Key Features of the PMJAY Scheme: Understanding India's Healthcare Initiative

Pradhan Mantri Jan Arogya Yojana (PMJAY), Ayushman Bharat Yojana Scheme, is the flagship programme of the Government of India. It primarily functions as a health insurance programme for the vulnerable, lower-class, and poor. The programme provides financial security in hospitalisation for emergency medical issues.

PMJAY aims to make medical care accessible to Indian citizens below the poverty line by giving them health insurance coverage. Let us make you know more about PMJAY in detail:

What is PMJAY?

Ayushman Bharat Yojana, one of the largest healthcare programmes in the world, aims to provide coverage for more than 50 crore Indian citizens. It is primarily intended for the country's less prosperous regions.

The PMJAY was introduced in September 2018 and offers health insurance with Rs. 5 lakh maximum sum insured. PMJAY released a list of 1,393 medical procedures covered by the programme. Several different stakeholders are involved in this model, including the federal government, state governments, and insurance industry partners.

PMJAY Offerings

Most of the costs associated with pre-hospitalization, medications, diagnostics, and medical treatment are covered by this government health insurance programme. Additionally, the programme offers cashless hospitalisation services through the Ayushman Bharat Yojana e-card, which you can use to receive medical attention at any hospital across the country that has been granted empanelled status. The goal of PMJAY is to offer expensive medical procedures that the majority of people cannot afford. Ensure to carry your PMJAY Golden Card with you, as it covers the cost of the patient's food and other expenses.

PMJAY beneficiary list of the programme may access hospitalisation for required care by displaying their PMJAY e-card. The foundation of PMJAY is the trust in offering easily accessible and reasonably priced healthcare to India's economically underprivileged regions. The goal of this plan has been accomplished in terms of helping the poor and vulnerable segments of society with money.

What is included under Ayushman Bharat Yojana Scheme?

The Ayushman Bharat Yojana Scheme offers coverage of up to Rs. 5 lakhs per family per year hospitalisation care with the intention of providing affordable healthcare to the poor and needy.

The hospitalisation costs of beneficiaries are covered by the AB-PMJAY health insurance, which includes the following elements: Pre-hospitalisation; medical examination, consultation and treatment; medicine and medical consumables; diagnostic and laboratory services; and intensive and non-intensive care services; medical implant services, wherever required; food services, accommodation, complication arising during treatment; Covid-19 treatment, and post-hospitalisation expenses for up to 15 days.

Features of PMJAY

PMJAY is, without a doubt, one of the best schemes. It addresses financing medical treatments and a number of shortcomings in the health infrastructure. So let's know the PMJAY's features.

• PMJAY is one of the most significant health insurance programmes in the world, supported by the Indian government.
• Nearly 50 crore beneficiaries are eligible for the programme.Health coverage for secondary and tertiary care at public and private hospitals of Rs. 5 lakhs per family living below the poverty line annually.
• It covers the costs of hospitalisation and all additional costs from the 3-day pre-treatment period, such as diagnostics, consulting fees, etc., and up to 15 days of post-hospitalization expenses, such as medications and diagnostics.
• Age or gender restrictions do not apply to PMJAY, which pays for all family members.
• Can access services at any public or private hospital with an empanelled licence anywhere across the country.
• There are 1,393 medical procedures in the plan.
• includes expenses for diagnostic services, medications, room and board, doctor and surgeon fees, supplies, ICU and OT fees, and room and board.
• The payment to public hospitals is equivalent to that to private hospitals.
• PMJAY is a facility set up so that one can receive care and benefit from PMJAY in any location in India.
• It can support roughly 10.74 crore families or 40% of the Indian population.

Benefits of PMJAY Scheme

The PMJAY scheme is intended for the weaker and less fortunate groups in society. The PMJAY's advantages are listed here:

• It provides beneficiaries with cashless transactions that cover all hospital expenses.
• Free accommodation during hospitalisation for patients.
• With PMJAY, one benefits from receiving Rs. 5 lakhs for medical treatment while also not having to pay a dime in reimbursement.
• It prioritises the treatment of women, young girls, and senior citizens.
• It fully reimburses all costs associated with pre-existing conditions, unlike other insurance plans.
• One only needs to have a PMJAY health card in order to use PMJAY. As a result, its cashless transaction makes it simpler for cardholders to pay their bills.
• Poor people can also receive treatment and lead healthy lives.
• About six crore people per year who are plagued by diseases and unable to afford treatment are protected by PMJAY.
• Furthermore, it enables private hospitals that have registered with Ayushman Bharat to participate in developing medical infrastructure.
• The PMJAY programme also aims to benefit India's rural residents, who lack access to quality medical facilities. It will thus close the gap between rural and urban residents.
• To investigate better treatments, the government has kept track of all the hospitals it collaborates with. Their list is also frequently updated to guarantee that the patients receive the best care.

Ayushman Bharat Yojana: How to Apply Online?

To apply for the Ayushman Bharat Yojana / PMJAY online application, you must first determine whether you are a beneficiary of the programme. The procedure to determine your eligibility for the Ayushman Bharat Yojana Registration is listed below:

Step 1: Go to the PMJAY-exclusive website and select the "Am I Eligible" icon.

Step 2: Enter your contact information and select "Generate OTP."

Step 3: Choose your state and enter your name, phone number, or ration card number to search.

Step 4: You can check to see if you qualify for the government healthcare programme.

Conclusion

The Indian government must continue improving the country's health infrastructure, which will only be possible once its services are properly provided. Furthermore, its advantages must be fully utilised because some diseases have expensive treatments. Ayushman Bharat and PMJAY are the ideal teams to tackle this problem because they fight every day for the survival of Indian citizens, especially those from low-income families. Hence, quickly start using this scheme with PMJAY card download online to get benefits for your serious health issues.

FAQs

Which documents are required to apply for PMJAY scheme?

The documents required to be submitted to apply for PMJAY scheme include the following:

• Aadhar Card / Pan Card
• Income Certificate
• Caste Certificate
• Marriage Certificate (if married)

What is the list of critical diseases covered under PMJAY?

Few critical illnesses that PMJAY covers: Pulmonary valve surgery, Carotid angioplasty with stent, Skull base surgery, Prostate cancer, Double valve replacement surgery, Anterior spine fixation, Coronary artery bypass grafting, and Tissue expander for disfigurement following burns.

Does PMJAY provide coverage for existing medical diseases?

Yes, pre-existing diseases are covered by the scheme.

Can one receive treatment at any hospital and have PMJAY reimburse for it?

No, the healthcare facilities where one will be reimbursed are only those registered under Ayushman Bharat.

What does the PMJAY programme not cover?

The Ayushman Bharat Yojana scheme does not cover medical services like cosmetic surgery, drug rehabilitation, fertility treatment, or organ transplant.

Are farmers eligible for the Ayushman Bharat Yojana?

The scheme's primary goal is to make healthcare available and accessible to the most vulnerable and underprivileged members of society. Hence, this scheme applies to the farmers.

Does Ayushman Bharat involve state governments in any way?

Yes, the central and state governments split the insurance reimbursement. The state government covers 40% of the cost, and the central government covers 60%.

How can data be updated in PMJAY?

If you are a scheme beneficiary, you can update your information by contacting the Common Service Center (CSC) or calling the Ayushman Bharat helpline at 1800-111-565 or 14555.