Ayushman Bharat stands as a prominent initiative of the Indian government, aimed at delivering extensive healthcare coverage to the populace. This initiative was launched in accordance with the National Health Policy of 2017.
Within the Ayushman Bharat framework, qualifying families have the opportunity to avail an annual healthcare coverage of ₹5 lakhs, catering to secondary and tertiary hospitalization expenses. This coverage is applicable for services rendered in both public and private hospitals throughout India.
What is Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?
The Pradhan Mantri Jan Arogya Yojana (PM-JAY), a component of the Ayushman Bharat initiative, stands as a health insurance scheme sponsored by the government. Its funding is entirely provided by the government, and the associated implementation costs are shared between the Central and State Governments.
The health insurance offered under Ayushman Bharat encompasses various services, such as covering hospitalization expenses, daycare surgeries, post-hospitalization care, pre-hospitalization benefits, and healthcare services for newborns.
PM-JAY is recognized for its overarching objective of reshaping the healthcare system, encompassing preventive measures, health promotion, and outpatient care.
Key Highlights of PM-JAY
- PM-JAY extends comprehensive coverage of ₹5 lakhs annually per family for hospitalization, covering both secondary and tertiary care. This coverage is applicable through an approved network of public and private hospitals across the country.
- When beneficiaries seek healthcare services at a hospital, PM-JAY facilitates a cashless experience at the point of service.
- The scheme incorporates coverage for up to 3 days of pre-hospitalization and 15 days of post-hospitalization expenses, encompassing diagnostic and medication costs.
- PM-JAY is inclusive, with no restrictions based on family size, age, or gender. Right from the start, it covers all pre-existing medical conditions.
- The benefits of the scheme are not confined by geographical boundaries, allowing beneficiaries to access cashless treatment at any accredited public or private hospital in India.
- Ayushman Bharat health insurance encompasses a wide array of approximately 1,929 medical procedures. This coverage includes all expenses associated with treatment, covering medications, supplies, diagnostic services, physician fees, room charges, surgeon fees, operating theatre and intensive care unit expenses, and more.
- Both public and private hospitals are reimbursed for healthcare services at rates equivalent to those paid to private hospitals.
What is the ABHA Card?
In 2021, the Indian government unveiled the Ayushman Bharat Health Account (ABHA), formerly referred to as the Ayushman Bharat Health ID. This initiative was designed to provide the public with a digital health identity.
The ABHA card stands out as a unique health identifier, utilizing a 14-digit identification code that can be generated using either your Aadhaar card or mobile number.
This innovative system allows individuals to electronically share their medical records with healthcare facilities, clinics, insurance companies, and various other stakeholders.
How to Apply for the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?
This government-initiated program is designed as a rights-based effort to support socioeconomically disadvantaged sections of the population.
Notably, there is no formal registration process; individuals qualify based on their inclusion in the Socio-Economic Caste Census of 2011 and participation in the Rashtriya Swasthya Bima Yojana (RSBY) scheme. To determine your eligibility for this initiative, kindly follow the steps outlined below:
- Step 1: Head to the official government website dedicated to the Pradhan Mantri Jan Arogya Yojana (PM-JAY) scheme and click on the “Am I Eligible” icon.
- Step 2: Input your contact details and generate a One-Time Password (OTP).
- Step 3: Choose your respective state from the options provided.
- Step 4: Conduct a search by entering your name, mobile number, Household ID (HJD) number, or ration card number.
If your family is registered under the Ayushman Bharat Yojana, you will find your name listed in the results.
Moreover, for further assistance, you can get in touch with Ayushman Bharat Yojana customer support through either 1800-111-565 or 14555. Alternatively, feel free to reach out to any of the Empanelled Health Care Providers (EHCP) for support.
Documents Required During The PM-JAY Ayushman Application Process
- Proof of address
- Age and identity proof (Aadhaar Card / PAN Card)
- Caste certificate
- Contact details (Mobile number, e-mail address, etc.)
- Income certificate
- Aadhaar Card
- Documented proof of the current status of the family (joint or nuclear)
The Ayushman Bharat health card serves as a distinctive health identifier, providing access to medical services and health records. Applying for the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana does not involve a formal registration process. Nevertheless, you can verify your eligibility for this program by visiting its official website online.
Certain essential documents, such as address proof, identity proof, and caste certification, may be necessary. Obtaining your ABHA card is a straightforward process, and you can search and download it using either your Aadhaar card or mobile number.