Ayushman Bharat PM-JAY Bihar

How PM-JAY works in Bihar

To ensure universal healthcare access, Bihar adopts a dual-structure approach whereby the benefits of the Ayushman Bharat scheme and Mukhyamantri Jan Arogya Yojana scheme are integrated to form a single health insurance system for all beneficiaries of both schemes, where the beneficiaries are issued with one Ayushman Card, known as the Golden Card. Both schemes are governed by the national-level National Health Authority and the local-level Bihar Swasthya Suraksha Samiti (BSSS).

Key Highlights- PM-JAY Bihar

Who is Eligible for PM-JAY in Bihar

To qualify for PM-JAY coverage in Bihar, beneficiaries must fall under one of three main eligibility streams:

• SECC 2011 Families: Families that satisfy certain rural deprivation characteristics (like having single-room kucha huts, being landless casual labourers, or SC/ST families), or certain occupational categories in urban areas.
• NFSA Ration Card Holders: All active Ration Card Holders of Bihar state are covered directly through the state-sponsored extension of the scheme called Mukhyamantri Jan Arogya Yojana (MM-JAY).
• Senior Citizens (Above 70): All senior citizens above 70 years are eligible to be covered under the Ayushman Vay Vandana scheme extension.

How to Check PM-JAY Eligibility in the state

To check if your family is included in the Ayushman Bharat beneficiary list in Bihar, you can use any of the following official channels:

• Web Portal: Log in to the website www.beneficiary.nha.gov.in to search using the details.
• Toll-Free Helpline Numbers: Contact the state helpline number 104 or the national helpline number 14555 (both 24X7).

Benefits and Coverage Under PM-JAY Bihar

Under the implementation of the Bihar Swasthya Suraksha Samiti (BSSS), PM-JAY and Mukhyamantri Jan Arogya Yojana (MM-JAY) deliver comprehensive medical coverage to eligible households across the state. It offers unified medical coverage specifically tailored to eligible Bihar residents:

• ₹5 Lakh Annual Family Cover: ₹5 Lakh cover annually for each family on a family floater basis in secondary and tertiary care hospitalisation.
• Statewide Implementation (PM-JAY + MM-JAY): Provides identical benefits to more than 1.21 crore eligible families (about 5.5 crore people) across Bihar for both central SECC 2011 and active NFSA Ration Cardholders of Bihar.
• More Than 1,900 Medical & Surgical Packages: More than 1,900 medical treatment packages in public/private hospitals, which include major surgeries, ICU treatments, and newborn care.
• Coverage for Pre & Post Hospitalisation Expenses: It covers all expenses that happen up to 3 days before hospitalisation and 15 days after discharge (diagnostic and follow-up medicines and consults).
• Cover for Pre-existing Conditions from Day One: All pre-existing medical conditions are insured from the very first day of joining the scheme without any waiting periods.
• No Out-of-Pocket Expenses: The treatments in empanelled Bihar hospitals are entirely cashless and paperless through the national health authority's IT platform in fixed package prices and include bed rent, surgeon fees, diagnosis, surgery costs, implants, and medicine.
• Unspecified Surgical Condition Cover: Includes preauthorization facility for unspecified surgical conditions up to ₹1 lakh ceiling limit.
• National Portability: Any beneficiary covered under Bihar is entitled to receive treatment in a cashless manner through the Ayushman Card at any hospital in the country, such as central hospitals like AIIMS Patna, AIIMS New Delhi, and Safdarjung Hospital.

How to Apply for Ayushman Card in Bihar

There are several ways in which you can apply for the Ayushman card in Bihar, namely:

The procedure for obtaining an Ayushman Card in Bihar may be done using any of the following means:

1. Online Registration: If you wish to go about the process of applying for your Ayushman card in Bihar online, do so as follows: Log in to the NHA Beneficiary Portal or install the Ayushman App. Find your family listing and perform e-KYC using Aadhaar OTP, iris or face recognition.
2. Offline Assistance: Go to any Common Service Center (CSC / Vasudha Kendra) or empanelled hospitals where an Ayushman Mitra or the designated person to make your card will help you with your application.
3. Download & Print Your Card: Upon approval from the Bihar Swasthya Suraksha Samiti (BSSS), you will be able to download your card free of charge.

Documents Required for PM-Jay Bihar

In order to be eligible for the Ayushman Card or benefits from PM-JAY in Bihar, there are two categories of documents that have to be submitted, which include individual identity and family linkage proof.

Proof of Individual Identity (Either One)

• Aadhar Card: This is the main form of identification used for e-KYC of individuals through biometrics or the OTP method.
• Photographic Alternative Identification (If Secondary Verification required for Aadhar e-KYC): Driver's license, Voter ID, Passport, or PAN card.

Proof of Family Eligibility and Linkage (Either One)

• Active Ration Card: It is a valid Bihar NFSA ration card showing the names of all family members (required for MM-JAY coverage of the state).
• PM/CM Official Letter: Official letter from the PM-JAY or MM-JAY scheme issued by government authorities, including Family ID/HHID.
• SECC Household Document: It is the evidence of being registered in the SECC database of 2011.

How to Find PM-JAY Hospitals in Bihar

To find PM-JAY empanelled hospitals in Bihar, you can search using any of the following official channels:

• BSSS Official Portal: Visit the Bihar Swasthya Suraksha Samiti Portal (biswass.bihar.gov.in) to view the updated list of state-empanelled public and private hospitals.
• NHA Hospital Finder: Access the central PM-JAY Hospital Search Portal (https://hospitals.pmjay.gov.in/) to filter facilities by state (Bihar), district, hospital type (public/private), and speciality.
• Ayushman App: Open the official Ayushman App on your mobile device to search for nearby empanelled hospitals using your device's location or location filters.
• District Common Service Centre (CSCs): Visit any local Common Service Centre (CSC / Vasudha Kendra) or ask the Ayushman Mitra desk at any major government hospital (such as Sadar Hospitals or PMCH) for a local list of enrolled healthcare providers.

Steps to Access Cashless Healthcare under PM-JAY in Bihar

For cashless healthcare under the PM-JAY/MM-JAY scheme in Bihar, just follow the steps below in any of the empanelled hospitals:

Step 1: Find the Empanelled Hospital and Approach the Help Desk

Go to any empanelled public and private hospitals and reach the help desk named “Ayushman Mitra” near the admission or reception point of the hospital.

Step 2: Provide Identification Documents

Give your Ayushman Card (Golden Card) and Aadhar Card or Ration Card.

Step 3: Pre-authorise your Request

The hospital sends an electronic request for pre-authorisation of your request directly to the Bihar Swasthya Suraksha Samiti (BSSS).

Step 4: Enjoy Cashless Healthcare

Get complete cashless and paperless healthcare services, which include diagnostic tests, surgery charges, medicine bills, and hospitalization charges.

Helpline and Support

Other Related Government Schemes

• Mukhyamantri Chikitsa Sahayata Kosh (Bihar): A state grant in Bihar, which provides coverage for serious illnesses and costly procedures.
• PM-JAY: A central scheme which provides up to ₹5 lakh annual cashless hospital coverage to low-income families.
• Central Government Health Scheme (CGHS): Central Scheme which provides comprehensive health care coverage to Central Government Employees.
• Pradhan Mantri Matru Vandana Yojana (PMMVY): It is a Central scheme under the Ministry of Women and Child Development's Mission Shakti. It provides financial assistance to women and lactating mothers.