PMJAY Scheme: Ayushman Bharat Yojana Eligibility & Registration Online

Prime Minister Shri Narendra Modi announced the launch of PMJAY, or Ayushman Bharat Yojana, in his Independence Day speech for 2018. Pradhan Mantri Jan Arogya Yojana (PMJAY) is a flagship National Health Protection Scheme funded by the Government of India.

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      Ayushman Bharat Yojana includes the Senior Citizen Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojana (RSBY). Also known as the AB-PMJAY scheme, it not only caters to the poor but also to rural families, which is why it is economically beneficial to the poor and destitute households in rural and urban areas.

      Pvt Health Insurance Vs Ayushman Bharat Yojana Mobile Pvt Health Insurance Vs Ayushman Bharat Yojana Mobile

      Disclaimer: The basic health insurance coverage and premiums may vary from one health insurance plan to another.

      What is Ayushman Bharat Yojana or PMJAY Scheme?

      The PMJAY scheme, also known as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, is the biggest healthcare scheme in the world. Sponsored by the Government of India, Prime Minister Narendra Modi rolled out the Pradhan Mantri Jan Arogya Yojana healthcare scheme to cover more than 12 crore poor and underprivileged families without any limitations on family size and age. Ayushman Bharat Yojana (PMJAY) will help these households to avail better healthcare services with medical insurance coverage of up to ₹5 lakh per year for tertiary and secondary hospitalization expenses.

      The PM Ayushman Bharat Yojana scheme is paperless and offers cashless hospitalization cover at public hospitals and network private hospitals. Ayushman Bharat health insurance covers the cost of hospitalization, pre-hospitalization, medication, and post-hospitalization during the treatment of tertiary and secondary care procedures.

      The Ayushman Bharat Yojana includes nearly 1,949 treatments like skull surgery, knee replacement surgery, etc. Moreover, it covers the cost of follow-up care and treatments to ensure full recovery.

      Regular Health Insurance Plans vs Government Health Insurance Scheme

      Features Private Health Insurance Government Health Insurance Scheme
      Eligibility Available to all sections of society Available to lower-income groups only
      Sum Insured Maximum sum insured of up to ₹6 crore Maximum sum insured of up to ₹5 lakh
      Premium ₹200 per month onwards (depending on the plan) ₹100 per month onwards or fully paid by the government
      (depending on the plan)
      Coverage Offers a broader coverage Offers a narrow coverage
      Private Hospital Room Available
      (depending on the plan)
      May or may not be available
      Policy Purchase Policy can be purchased instantly Policy purchase may take time
      Network Hospitals A wide network of empanelled private hospitals A large number of public and private network hospitals
      Maternity Benefits Available
      (depending on the plan)
      (Only for a single child in some cases)
      Ambulance Charges Available under most plans Available under a few plans
      Domiciliary Hospitalization Cover Available
      (depending on the plan)
      Not available
      Online Renewal Can be renewed online May or may not be renewed online
      Cumulative Bonus Available if no claim was filed in the previous policy year Not available
      Health Check-up Covered under some plans Not covered
      Monthly Premium Instalment Facility Available under some plans Not available
      Tax Benefits Available under the Income Tax Act, 1961 Not available

      Features of PMJAY: Ayushman Bharat Yojana Scheme

      In addition to being a life-saver for lower middle-income families, the other key features of Pradhan Mantri Ayushman Bharat Yojana (PMJAY) are as follows:

      • The Ayushman Bharat Yojana scheme is a family floater scheme with a sum insured of ₹5 lakh per family per year.
      • This scheme is specially designed for people below the poverty line who do not have access to the internet or online health plans.
      • The PMJAY scheme facilitates cashless healthcare services for its beneficiaries at any of the public-sector hospitals and private network hospitals.
      • Ayushman Bharat PM Jan Arogya Yojana also recompenses the transportation cost incurred by the beneficiary during the pre and post-hospitalization period.
      • Along with medical treatment expenses, Ayushman Bharat Pradhan Mantri Yojana also covers the day care expenses incurred by the beneficiary.
      • The PMJAY scheme also covers all pre-existing diseases from day 1.
      • The payment for medical expenses is to be made based on the package rate as pre-determined by the government.
      • Ayushman Bharat Yojana also announced the creation of 1.5 lakh Health and Wellness Centres to deliver comprehensive primary healthcare.

