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    PMJAY: How to Apply Ayushman Bharat Golden Card

    Health insurance is a financial necessity for everyone. It helps people to get financial assistance from an insurance company in case they suffer from an unforeseen medical emergency. Nonetheless, people from lower economic groups and rural areas skip buying a health policy due to monetary issues, lack of awareness or the internet. To ensure the benefits of health insurance to such people, the Government of India introduced the PMJAY or Ayushman Bharat Yojana. Let’s read more to know about its benefits and how to apply for an Ayushman Bharat Golden card.

    What is PMJAY or Ayushman Bharat Yojana?

    PMJAY or Ayushman Bharat Yojana

    PMJAY or Pradhan Mantri Jan Arogya Yojana is a flagship health insurance scheme by the Government of India. Also known as Ayushman Bharat Yojana, it provides financial security to the beneficiaries against hospitalization expenses in case of a medical emergency. It has been designed to cover the poor, vulnerable and the economically  weaker sections of the society. 

    The Ayushman Bharat Yojana was launched in September 2015 after it was announced by Prime Minister Narendra Modi in his Independence Day speech. The scheme aims to cover more than 50 crore citizens of India. Amongst these, there would be about 10 crore underprivileged families irrespective of any limitations to the age of the family members and the family size.

    The PMJAY scheme comes with a maximum sum insured of Rs 5 lakh per family. Besides the hospital treatment cost, the scheme also covers the cost of diagnostic tests, medicines, pre-hospitalization expenses, COVID-19 treatment and post-hospitalization cost for almost all secondary and tertiary healthcare procedures. It also includes nearly 1400 expensive treatments, such as knee replacements, skull surgery, etc. The follow-up treatment expenses will also be covered under this scheme.

    Moreover, the PMJAY scheme also offers cashless hospitalization treatment at network hospitals across the country. To be eligible for cashless treatment, the beneficiaries will be issued an Ayushman Bharat Golden card. The PMJAY or Ayushman Golden card is an e-card that needs to be shown at the network hospital to avail cashless treatment.

    Who Can Apply for Ayushman Bharat Yojana?

    Not everyone is eligible for the Ayushman Bharat Yojana. Only people whose names are listed in the data provided under the Socio-Economic Caste Census (SECC) of the year 2011 and have the Rashtriya Swasthya Bima Yojana card are eligible for the PMJAY scheme. Thus, before applying for the Ayushman Bharat Yojana, people should check their names in the SECC database first. 

    Moreover, there are different eligibility criteria for people living in rural and urban areas to apply for Ayushman Bharat Yojana. The following people from the rural areas are eligible for the Ayushman Bharat Yojana:

    • Households without any members between the age group of 16 to 59 years
    • Families without any male/ adult/ earning member within the age group of 16 to 59 years
    • Households living in one room kuccha house with walls and roof
    • Families with one disabled member and no healthy adult member
    • Households of manual scavenger
    • Families without a house who major part of the income comes from manual labour

    The following people from the urban areas are eligible for the PMJAY scheme:

    • Domestic workers
    • Home-based tailors/ handicraft workers/ gardeners/ sweepers/ artisans/ sanitation workers
    • Hawkers/ street vendors/ cobblers
    • Security guards/ construction workers/ welders/ coolies/ painters/ labourers
    • Ragpickers
    • Washermen/ masons/ plumbers
    • Cobblers
    • Mechanics/ repair workers/ electricians/ assemblers
    • Beggars
    • Waiters/ peons/ shop workers/ delivery assistants
    • Transport workers/ cart pullers/ conductors/ rickshaw pullers

    Benefits of Applying for Ayushman Bharat Yojana 

    The PMJAY scheme is beneficial for poor and economically weaker sections of the society in a number of ways. Take a look at some of the benefits of applying for Ayushman Bharat Yojana:

    • The PMJAY scheme is a family floater scheme, which means the entire family can be enrolled under the same policy.
    • It enables people belonging to lower economic groups without access to the internet to avail online health insurance plans.
    • The scheme enables the beneficiary from across the country to get healthcare treatment and facilities for free of cost.
    • It provides coverage for 25 speciality categories and about 1354 medical and surgical packages, such as cardiology, neurology, etc.
    • It provides coverage for the treatment cost of about 50 types of cancers along with the cost of chemotherapy.
    • If someone is having multiple surgeries, the PMJAY scheme will cover the cost of the highest package. However, the cost of the second surgery will be covered for up to 50 per cent and the third surgery cost will be covered for up to 25 per cent of the total expenses.
    • It also provides coverage for day care expenses.
    • It covers pre-hospitalization as well as post-hospitalization expenses along with the transportation cost incurred during the period.
    • It enables the beneficiaries to avail coverage for follow-up treatment.
    • It also provides coverage for certain pre-existing diseases.
    • The scheme allows people to avail cashless treatment facilities at public and private network hospitals. All they need is an Ayushman Bharat Golden card.

    How to Apply for Ayushman Bharat Golden Card? 

    To obtain the cashless treatment facility under PMJAY, you need to obtain an Ayushman Golden card. Following are the steps to apply for an Ayushman Bharat Golden card:

    • Visit the official website of PMJAY
    • Go to the option of login to the website
    • Enter your ‘mobile number’ and the captcha code
    • Generate the OTP and enter it to log in to your website
    • Opt for HHD code and provide the code to the Common Service Centre (CSC). The CSC would check the HHD code as well as other details
    • The Ayushman Mitra or the CSC representatives will complete the remaining process
    • A fee of Rs 30 will have to be paid to obtain the Ayushman Golden card
    • Your Ayushman Bharat Golden card will be issued

    In a Nutshell 

    Ayushman Bharat Yojana or PMJAY is considered one of the biggest health insurance scheme across the world. It covers the hospitalization expenses incurred by people belonging to the poor, vulnerable and economically weaker sections. They can also avail cashless treatment facility under network hospitals, provided they have the Ayushman Bharat Golden card. Make sure to follow the steps given above to apply for an Ayushman Golden card.

    Written By: PolicyBazaar - Updated: 10 August 2021
    Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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