSBY) and is additionally called the AB-PMJAY scheme. Ayushman Bharat Yojana scheme caters not only the poor but rural families too, which is why it’s economically beneficial to the poor and destitute households in rural and concrete areas.

What’s The Ayushman Bharat Yojana or PMJAY Scheme?

PMJAY is additionally called Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Scheme, one among the most important healthcare schemes that’s sponsored by the govt. of Inidia. Prime Minister, Narendra Modi unrolled Pradhan Mantri Jan Arogya Yojana healthcare scheme with an aim to hide quite 50 crore Indian citizens and nearly 10 Crore underprivileged families with none limitations per family size and age. Ayushman Bharat Yojana (PMJAY) will help these households avail the bet healthcare services with sum of money up to INR 5 lakh for every family p.a. for tertiary and secondary hospitalization expenses. Prime Minister’s Ayushman Bharat Yojana Scheme runs with zero paper work and provides cashless hospitalization cover at the public hospitals and the network private hospitals as well. Ayushman Bharat insurance covers the price of hospitalization, pre-hospitalization, medication, and post hospitalization expenses incurred during the treatment, which is applicable to the majority tertiary and secondary care procedures.

Moreover, Ayushman Bharat Yojana scheme includes nearly 1,400 exorbitant treatments like skull surgery, knee replacements, and also the likewise. and therefore the patients can even follow-up for the treatments to make sure full recovery.

Read below to know all about the (PMJAY) Ayushman Bharat Yojana Scheme including the major features, the eligibility criteria and also the application procedure.

Features of PMJAY: Ayushman Bharat Yojana Scheme

In addition to be a life saver scheme for lower middle income the opposite key features of Pradhan Mantri Ayushman Bharat Yojana (PMJAY) are as follows:

1. Ayushman Bharat Yojana scheme may be a family floater scheme with a sum assured of Rs. 5 lakh per family enrolled.

2. This scheme is specially designed for people below the personal income who do have access to internet or online health plans.

3. PMJAY scheme facilitates cashless healthcare services to its beneficiary in any of the general public sector hospitals and personal network hospital.

4. Moreover, Pradhan Mantri Ayushman Bharat Yojana also bears the transportation cost incurred by the policy owner during both the pre hospitalisation and the post hospitalization period.

5. Together with medical treatment expenses, Ayushman Bharat Yojana insurance package also covers the day-care expenses incurred by the beneficiary.

6. PMJAY scheme also covers a number of the precise pre-existing diseases.

7. The payment for medical expenses is to be made supported the package rate as pre-determined by the government.

8. Under the govt backed scheme, a considerate number of health and wellness centres are going to be established asper the Socio-Economic Caste Census data.

Benefits of Ayushman Bharat Yojana Scheme

Pradhan Mantri Ayushman Bharat Yojana Scheme makes sure almost 40 percent of the vulnerable and needy families living in India. The healthcare services and benefits that they will avail are listed below:

1. The treatment and healthcare facilities under PMJAY is offered across India and is freed from cost.

2. The Ayushman Bharat Scheme offers 25 speciality categories and it covers a large range of 1,354 medical and surgical packages like neurosurgery, cardiology, etc.

3. Ayushman Bharat Yojana scheme also covers post-hospitalization expenses.

4. Just in case of multiple surgeries, the price shall be covered with the very best package. And for second and third surgery it should be covered 50% an 25% respectively.

5. The scheme also covers the treatment cost of oncology with chemotherapy for 50 differing kinds of Cancer. However, both medical and surgical package can not be availed at the identical time.

6. The beneficiaries under PMJAY scheme also can avail follow-up treatment coverage.

What’s Covered under Ayushman Bharat Yojana Scheme?

PMJAY covers the subsequent expenses during the treatment:

1. Ayushman Bharat Yojana Scheme provides coverage for scrutiny, treatment and consultation fee.

2. Pre-hospitalization expenses are covered under Ayushman Bharat Yojana policy.

3. Post-hospitalization expenses are covered for 15 days.

4. The policy also covers the value of medication and medical consumables

Hospital accommodation charges also are covered.

5. Non-intensive and ICU services

The expenses incurred on the Diagnostic procedures are covered.

6. Medical implantation services are covered where required.

7. Expenses incurred on complications arising during the medical treatment

Food services.

Who isn’t entitled to avail coverage under the Ayushman Bharat Yojana?

