Ayushman Bharat PM-JAY Dadra & Nagar Haveli and Daman & Diu

How PM-JAY works in Dadra and Nagar Haveli and Daman and Diu

The scheme is implemented by the State Health Agency (SHA) under the U.T. Administration of Dadra and Nagar Haveli and Daman and Diu. SHA works in coordination with the National Health Authority (NHA) to oversee policy implementation, process e-KYC/card issuances via portals like SUGAM, manage claim settlements, and monitor healthcare delivery.

To ensure adequate coverage across the districts, the UT administration actively empanels both public and private healthcare facilities via NHA's Hospital Empanelment Module (HEM). This network includes primary, secondary, and tertiary care hospitals equipped to deliver cashless treatments across 27+ medical specialities.

Key Highlight: PM-JAY Dadra and Nagar Haveli and Daman and Diu

Who is Eligible for PM-JAY Dadra and Nagar Haveli and Daman and Diu

Eligibility for the AB-PMJAY scheme is based upon the information obtained from the Socio-Economic and Caste Census 2011, which includes the following categories of households:

1. Urban Informal Workers: Informal and low-income occupational groups, including domestic workers, street vendors, ragpickers, construction workers, drivers, mechanics, delivery staff, and sanitation workers, are automatically covered.
2. Rural Vulnerable Households: Those Families living in single-room kucha houses, female-headed or disabled-member households without able-bodied adults, SC/ST families, and landless daily-wage labourers qualify.
3. Senior Citizens (70 Years and Above): Under the Ayushman Vaya Vandana Card, all seniors aged 70+ receive coverage regardless of family income.
   • If the family is already enrolled in PM-JAY, the senior gets a separate, dedicated ₹5 lakh annual top-up.
   • If the family is not covered, the senior citizen receives an individual ₹5 lakh annual health cover.
4. Frontline Healthcare & Anganwadi Workers: Active ASHA workers, Anganwadi Workers (AWW), and Anganwadi Helpers (AWH) in Dadra & Nagar Haveli and Daman & Diu , along with their immediate families, receive full benefits.

Benefits and Coverage under PM-JAY Dadra & Nagar Haveli and Daman & Diu

• ₹5 Lakh Cover: Provides coverage of up to ₹5 lakh of health insurance per family annually for secondary and tertiary hospitalisation services.
• No Limitations: Runs on a family floater plan with unlimited family size, age, or gender limitations.
• Senior Citizen Top-Up: Senior citizens (70 years and above) will be eligible for an extra coverage of up to ₹5 lakh annually through the Ayushman Vay Vandana Card.
• Cashless Hospitalisation: Cashless medical service is available at all government as well as private hospitals of the UT, and also across the nation due to the national portability facility.
• Medical Coverage: All medical cost expenses, diagnostic fees, room charges, and doctor consultation fees while hospitalisation are covered without any payment at all.
• Pre-Existing Diseases: Coverage for all pre-existing diseases is included from day one with no waiting period.
• Procedures for Day Care: Consists of medical procedures that need special attention but do not call for 24-hour admission to the hospital.
• Pre & Post-Hospitalisation: Covers the expenses of treatments incurred for 3 days before hospitalisation and 15 days after discharge (includes consultation and medicines).
• Medical Procedures: Covers over 1,900+ procedures in 27+ specialities like general surgery, cardiology, oncology, orthopaedics, neurosurgery, and intensive care services.
• National Portability: The benefits can be availed in any PM-JAY empanelled hospital across the country (also including states like Gujarat and Maharashtra).

Documents Required for PM-JAY Dadra & Nagar Haveli and Daman & Diu

• AADHAAR Card (Compulsory): Acts as the main document to provide proof of identity, age, and biometric (E-KYC) verification.
• Proof of Family / Household Identification:Ration Card (Antyodaya Anna Yojana / Priority Households).
• Active Mobile Number: Required to obtain One-Time Passwords (OTPs) while creating the card online or during online portal verification.
• Proof of Domicile / Address: Proof of domicile or utility bill proving residency in Dadra & Nagar Haveli or Daman & Diu.Senior Citizens (Above 70 Years): Aadhaar Card for age verification to get enrolled in Ayushman Vay Vandana Card.
• Construction Workers: BoCW Card (Building and Other Construction Workers Board).
• ASHA / Anganwadi Worker: UT Departmental ID card or engagement letter for new family members.
• Addition of Family Members: Birth Certificate for babies or newly added spouse.

How to Apply Step by Step for PM-JAY Dadra & Nagar Haveli and Daman & Diu

Method 1: Through the Beneficiary's Official Portal

Step 1: Visit the Beneficiary's Official Portal:

• Open beneficiary.nha.gov.in. Login:
• Click on the Beneficiary tab, insert your 10-digit mobile number, click on verify and then log in by OTP sent to your mobile.

Step 2: Search Beneficiary's Record

Choose the state/UT as Dadra and Nagar Haveli and Daman and Diu scheme as PMJAY.

Step 3: Choose Your Search Mode

Either by Aadhar Number, Family ID/Ration Card or by Name.

Step 4: Do e-KYC

Your name/family will be available in the result. If your status is either unverified or action required, do e-KYC.

Step 5: Completing the Process of Verification

Aadhar OTP option, enter your OTP, send to your registered mobile number and click submit.

Step 5: Download Ayuahman Card

Once your e-KYC is done, click on the download card for the PDF version of the Ayushman Card.

Method 2: Offline Application Procedure

For offline application or for those requiring assistance, kindly proceed with the following steps:

• Find Centre: Please visit any of the centres located in the state of Dadra and Nagar Haveli (such as Silvassa, Rakholi, Khanvel):
• Empanelled Hospitals: Please visit the dedicated Ayushman Mitra counter situated at government/public hospitals such as NAMO Hospital and Rakholi Hospital, or empanelled private hospitals.
• Common Service Centre (CSC): Please visit any local CSC/Jan Seva Kendra.
• Required Documents: Please carry your required documents and submit them to the respective operator or Ayushman Mitra.
• Biometric e-KYC Registration: Your family will be registered by the operator in the PM-JAY portal and biometric verification will be done for the same (fingerprint, iris or face scan).

Helpline and Support 

Other Government Health Insurance Schemes

State Government Schemes

• Sanjeevani Swasthya Bima Yojana (SSBY): a state health insurance scheme that provides financial protection against medical expenses.

Central Government Schemes

• Ayushman Bharat Yojana: Centrally sponsored health insurance scheme, providing coverage up to ₹5 Lakhs per family per year for secondary & tertiary hospitalisation.
• Central Government Health Scheme: Centrally Sponsored Scheme providing medical cover to Central Government Employees & Pensioners.
• Ex-Servicemen Contributory Health Scheme (ECHS): Provides all health care-related services on a cashless basis through Armed Forces Polyclinics, such as ECHS Polyclinic Leh, and other empanelled private hospitals to ex-servicemen and their dependents.