      Benefits of Ayushman Bharat Yojana

      The Ayushman Bharat Yojana scheme insures 40% of the Indian population, comprising of vulnerable and needy families in India. The healthcare services and benefits that they can avail are listed below:

      • The treatments and healthcare facilities under PMJAY are available across India and are free of cost.
      • The Ayushman Bharat scheme covers 27 speciality categories, including medical oncology, orthopaedic, emergency care and urology that cover a wide range of medical and surgical packages.
      • Ayushman Bharat Yojana also covers pre-hospitalization expenses.
      • In case of multiple surgeries, the cost will be covered with the highest package. The second and third surgeries will be covered at 50% and 25% respectively.
      • The scheme also covers the treatment cost of oncology with chemotherapy for 50 different types of cancer. However, both medical and surgical packages cannot be availed at the same time.
      • The beneficiaries under the PMJAY scheme can also avail follow-up treatment coverage.

      What is Covered Under Ayushman Bharat Yojana?

      PMJAY covers the following medical expenses during the treatment:

      • Medical examination, treatment and consultation fees
      • Pre-hospitalization expenses for up to 3 days
      • Post-hospitalization expenses for up to 15 days
      • Cost of medicine and medical consumables
      • Hospital accommodation charges
      • Non-intensive and ICU services
      • Laboratory and diagnostic procedures
      • Medical implantation services, where required
      • Complications arising during the medical treatment
      • Food services

      Who is Not Covered by Ayushman Bharat Yojana?

      The following people are not covered under Ayushman Bharat Yojana:

      • People who own a vehicle like a two wheeler, three wheeler, or a car
      • Government employees
      • People whose monthly income is more than ₹10,000
      • Those who have farming machinery and equipments
      • Those who live in properly built houses
      • Those who hold a Kisan card
      • Those owing a motorized fishing boat
      • Those owing agriculture land of more than 5 acres
      • People employed in government-run non-agricultural enterprises
      • People who have refrigerators and landline phones in their houses

      Ayushman Bharat Eligibility Criteria for Rural and Urban People

      To avail the benefits of the Ayushman Bharat Yojana health insurance scheme, it is essential for all people to check for their names in the Socio Economic and Caste Census-2011 data. Doing so will help them confirm whether their family is eligible to be covered under the Ayushman Bharat Yojana or not. Take a look at the Ayushman Bharat Yojana eligibility criteria for both rural and urban households below:

      Pradhan Mantri Jan Arogya Yojana allows eligible members to avail the healthcare services across India.

      PMJAY Scheme: Eligibility Criteria for Rural Households:

      The following rural households are eligible for the PMJAY scheme based on six deprivation criteria:

      D1 - Families living in one room with kucha walls and roof

      D2 - Households with no adult member within the age group of 16-59 years

      D3 - Families with no adult male members within the age group of 16-59 years

      D4 - Households without an able-bodied adult member or with a disabled member

      D5 - SC/ST households

      D6 - Landless households earning a major part of their family income from manual casual labour

      PMJAY Scheme: Eligibility Criteria for Urban Households:

      The following urban households are eligible for the PMJAY scheme based on 11 occupational categories:

      • Domestic worker
      • Beggar
      • Ragpicker
      • Home-based workers/ artisans/ tailors/ handicrafts workers 
      • Sanitation workers/ sweepers/ mali
      • Construction worker/ labour/ painter/ welder/ security guard/ plumber/ coolie/ mason and other head-load workers
      • Chowkidar/ washer-man
      • Electrician/ mechanic/ assembler/ repair worker
      • Transport worker/ rickshaw puller/ conductor/ cart puller/ driver/ helper to drivers and conductors
      • Waiter/ shop worker/ assistant/ attendant/ helper/ peon in small establishment/ delivery assistant
      • Street vendors/ hawkers/ cobbler/ other service providers on the street

      How to Register for the PMJAY Scheme Online?

      It is quite simple to register for the PMJAY scheme. To register for PMJAY online, follow the steps given below:

      • Visit the official government website for the PMJAY scheme
      • You will find an ‘Am I Eligible’ tab on the right-hand side of the page, simply click on it.
      • Submit your mobile number, CAPTCHA code, and the OTP
      • Enter your state and your name, ration card number, household number, or mobile number
      • If your family is covered under Ayushman Bharat Yojana, then your name will be displayed in the results

      Documents Required to Apply for Ayushman Bharat Yojana

      The following documents are required to apply for the Ayushman Bharat PMJAY scheme:

      • Age & identity proof (Aadhaar Card/PAN Card)
      • Contact details (mobile, address, email)
      • Caste certificate
      • Income certificate 
      • Document proof of the current status of the family to be covered (Joint or nuclear)

      How to Check Your Name in the Ayushman Bharat Yojana Scheme List?