The following categories of entities aren’t covered under the Ayushman Bharat Yojana:

1. People that own a vehicle sort of a two-wheeler, three-wheeler, or a car

Government employees.

2. People whose monthly income is quite Rs 10,000.

3. Those that have farming machinery and equipments.

4. Those that board properly build houses.

5. Those that hold a Kisan card.

6. Those owing a motorized fishing smack.

7. Those owing an agriculture land of quite 5 acres.

8. People employed in government-run non-agricultural enterprises.

9. Those who have refrigerators and landline phones in their houses.

Ayushman Bharat Eligibility Criteria for Rural and concrete People

1. To avail the advantages of Ayushman Bharat Yojana insurance scheme, it’s essential for all the people to test for his or her names within the Socio-Economic Caste Census-2011 data. this may ensure if their family is eligible to be covered under Ayushman Yojna or not. Only those households whose names are listed in SECC database and are active RSBY card owners are entitled to enjoy the PMJAY benefits.

2. Pradhan Mantri Ayushman Bharat Yojana allows the eligible members to avail the healthcare services across India.

PMJAY Scheme: Eligibility Criteria for Rural

1. Household with no adult/male/ earning member within the cohort of 16-59 years.

2. Families living in one room with Kuccha Kuccha walls and roof.

3. Families with no members within the people of 16-59 years.

4. Household without a healthy adult member and one disabled member.

5. Manual scavenger families.

6. Landless households earning a serious a part of their family income from toil.

PMJAY Scheme: Eligibility Criteria for Urban

1. Domestic worker

2. Beggar

3. Ragpicker

4. Home-based Artisans/ Tailor

5. Sweeper/ Handicrafts worker/

6. Sanitation worker/ Mali

7. Construction worker/ Labour/ Painter/ Welder/ Security guard/ Coolie

8. Washer-man/ Plumber/ Mason

9. Electrician/ Mechanic/ Assembler/ Repair worker

10. Transport worker/ Rickshaw puller/ Conductor/ Cart puller/

Waiter/Shop worker/ Assistant/ Peon/Delivery assistant

11. Street vendors/ hawker / Cobbler

A way to Register for PMJAY Scheme Online?

It is very easy and simple to register for PMJAY scheme. it’s applicable to any or all beneficiaries who are identified under the SECC 2011 list and people who are as a part of the RSBY scheme. However, if you would like to register for PMJAY online, you’ll be able to follow the steps given below:

1. Visit the official government website for PMJAY scheme.

2. you’ll find Am I Eligible tab, simply click thereon.

3. Submit your mobile number, CAPTCHA code, and click on on Generate OTP button

Now enter your State and your name, identity card number, household number, or mobile number.

4. If your family is roofed under Ayushman Bharat Yojana, then you name are displayed within the results

Documents Required to use For Ayushman Bharat Yojana Scheme

Age & Identity Proof (Aadhaar Card/PAN Card).

5. Contact details (mobile, address, email).

6. Caste certificate.

7. Income certificate (maximum annual income to be only up to Rs. 5 lakh a year).

8. Document proof this status of the family to be covered (Joint or nuclear).

A way to Check your Name in Ayushman Bharat Yojana Scheme List?

There are various methods to test your name within the PM Jan Arogya Yojana -PMJAY beneficiary list. Listed below are a number of the ways in which you’ll try:

1. Online Method– Ayushman Bharat online list is checked by the beneficiaries. All you wish to try and do is visit the official online site of the National Health Authority for Ayushman Bharat Yojana.

2. Common Service Centres (CSC)– If you’re a beneficiary of Ayushman Yojna you’ll be able to also visit the closest Common Service Centres. If it’s unattainable to try and do so you’ll also visit any of the empanelled hospitals to gather the knowledge form. you’ll be able to check the Ayushman Bharat hospital list on their site or in your policy documents.

3. Contact their Helpline Number– you’ll be able to appeal any of the govt. of India provided helpline numbers (e.g. 1800111565) to contact their customer care and seek the knowledge about PMJAY Scheme, Ayushman card/e-card, Ayushman card apply, Ayushman card download and even Ayushman Bharat Scheme registration.

If your name is there within the list, then only you’ll get the Ayushman Bharat Card.

