PMJAY Scheme: Ayushman Bharat Yojana Eligibility & Details

Ayushman Bharat Yojana or National Health Protection Scheme is a program that aims to provide a service to create a healthy, capable and content new India. It has two goals, one, creating a network of health and wellness infrastructure across the nation to deliver comprehensive primary healthcare services, and another is to provide insurance cover to at least 40% of India's population which is majorly deprived of secondary and tertiary care services. 

This centrally sponsored flagship scheme aims to provide an annual health cover of up to Rs. 5 lakh to vulnerable 10 crore families (approximately 50 crore persons - 40% of the country's population) based on the Socio-Economic and Caste Census database.

What is Ayushman Bharat Yojana Scheme (PMJAY)?

Considered one of the largest health schemes in the world, the Ayushman Bharat Scheme aims to reach more than 50 crores, Indian citizens. It is specifically designed for the economically weaker sections of the country. PMJAY was launched in September 2018, providing a maximum of Rs 5 lakh in uninsured health insurance. 

The Government health insurance plans cover most medical expenses, pre-medication, diagnosis, and hospitalization costs. In addition, the scheme provides cashless hospital services through the Aushman Bharat Yojana e-card, which you can avail for healthcare at any hospital across the country. Beneficiaries of this scheme can be admitted to the hospital for necessary treatment by showing their PMJAY card.

What are the benefits of ayushman bharat ? 

• Health cover of `5 lakhs per family per year, for secondary and tertiary care hospitalization through a network of empanelled public and private providers.
• No restrictions on family size, age or gender.  
• Cashless access to services for the beneficiary at the hospital. 
• All pre–existing conditions are covered from day one. 
• Covers up to 3 days of pre-hospitalization and post-hospitalization expenses such as diagnostics and medicines.  
• Benefits of the scheme are portable across the country where a beneficiary can visit any empanelled public or private hospital for cashless treatment.
• Services include approximately 1,400 procedures covering all the costs related to treatment, including but not limited to drugs, supplies, diagnostic services, physician's fees, room charges, surgeon charges, OT and ICU charges, etc.

Ayushman Bharat Yojana Scheme Eligibility Criteria for Rural and Urban areas.

The PMJAY health facility is available for Rural Areas:

• People belonging to scheduled caste and scheduled tribe families
• Households with no male member between the age of 16 years and 59 years
• Beggars and those surviving on alms
• Families with no individual between the age of 16 years and 59 years
• Households with at least one physically challenged member and no healthy adult individual
• Landless families who make a living by working as casual manual labourers
• Primitive tribal communities
• Legally released bonded labourers
• People living in one-room makeshift houses with no proper walls or roof
• Manual scavenger families

The PMJAY health facility is available for Urban Areas:

• Washerman/ Chowkidars
• Rag Pickers
• Mechanics, electricians, and repair workers
• Domestic help
• Sanitation workers, gardeners, and sweepers
• Home-based artisans and handicraft workers
• Tailors
• Cobblers, hawkers, and people providing services by working on streets or pavements
• Plumbers, masons, construction workers, porters, welders, painters, and security guards
• Transport workers such as drivers, conductors, helpers, cart, or rickshaw pullers
• Assistants, peons of a small organization, delivery men, shopkeepers and waiters

Who are Not Eligibility for Health Coverage under PMJAY Scheme?

• Owning a two, three, or four-wheeler or a motorized fishing boat
• Have a mechanized farming equipment
• Have a Kisan card with a credit limit of INR 50,000
• Employed by the government
• Working in government-managed non-agricultural enterprises
• Earning a monthly income above INR 10,000
• Owning refrigerators and landlines
• With decently build houses
• Owning 5 acres or more of agricultural land

Important Document required for PMJAY.

Eligibility under PM-JAY may be checked by visiting the nearest Common Service Center 

• Voter ID or Aadhar Card 

• Ration Card (family ID)

How to Apply for Ayushman Bharat Yojana & Helpline Number.

Visit https://www.pmjay.gov.in/ and click on ‘Am I Eligible’

Enter your Moblie Number and the CAPTCHA code and click on ‘Generate OTP’

Then select your state and search by Name /HHD Number /Ration Card Number/ Mobile Number

Based on the search result you can verify if your family is covered under PMJAY

Alternatively,to know if you are eligible for PMJAY you can approach any Empanelled Health care provider (EHCP) or dial the Ayushman Bharat Yojana Call center: 14555 or 1800-111-565.