      There are various methods to check your name in the Pradhan Mantri Jan Arogya Yojana (PMJAY) beneficiary list. Listed below are some of the ways that you can try:

      • Online Method- The Ayushman Bharat list can be checked online by the beneficiaries. All you need to do is visit the official website of the National Health Authority for Ayushman Bharat Yojana and provide the requested details.
      • Common Service Centres (CSC)- If you are a beneficiary of Ayushman Bharat Yojana, you can also visit the nearest Common Service Centres. If it is not possible to do so, you can visit any of the empanelled hospitals to collect the information form. You can also check the Ayushman Bharat hospital list on their website.
      • Call on the Helpline No.- You can call on the PMJAY toll-free number on 14555 to contact their customer care and ask them to check your name on the beneficiary list.

      If your name is there on the list, then only you will get the Ayushman Bharat Card.

      List of Critical Diseases Covered by Pradhan Mantri Jan Arogya Yojana (PMJAY)

      PMJAY covers 1,949 procedures at any of the private network hospitals and all public hospitals. Below are some of the critical illnesses that Ayushman Yojana covers:

      • Carotid angioplasty with stent
      • Prostate cancer
      • Coronary artery bypass grafting
      • Skull base surgery
      • Pulmonary valve surgery
      • Double valve replacement surgery
      • Anterior spine fixation
      • Tissue expander for disfigurement following burns

      How to Download Your Ayushman Bharat Yojana Card Online?

      It is important to apply for the Ayushman card as it consists of a dedicated family identification number. AB-NHPM, or Ayushman Bharat-National Health Protection Mission, is provided to every beneficiary household. Below are the steps that you can follow to apply or download your Ayushman card online-

      • Firstly, visit Ayushman Bharat Yojana official website
      • Now, log in with your email id and generate a password
      • Enter your Aadhaar Card number to proceed further
      • Click on the approved beneficiary option. It will be redirected to their help centre.
      • Now, enter your password and the pin number in the CSC. It will be redirected to the homepage.
      • You will see the download option for your Ayushman Bharat golden card.

      Ayushman Bharat Scheme Hospitalization Process

      The Ayushman Bharat Yojana scheme offers health insurance cover to beneficiaries without paying any premium during hospitalization. The Ayushman Bharat scheme covers both pre and post-hospitalization expenses in addition to in-patient treatment charges.

      All empanelled hospitals under the PMJAY Scheme have appointed Pradhan Mantri Arogya Mitras, who helps the patient by coordinating with the hospital in order to cut expenses. You will find these Arogya Mitras at their helpdesk, where they will verify the eligibility criteria, documents, and the enrolment process. They also provide letters to all beneficiaries with their respective QR codes.

      Furthermore, this QR code is scanned and verified to check the eligibility of people to avail Ayushman Bharat Yojana benefits.

      The Ayushman Bharat scheme offers medical coverage across India and cashless hospitalization benefits to enrolled families in both public and private hospitals.

      PMJAY Patient Card Generation

      You can apply for an Ayushman Bharat e-card once you find out about your eligibility for the PMJAY scheme. But before you get this e-card, you will have to go through an identity verification at one of the PMJAY kiosks based on your documents like the Aadhaar card or ration card. Your family’s identification can be done using the RSBY cards or a govt. certified list of members. After this verification is done, your patient e-card is printed along with your Ayushman Bharat ID, which can be used for future reference.

      COVID-19 Treatment Covered Under Ayushman Bharat Yojana (PMJAY)

      As per IRDAI regulations, all health insurance providers in India cover COVID-19 hospitalization expenses. Similarly, the Government-backed Ayushman Bharat scheme also offers coverage against the COVID-19 pandemic. The beneficiary can avail medical test facilities at any of the empanelled hospitals without paying any money as per the National Health Authority (NHA) notification. The Ayushman Bharat scheme also covers isolation and quarantine expenses.

      PMJAY Toll-free Number and Address

      The PM Ayushman Bharat scheme enables people to call on their helpline number for any queries, assistance or grievances. The toll-free number is 14555 and 1800111565.

      Address: 9th Floor, Tower-I, Jeevan Bharati Building, Connaught Place, New Delhi – 110001

      PMJAY FAQs

      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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