Ayushman Bharat PM-JAY Goa

How PM-JAY works in Goa

The PM-JAY Goa scheme is headed by the Directorate of Health Services (DHS) as per the NHA. They handle the process of identifying eligible families, authorise the treatment in hospitals, and also settle the claims. They are also responsible for integrating the PM-JAY scheme with the existing healthcare system of Goa through the use of the same hospitals and administrative framework for providing cashless treatment throughout the state.

Key Highlights : PM-JAY Goa

Who Is Eligible for PM-JAY Goa?

• Rural Families: Rural families that qualify according to the government’s low-income criteria (according to the SECC Survey of 2011).
• Urban Workers: Urban workers from certain occupations, like street vendors, domestic servants, and construction workers.
• Ration Card Holders: Ration card holder families (under NFSA regulations).
• Senior Citizens Over 70 Years Old: Any citizen aged 70 years or more is individually covered under the Ayushman Vay Vandana scheme.

Benefits and Coverage Under PM-JAY Goa

• Coverage Amount: Coverage of ₹5 lakh per annum for every family in secondary & tertiary hospitalisations in both public and empanelled private hospitals.
• No Family Cap: There are no caps for family size, age or gender under PM-JAY Goa
• Pre-existing Conditions: All pre-existing conditions are covered on the first day itself with no waiting period.
• 1,650 Defined Packages: Directorate of Health Services (DHS), Goa, along with NHA, has defined 1,650 medical and surgical treatment packages.
• Pre-hospitalisation: Up to 3 days of pre-hospitalisation expenses, including diagnostic tests, doctor consultation and medicines before admission.
• Inpatient Treatment: Bed charges, ICU/ICCU, doctor and surgeon charges, OT charges, oxygen, blood products and food while admitted.
• Post-hospitalisation: Follow-up medication, post-discharge tests and consultations for up to 15 days.

Documents Required to Apply for PM-JAY Goa

• Goa Ration Card (AA Yojana, PHH, or Priority Card)
• Aadhaar Card (Compulsory for verification)
• PMO / Prime Minister's Office Eligibility Letter
• Any Government Issued Photo ID (One of the following):
• Voter Card
• Driving License
• PAN Card
• Passport
• Specific Category Card (If any):
  • Handicapped / Disability Card
  • Pension Card
  • MNREGA Card

How to Apply Step by Step for PM-JAY Goa

You can apply for the Ayushman Card through PM-JAY Goa either through Online Mode or in an Offline Mode in designated state centres.

1. Method 1: Online Procedure (Self-application)

   This mode is suitable if your mobile number is linked to your Aadhaar Card.

   Step 1: Go to the NHA Website/Download the App

   • Visit the official portal of the National Health Authority Beneficiary Portal (beneficiary.nha.gov.in)
   • Alternatively, download the Ayushman Card Application Mobile App on your mobile phone.

   Step 2: Log in as Beneficiary

   • Select the Beneficiary tab to log in.
   • Enter your 10-digit mobile number and click Get OTP, followed by entering the OTP.

   Step 3: Locate your Family in Goa

   • Select Goa, PMJAY, and your District, then search by Family ID, Aadhaar, or Name.
   • Click Search to locate your family details.

   Step 4: Verify your e-KYC

   • Click on your name from the list. If the status is “Not Generated”, click on Do e-KYC.
   • Click on Next to proceed to e-KYC.
   • Verify yourself through Aadhaar OTP (via the Aadhaar-linked mobile number) or via Face Authentication through the mobile app.
   • Upload a live picture of yourself.

   Step 5: Approval and Download Ayushman Card

   • After submitting, your e-KYC will be processed and forwarded for verification to the DHS Goa.
   • Once approved, sign in again, click on Download Card and download the PDF version of the Ayushman Card.

2. Method 2: Offline Process (Personal Assistance)

   If you have not linked your mobile number to your Aadhaar, then this method will work best for you, or if you prefer a person in authority to do your submission process for you.

   Step 1: Collect Required Documents

   • Proof of Family Identification (Required):Ration Card issued by the Department of Civil Supplies, Goa or PMO letter.
   • Proof of Identity (Required): Aadhaar card for e-KYC authentication.
   • Proof of Secondary Photo ID: Voter ID, Driving License, PAN card or Passport.

   Step 2: Go to Any Official Registration Centre in Goa

   Visit any of the following centres:

   • PMJAY Kendras: Established by Goa Electronics Limited (GEL) in different talukas of Goa.
   • Hospital Helpdesks (Ayushman Mitra): Present in empanelled public hospitals such as Goa Medical College (GMC), Bambolim, South Goa District Hospital (Margao), North Goa District Hospital (Mapusa), or in any empanelled private hospitals in Goa.
   • State Nodal Office: Ayushman Bharat PM-JAY Cell, Ground Floor, Directorate of Health Services (DHS), Campal, Panaji, Goa.

   Step 3: Verification of Documents and Biometric Authentication

   • Show your Ration Card and Aadhaar Card to the Ayushman Mitra / GEL representative.
   • Your family name is checked in the database to make sure your family qualifies as per the SECC 2011 / RSBY list of families in Goa.
     Put your finger in the biometric device for authentication.

   Step 4: Issue of Card

   On the approval of the DHS Goa officials, the representative prints out the Ayushman Card for you.

Other Government Schemes

• Deen Dayal Swasthya Seva Yojana (DDSY) Goa: State health Insurance Scheme that provides annual coverage of up to ₹2.5 lakh (for families up to 3 members) and ₹4 lakh (for families of 4 or more members) for residents living in Goa for 5+ years.
• Goa Mediclaim Scheme: State Health Scheme that offers coverage of up to ₹8 lakh to permanent residents for super-speciality medical treatments, surgeries, and procedures that are not available within Goa’s government hospitals.
• Free OPD & Primary Care Services: Offered directly by the Directorate of Health Services (DHS) system, primary health centres (PHCs), and Goa Medical College (GMC), providing free services related to basic health care, testing, and medicines for the population.
• Ayushman Bharat: A centrally sponsored Health Insurance scheme that offers coverage of up to ₹5 lakh per family per year on a family floater basis.
• Central Government Health Scheme: It is a health insurance program for central government employees and pensioners residing in CGHS-covered areas.