Major Critical Diseases which are covered under the PM  Ayushman Bharat Yojana Scheme (PMJAY)

PMJAY offers nearly 1,350 medical packages at any of the private network hospitals and every one the general public hospitals. Below are a number of the critical illnesses that Ayushman Yojna covers:

1. Carotid angioplasty with stent

2. adenocarcinoma

3. arterial blood vessel bypass grafting

4. Skull base surgery

5. semilunar valve surgery

6. Double valve replacement surgery

7. Anterior spine fixation

8. Tissue expander for disfigurement following burns

A way to Download your Ayushman Bharat Yojana Card Online?

It is important to use for the Ayushman card because it consists of an obsessive family number. AB-NHPM is provided to each beneficiary household. Below are the steps that you just can follow to use or download your Ayushman card online-

1. Firstly, visit Ayushman Bharat Yojana official website.

2. Now login together with your email id and generate password.

3. Enter your Aadhaar number to proceed further, Click on the approved beneficiary option.

4. it’ll be redirected to their help centre.

5. Now enter your password in CSC and also the PIN.

6. it’ll be redirected to the house page.

7. you may see the download option form where you’ll be able to download your Ayushman Bharat golden card.

Ayushman Bharat Scheme Hospitalization Process

Ayushman Bharat Yojana scheme offers insurance cover to beneficiaries with none premium cost, treatment cost during and after the hospitalization. Ayushman Bharat scheme covers both the pre and the post hospitalization expenses along with the in-patient charges.

1. Every one the empanelled hospitals under PMJAY Scheme would have appointed Ayushman Mitra’s who will aid the patent by coordinating with the hospital’s beneficiary so as to chop the expenses. you’ll find these Ayushman Mitra at their help desk where they’re going to be verifying the eligibility criteria, documents, and therefore the enrolment process. they supply letters to any or all the beneficiaries with respective QR codes.

2. Furthermore, this QR code is scanned and verified for authentication to test the eligibility for people to avail Ayushman Bharat Yojana benefits.

3. Also the better part about Ayushman Bharat scheme is that it offers coverage across PAN India and offers cashless hospitalization benefits to the enrolled families in both the general public and personal hospitals.

PMJAY Patient Card Generation

You can apply for an e-card once you discover out your eligibility for Ayushman Bharat yojana scheme. But before you get this e-card, you’ll need to undergo an biometric authentication at one among the PMJAY kiosk supported your documents like Aadhaar card or card. Even your family identification are often furnished including the RSBY cars, or a government certified list of members. After this verification is completed, you patient e-card is printed together with your Ayushman Bharat ID, which may be used for future references.

COVID-19 Treatment which are Covered under the Prime Minister’s Ayushman Bharat Yojana Scheme (PM-JAY)

As per the IRDAI’s regulation all the insurance providers are covering COVID-19 hospitalization expenses. Even the govt. backed Ayushman Bharat scheme also offers coverage against the world pandemic COVID-19. The beneficiary can avail medical test facilities at any of the panel hospitals with none money being charged as per the NHA’s announcement. Ayushman Bharat Scheme also provides coverage im case of the isolation and the  quarantine expenses are also included. All the empanelled hospitals under this policy are well-equipped to hold out Coronavirus testing, treatment, and quarantine facilities. it’s great initiative to supply protection to the poor and needy families against the impact of the deadly COVID-19. As this policy is for people below the poverty level, those within the higher income groups who will pay premium on their own should also get adequate health cover. Considering the continued medical inflation, a health cover of minimum Rs. 10 lakhs is usually recommended that may go up to of Rs. 1 Crore and more as per your need. This can be required to avail the simplest possible treatment for emergency medical treatment including life threatening diseases like cancer, surgical operation, heart surgeries, etc.

PMJAY Toll-free Number and Address:

PM Ayushman Bharat scheme enables the applicants to invoke their helpline number for any grievances 14555 & 1800111565.

Address: 7th and 9th Floor, Tower-L, Jeevan Bharati Building, Connaught Place, national capital – 110001

FAQs

1. What’s an Ayushman Bharat card?

Ans: people who are eligible to avail PMJAY benefits can apply for an e-card. This card can be taken as the proof to avail healthcare benefits in regards to the future. This card is issued after verifying the beneficiary’s identity at a PMJAY kiosk. this is often finished the assistance of identity documents like card or your Aadhaar card. Family identification proofs should be produced to include a government certified list of members, Prime Minister’s letter and an RSBY card. And after the verification is completed, the e-card is printed together with the unique AB-PMJAY ID.

2. What’s the method to induce an Ayushman card?

Ans: there’s no special registration procedure per Ayushman Bharat Scheme. All the beneficiaries under PMJAY are either a component of RSBY Scheme or are identified by the SECC 2011. Mentioned below is how you’ll be able to check your eligibility as a PM-Jay beneficiary.

