Ayushman Bharat Yojana(Pradhan Mantri Jan Arogya Yojana)

Pradhan Mantri Jan Arogya Yojana(PMJAY) or Ayushman Bharat Yojana is an initiative to ensure that poor and vulnerable population is provided health cover. This initiative is part of the Government’s vision to ensure that its citizens – especially the poor and vulnerable groups have universal access to good quality hospital services without anyone having to face financial hardship as a consequence of using health services.

Ayushman Bharat Yojana PMJAY

Benefits

Ayushman Bharat Scheme provides an insurance cover upto Rs 5 lakh per family, per year for secondary and tertiary hospitalization. All pre-existing conditions are covered from day 1 of implementation of PM-JAY in respective States/UTs.

Ayushman Bharat Yojana PMJAY Benefits

The health services covered under the programme include hospitalization expenses, day care surgeries, follow-up care, pre and post hospitalization expense benefits and new born child/children services.

Eligibility Criteria

Ayushman Bharat scheme is entitlement based there is no registration required for it.

Ayushman Bharat Yojana PMJAY Eligibility Criteria

Ayushman Bharat scheme will target poor, deprived rural families and identified occupational category of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) 2011 data, both rural and urban. Additionally, all such enrolled families under Rashtriya Swasthaya Bima Yojana (RSBY) that do not feature in the targeted groups as per SECC data will be included as well.

The categories in rural and urban that will be covered under PMJAY are given as follows:

For Rural:

Total deprived Households targeted for PMRSSM who belong to one of the six deprivation criteria amongst D1, D2, D3, D4, D5 and D7:

  • Only one room with kucha walls and kucha roof (D1)

  • No adult member between age 16 to 59 (D2)

  • Female-headed households with no adult male member between age 16 to 59 (D3)

  • Disabled member and no able-bodied adult member (D4)

  • SC/ST households (D5)

  • Landless households deriving major part of their income from manual casual labour (D7)

Automatically included:

  • Households without shelter

  • Destitute/ living on alms

  • Manual scavenger families

  • Primitive tribal groups

  • Legally released bonded labour

For Urban:

  • Occupational Categories of Workers

  • Ragpicker

  • Beggar

  • Domestic worker

  • Street vendor/ Cobbler/hawker / Other service provider working on streets

  • Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard

  • Coolie and another head-load worker Sweeper/ Sanitation worker / Mali

  • Home-based worker/ Artisan/ Handicrafts worker / Tailor

  • Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart puller/ Rickshaw puller

  • Shop worker/ Assistant/ Peon in small establishment/ Helper/Delivery assistant / Attendant/ Waiter

  • Electrician/ Mechanic/ Assembler/ Repair worker

  • Washer-man/ Chowkidar

As per the SECC 2011, the following beneficiaries are automatically excluded:

  • Households having motorized 2/3/4 wheeler/fishing boat

  • Households having mechanized 3/4 wheeler agricultural equipment

  • Households having Kisan Credit Card with credit limit above Rs. 50,000/-

  • Household member is a government employee

  • Households with non-agricultural enterprises registered with government

  • Any member of household earning more than Rs. 10,000/- per month

  • Households paying income tax

  • Households paying professional tax

  • House with three or more rooms with pucca walls and roof

  • Owns a refrigerator

  • Owns a landline phone

  • Owns more than 2.5 acres of irrigated land with 1 irrigation equipment

  • Owns 5 acres or more of irrigated land for two or more crop season

  • Owning at least 7.5 acres of land or more with at least one irrigation equipment

A dedicated Pradhan Mantri Jan Arogya Yojana family identification number will be allotted to eligible families. Additionallyan e-card will also be given to beneficiary at the time of hospitalization.

How to Apply

You don't need to apply for Ayushman Bharat scheme (Pradhan Mantri Jan Arogya Yojana). It is based on entitlement. Your name might or might not be already included in the list.

