Ayushman Bharat PM-JAY Arunachal Pradesh

How PM-JAY Works in Arunachal Pradesh

The Scheme is managed by an independent body known as the Chief Minister Arogya Arunachal Society (CMAAS) under the State Health Agency (SHA) and has a centralised system for beneficiary registration, pre-authorisations, and claims settlement in a cashless manner.

As compared to the central PM-JAY scheme that provides its services only to the families enlisted through the Socio-Economic Caste Census (SECC 2011) lists, the Government of Arunachal Pradesh has widened its coverage through the implementation of the CMAAY scheme, which covers Arunachal Pradesh Scheduled Tribes (APST), non-tribal permanent residents (with Resident Certificates in selected districts), and state government employees and their dependents.

Key Highlights: PM-JAY Arunachal Pradesh

Eligibility Criteria of PM-JAY Arunachal Pradesh

• Arunachal Pradesh Scheduled Tribe (APST): Individuals from the APST category within Arunachal Pradesh.
• State Government Servants & Pensioners: Regular servants and pensioners of the Arunachal Pradesh government, along with their dependent families.
• Non-APST Permanent Residents: Non-APST residents residing in any one of the Changlang, Lohit, or Namsai districts having a valid Resident Certificate (RC).
• Working Journalists: Individual journalists from Arunachal Pradesh registered with Arunachal Pradesh Union of Working Journalists (APUWJ) or Arunachal Press Club (APC).
• Families in PM-JAY: Families registered with the Socio-Economic Caste Census (SECC) 2011 or holders of active NFSA cards.

What is Covered under PM-JAY, Arunachal Pradesh

• Annual Coverage: Covers up to ₹5 Lakh per annum per family on a family floater basis for secondary and tertiary care hospitalisation.
• Family Protection: For all registered individuals on NFSA Ration Card or SECC database with no restrictions on family size, age and gender.
• Cashless Treatment: No cash payment by beneficiaries at authorised government hospitals and private hospitals.
• Pre & Post Hospitalisation: Diagnosis and medicines 3 days before admission and 15 days after discharge.
• Inpatient Treatment: Charges for general ward bed occupancy, ICU stay, nursing, boarding and meals during hospitalisation.
• Medical Consultations: Doctor's fee, Surgeon's fee, Anaesthetist's fee, Consultation and treatment fee.
• Diagnostics and Surgical: OT charges, Pathology and laboratory investigations, X-Rays, CT and MRI, Oxygen charges.
• Medicines and Implantation: Medicines, Blood transfusion, surgery consumables, implants and prosthetics prescribed in treatment.
• Pre-existing disease: Every pre-existing illness is covered from day one without any waiting period.

What is not covered under PM-JAY, Arunachal Pradesh

• Outpatient Care (OPD consultations & medicines): Doctor consultations on a routine basis, routine clinical consultations, purchasing medicine from the pharmacy and medicines which do not require the patient to be admitted into the hospital for an overnight stay.
• Routine health check-ups & diagnostic tests: Preventive health check-up, executive body scan, routine blood test, screening MRI/CT scan, or diagnostics that are ordered without any active medical condition or disease.
• Cosmetic, Plastic Surgery & Aesthetic treatments: Cosmetic procedures, hair transplant, anti-ageing treatment, non-medical plastic surgery and aesthetic dentistry (e.g. teeth whitening, cosmetic braces, routine filling).
• Infertility & assisted reproduction treatments: Infertility evaluation, In Vitro Fertilisation (IVF), Intrauterine insemination (IUI), surrogate expenses, vasectomy/tubectomy reversal and artificial reproductive technology (ART).

Documents Required to Apply for PM-JAY Arunachal Pradesh

1. Primary Mandatory Documents

   • NFSA Ration Card: Functions as the first document to prove the family's eligibility (both PHH and AAY cards).
   • Aadhar Card: Must be possessed by all family members as the document for individual identification and e-KYC through biometrics.
   • Mobile Number: Necessary to get OTPs for the registration process and e-KYC from the website.

2. Secondary Documents (When Applicable)

   • Voter ID / Govt Photo ID: Helpful when Aadhar needs to be updated.
   • Income Certificate: Only required if the application is made under a special state-enlarged category other than NFSA.
   • Birth Certificate: In case of children below 5 years who don't have Aadhar.

How to Apply Step by Step to PM-JAY Arunachal Pradesh

1. Method 1: Online Registration through NHA Portal (Self-Service)

   Step 1: Visit Portal

   Visit the official website of the National Health Authority Beneficiary Portal.

   Step 2: Login

   From the login page, select 'Beneficiary', enter your active mobile number, click Verify, and enter the OTP received on SMS.

   Step 3: Search Beneficiary Details

   From the list, select Assam as your state, then select the scheme (PMJAY / AA-MMJAY), choose your district, and search your details using your Aadhaar Number or NFSA Ration Card Number (Family ID).

   Step 4: Initiate eKYC

   Identifying your family members will give you their card status. Click on the eKYC button adjacent to the name of the person who needs to be enrolled.

   Step 5: Submit for Aadhaar Authentication

   Choose either 'Aadhaar OTP' or 'Face Authentication' option, enter the OTP received on your Aadhaar-linked mobile phone, and submit.

   Step 6: Upload Photo & Submit

   Either click 'Take Live Photo' or upload a photo along with the details of your address, and click Submit.

   Step 7: Download Ayushman Card

   Download your Ayushman Card online in PDF format.

2. Method 2: App-Based Application Process

   • Install App: Download the official Ayushman App on the Google Play Store.
   • Login: Select Beneficiary, put in your phone number, and verify through OTP.
   • Search & Verify: Search by putting NFSA Ration Card Number or Aadhar Number, authenticate by completing Aadhar eKYC through OTP/face authentication and submit the application.
   • Download Ayushman Bharat Card: Generate the Ayushman Card and download it on your phone.

3. Method 3: Offline Mode (Assisted Mode)

   • Visit a Centre: Visit any Common Service Centre (CSC), Fair Price Shop camp, or Ayushman Mitra counter of any enrolled government hospital in Assam.
   • Provide Documents: Hand over your NFSA Ration Card and Aadhaar Card to the operator.
   • Biometric Authentication: Provide your fingerprint or iris scan for instant verification through Aadhaar.
   • Get Card: Upon successful eKYC authentication, the operator will provide you with the Ayushman Card.

Support and Contact Information

Other Government Schemes

• Chief Minister's Free Cancer Chemotherapy Scheme (CMFCCS): Health Initiative by the State Government of Arunachal Pradesh, providing financial coverage up to ₹10 lakhs per person annually to reduce the economic burden of cancer treatment on the people of the state.
• Mukhya Mantri Rogi Kalyan Kosh: a state health program that offers a dedicated emergency fund with an initial allocation of ₹10 crore by the Government of Arunachal Pradesh to reduce out-of-pocket expenses and deliver financial relief during medical emergencies.
• Neonatal Intensive Care Units (NICUs) & Sick Newborn Care Units (SNCUs): The State Health Scheme of Arunachal Pradesh aims to offer specialised neonatal care units to treat premature and critically ill newborns across state medical facilities.
• Ayushman Bharat Scheme: a centrally sponsored scheme that offers coverage of ₹5 lakh to economically vulnerable groups for secondary and tertiary care.
• Central Government Health Scheme: a central scheme that offers health insurance coverage to government employees and pensioners and their dependents.