Ayushman Bharat Yojana Scheme

The Pradhan Mantri Jan Arogya Yojana insures the vulnerable and underprivileged families in India. It is a family floater health scheme with a sum assured of Rs. 5 lakh per family enrolled and facilitates cashless healthcare services in any empanelled hospital.

A few of its benefits are:

• Free of cost treatment and healthcare facilities across India 
• Specific pre-existing diseases are covered from day one
• It offers around 1,400 medical and surgical procedures
• Coverage of pre and post hospitalisation expenses, day-care expenses incurred by the beneficiary, medical examinations, consultations, diagnostic and laboratory investigations, etc.
• In the case of multiple surgeries, the cost is covered with the highest package. For the second and third surgery, it covers 50% and 25%, respectively
• Follow-up treatment coverage
• The scheme also covers food services, accommodation, etc. 
• Testing and treatment of COVID-19

Applying for the Pradhan Mantri Jan Arogya Yojana is simple and can be done online. The documents required are:

• Age & identity proof (Aadhaar Card, PAN Card)
• Contact details (mobile, address, email)
• Caste certificate
• Income certificate (maximum annual income up to Rs. 5 lakh annually only)
• Document proving the current status of the family (joint or nuclear)

You will be issued a PMJAY Golden Card at registration containing all your necessary information.

To get your Ayushman Bharat Golden Card, follow the below steps:

• Visit the official PMJAY website
• Login with your registered contact number
• Enter the captcha code and generate the OTP (One-Time-Password)
• Opt for the HHD code
• Once you provide the correct HHD code, they will check and verify the details provided
• The PMJAY representative will complete the remaining process
• You will have to pay Rs. 30 to get your Ayushman Bharat Golden Card

For availing of the benefits of the Pradhan Mantri Jan Arogya Yojana, you would need to look for your name in the Socio-Economic Caste Census-2011 data to ensure if your family is eligible to be covered under this scheme or not. Only those listed in the SECC database and with active RSBY cards can avail PMJAY benefits.

You can check your name in the AB-PMJAY list using any of these three methods:

• Visit the Common Service Centre (CSC) of PMJAY or any empanelled hospital 
• Contact the Helpline Number at 14555 or 1800-111-565 to check your eligibility.
• Visit the PMJAY website 

Since the Pradhan Mantri Jan Arogya Yojana launch, many hospitals have been empanelled under the scheme across the country. 

Follow the steps below to find the list of these empanelled hospitals:

• Visit the link - https://hospitals.pmjay.gov.in/Search/empnlWorkFlow.htm?actionFlag=ViewRegisteredHosptlsNew
• Select your district area and state
• Select the type of hospital you are looking for 
• Select the kind of medical guidance you need
• Enter the captcha code
• Click on ‘Search’ to see the list of the PMJAY empanelled hospitals with respective addresses, contact details, and the official website

If you have enrolled for the Pradhan Mantri Jan Arogya Yojana, the hospitalisation process under the scheme is simple. Every empanelled hospital under the PMJAY appoints an Ayushman Mitra who would help you by coordinating with the hospital’s administration. Once you reach the empanelled hospital, contact the Ayushman Mitra at their help desk, who will verify your eligibility criteria, and documents, and explain the enrolment process.

The scheme offers coverage across India, providing cashless hospitalisation benefits to the enrolled families, along with covering the following expenses during the treatment:

• Medical examination and consultation fee
• Pre-hospitalisation expenses
• Post-hospitalisation follow-up care up to 15 days
• Cost of medicine and medical consumables
• Hospital accommodation 
• Non-intensive and ICU services
• Diagnostic procedures 
• Medical implantation services where required
• Expenses incurred on complications during any medical treatment
• Food services