You can check whether your name is already included in the list by using either or any of your

  • Mobile number

  • Ration Card Number

  • Socio-Economic and Caste Census (SECC) Name

  • Rashtriya Swasthya Bima Yojana (RSBY) URN

Please follow below steps to check your eligibility for Pradhan Mantri Jan Arogya (Ayushman Bharat) scheme

  • Enter Mobile Number and Captcha

  • Now you can search either by

    • Mobile number

    • Ration Card Number

    • Socio-Economic and Caste Census (SECC) Name

    • Rashtriya Swasthya Bima Yojana (RSBY) URN

Search by mobile number

An Additional Data Collection Drive (ADCD) was conducted on 30th April 2018 at Gram Sabha’s across India to capture active mobile number and ration card number of a family of the Socio-Economic Caste Census (SECC) database. If the individual got his/her Mobile number or Ration card number captured during this drive, only then it will show results on the portal.

Please follow the below steps to check details by mobile number

  • Choose your state

Ayushman Bharat Yojana PMJAY Search by Mobile Number

  • Select "Search by Mobile Number"

  • Enter the mobile number

  • Click on Search  button

Search by Ration Card number

Please follow the below steps to check details by Ration card number

  • Choose your state

Ayushman Bharat Yojana PMJAY Search by Ration card Number

  • Select "Search by Ration card Number"

  • Enter the mobile number

  • Click on Search button

If the individual got his details captured during the ADCD drive and still no results are displayed, then the “SECC Name” option should be used for searching.

Search by SECC Name

An individual can search if he/she is eligible for PMJAY using his details as per the SECC database such as Name, Father’s Name, Gender, State etc.  Please follow the below steps to check details by SECC Name

  • Choose your state

Ayushman Bharat Yojana PMJAY Search by Name

  • Select "Search by Name"

  • Enter the name followed by name of your father, mother and  spouse

  • Choose your Gender

  • Enter your Age

  • Select Rural or Urban part

  • Enter District, Village, Pincode

  • Click on Search  button

Even now, if no results are displayed, then the user should contact a nearby Ayushmaan Mitra.

Search by RSBY URN

If all active families that are enrolled under Rashtriya Swasthya Bima Yojana (RSBY) (till 31st March, 2018) that do not feature in the targeted groups as per SECC data will be included as well and can identify if they are eligible for PMJAY using RSBY URN.

Please follow the below steps to check details by RSBY URN

  • Choose your state

Ayushman Bharat Yojana PMJAY Search by RSBY URN

  • Select "Search by RSBY URN"

  • Enter the RSBY URN number

  • Click on Search button

If your name appears in any of these searches, you are a beneficiary of Ayushman Bharat scheme.

How to avail services

Please follow the below steps to access care under Ayushman Bharat scheme (Pradhan Mantri Jan Arogya Yojana)

  • Patients approaches empanelled hospital. You can find the list of empanelled hospitals here.

  • Arogya Mitras will assist in admission, beneficiary verification, authentication, query management, grievance redressal.

Ayushman Bharat Yojana PMJAY Arogya Mitra

  • Hospital will confirm person is an eligible beneficiary under Ayushman Bharat scheme through checking the beneficiaries Aadhar or any relevant documents.

Ayushman Bharat Yojana PMJAY How to Avail Services

  • Hospital select packages and checks balance.Submit supporting evidence required for treatment

Ayushman Bharat Yojana PMJAY How Patients Avail Services

  • Undergo Treatment

  • Discharge

  • Hospital should submit discharge summary and post-treatment evidence 

  • Electronic payments will be made to Hospital

If beneficiary has any issues, beneficiaries can also call the helpline number at 14555. Regular updates will also be provided through ASHAs, ANM and other specific touch points.

Ayushman Bharat Yojana PMJAY Toll Free Number

List of Hospitals

Follow the below steps to find empanelled hospitals under Ayushman Bharat scheme.

Ayushman Bharat PMJAY Hospital List

  • Now you can search for the hospital by State, District, Name, Type or Speciality.

Ayushman Bharat PMJAY Search Hospital

  • Details of hospital along with phone number of contact person will be displayed.

Ayushman Bharat PMJAY Empanelled Hospital List

Related Links

 

FAQs

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