1. Visit the official website and click on on Am I Eligible.

2. Provider your mobile number and therefore the CAPTCHA code and click on on ‘Generate OTP.

3. Then select your state and search by mobile number/HHD number/name/ identity card number.

4. Supported the results that appear in search you’ll check if your family is roofed under Ayushman Bharat Scheme.

On the opposite hand, if you would like to test your eligibility under PMJAY you check the Empanelled Health Care Provider or dial the PMJAY helpline number i.e. 14555 or 1800-111-565.

3. Do the beneficiaries should pay anything to urge coverage under Ayushman Bharat insurance scheme?

Ans: The scheme offers the beneficiaries free healthcare services for both secondary and tertiary inpatient hospitalization as per identified packages at empanelled private hospitals and also the government hospitals. Moreover, they’re given cashless and paperless access to inpatient hospitalisation under this Ayushman Yojana.

4. Are diabetic patients covered under PM Ayushman Bharat Yojana Scheme?

Ans: Yes, you’ll be insured from Day 1 under this scheme whether or not you’ve got diabetes but just for inpatient hospitalization, because it covers pre-existing diseases. But, OPD expenses won’t be covered.

5. How would i do know whether the hospital provides the relevant package under Ayushman Bharat Yojana while i’m traveling to a different state?

Ans: to grasp if the hospital offers the required health package you’ll be able to go into Ayushman Bharat tollfree helpline number i.e. 14555 and seek advice from their Ayushman Mitra who are appointed therein hospital.

6. Will i buy maternity coverage under JSY part of AB-NHPM?

Ans: The Ayushman Bharat Yojana compensates for Normal Labour and delivery, C-sections, similarly as high risk deliveries. But it doesn’t cover JSY and another voucher scheme benefit.

7. What should I do if the hospital refuses to treat a beneficiary under Ayushman Bharat Scheme?

Ans: The grievance are redressed within 30 days of filing the complaint by an infatuated Grievance Redressal Committee that’s appointed at national, state, and district level.

8. Is Cancer covered under Ayushman Bharat Yojana Scheme?

Ans: Yes, Ayushman Bharat Yojana covers cancer treatment, but the cancer type and duration vary for various kind of Cancers. The treatment for this disease has to undergo a treatment plan and a few approvals sort of a ‘tumour board concept’ to come to a decision the most effective patient management. It also requires mandatory approval for clinical treatment for cancer care, because it involves a multi model approach requiring coverage for chemotherapy, surgeries and radiotherapy and another supported take care of best patient care and management. it involves 2 step approach for pre-authorisation for the entire course of cancer treatment mentioning the various stages after treatment. It also requires signing and filling the detailed oncology treatment form and wishes to be uploaded as per pre-authorisation for every selected package and predefined cancer stage.

9. Is insurance cover under Ayushman Yojana scheme enough?

Ans: This scheme is launched by government to confirm healthcare services to below the poverty level and people who cannot afford to pay the premium amount once a year. However, others who pays the premium should have an adequate insurance plan ranging from Rs. 10 lakh insurance (nowadays) that covers the treatment cost of diseases like Diabetes, Cancer, attack and other illnesses. you’ll also buy that a Rs. 1 Crore insurance and more as per your pocket.

10. The way to update data in PMJAY?

Ans: All the beneficiaries of the scheme can update their data by calling at their helpline number i.e. 14555 or 1800-111-565 or by checking the Common Service Centre (CSC).

11. The way to change mobile number in PMJAY?

Ans: To change the registered mobile number under the PMJAY you are required to sit down with your State Health Agency (SHA).

12. Does PMJAY cover people above the age of 80 years?

Ans: Yes, it covers people above the age of 80 years because the scheme doesn’t have any ordinance criteria.

13. Does PMJAY scheme offer coverage to farmers?

Ans: The scheme offers coverage to people in both rural and concrete area.

14. Does Ayushman Bharat scheme cover Orthopaedics treatment?

Ans: The scheme offers coverage for Orthopaedics treatment up to a specified limit.

15. Does PMJAY cover pre-existing diseases?

Ans: All the pre-existing diseases are covered under PMJAY from day 1.

16. How am i able to find my Household ID number for PMJAY?

Ans: The HH ID number is of 24 digits and is provided to families who are identified under the SECC.