PM Jan Arogya Yojana (PMJAY)

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PM Jan Arogya Yojana (PMJAY)

PM Jan Arogya Yojana, also known as PM-JAY, is the largest health insurance scheme in the world. This scheme provides secondary and tertiary care facilities for the treatment of serious diseases. By taking advantage of PM-JAY, families can reduce the expenses incurred due to hospitalization. To know details about PM Jan Arogya Yojana, its key features and benefit cover, going through this article will be helpful to you.

About PM Jan Arogya Yojana

On 23rd September, 2018, PM Narendra Modi launched the Jan Arogya Yojana in Ranchi. The official name of PM-JAY is Ayushman Bharat PM-JAY. This scheme aims to provide health coverage to poor and vulnerable families that cannot afford health insurance policies.

PM-JAY provides a health cover of Rs. 5 lakhs per year to the eligible families for secondary and tertiary care hospitalization. This scheme was formerly known as the National Health Protection Scheme. PM-JAY is fully funded by the Government and cost of implementation is shared between the Central and State Governments. 

PM Jan Arogya Yojana is an entitlement-based mission and there’s no process to get enrolled under this scheme. The families who are eligible for PM-JAY are identified by the government on the basis of deprivation and occupation using the SECC database in rural and urban areas.

Key Features of PM Jan Arogya Yojana

Let’s check out the key features of the world’s largest health insurance scheme PM Jan Arogya Yojana:

• Each family gets a cover of Rs. 5 lakhs for secondary and tertiary care hospitalization across public and private empanelled hospitals within India.

  Each eligible family gets a dedicated PM-JAY family identification number. At the time of hospitalization, an e-card is also provided to the PMJAY beneficiary.

• The PM JAN Arogya Yojana covers all existing medical conditions and illnesses.

• Under the scheme, the infants can also avail treatments. After providing all the necessary documents, the infants can be added into the beneficiary family.

• The PM-JAY benefits can be availed by over 12 crore poor and vulnerable families that are eligible. 

• At the time of hospitalization, the scheme provides the beneficiaries with cashless access to the healthcare services.

• The scheme hopes to help reduce catastrophic expenditure on medical treatment which pushes approx. 6 crore Indian citizens into poverty every year.

• PMJAY covers expenses for pre-hospitalization for up to 3 days. For post-hospitalization expenses, up to 15 days are covered for expenses related to medicines and diagnostics.

• PM Jan Arogya Yojana doesn’t have any restriction on the family size or age or gender of family members.

• To avail of cashless treatment, the beneficiary can visit any empanelled private or government hospital in any part of the country.

• Under PM-JAY, government hospitals are reimbursed for healthcare services at par with private hospitals.

• About 1,929 procedures covering all the expenses related to treatment, including drugs, supplies, diagnostics services, healthcare physician’s fees, OT charges, ICU charges, room charges, surgeon charges, etc., are covered by the scheme.

Benefits Covered Under PM Jan Arogya Yojana

The benefits covered under PMJAY include all expenses incurred on the following components of medical treatments:

• Medical examination, treatment and consultation

• Pre-hospitalization

• Diagnostic and laboratory investigations

• Medical implantation services 

• Accommodation benefits

• Food services

• Medicine and medical consumables

• Non-intensive and intensive care services

• Complications arising during treatment

• Post-hospitalization follow-up care up to 15 days

Conclusion

PM Jan Arogya Yojana is a first-of-its-kind initiative by the Government of India to ensure that poor and vulnerable families in India get health coverage. It is the largest health assurance scheme in the world and is a part of the Ayushman Bharat initiative. Every individual deserves good quality hospital services without having to face financial hardships as a consequence of availing of health services. PMJAY plays an important role in ensuring this, by providing a health cover of Rs. 5 lakh to each eligible family. 

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