Ayushman Bharat PM-JAY Lakshadweep

How PM-JAY works in Lakshadweep

PM-Jay in Lakshadweep is implemented by the State Health Agency (SHA) under the Department of Health Services (DHS) , UT Administration of Lakshadweep, operating along with Dweep Suraksha Yojana (DSY).

The SHA handles basic administrative functions such as beneficiary e-KYC, issuance of Ayushman card, transparent claim processing, and grievance redressal. Considering the remote locations of the islands, one of the important functions of the administrative structure is handling referrals and transportation approvals to the mainland empanelled hospitals for tertiary care.

Key Highlights: PM-JAY Lakshadweep

Who is Eligible for PM-JAY Lakshadweep

The eligible categories for the AB-PMJAY scheme are derived from the information obtained through the Socio-Economic and Caste Census 2011 and comprise the following types of households:

1. Urban Informal Workers: Unorganised workers consisting of domestic help, street vendors, ragpickers, construction workers, drivers, mechanics, delivery boys, and sanitation workers are included by default.
2. Vulnerable Rural Households: These are Families living in one-room kuchha houses, female-headed or disability headed households without able-bodied members, SC/ST families, and landless day wage workers.
3. Senior Citizens (70 Years or above): Through the Ayushman Vaya Vandana Card Scheme, all senior citizens aged 70 or more are eligible, irrespective of the family income.
4. 4. Frontline Healthcare & Anganwadi Workers: All active ASHA workers, Anganwadi Workers (AWW), and Anganwadi Helpers (AWH) in Lakshadweep, along with their respective families.

Benefits and Coverage under PM-JAY Lakshadweep

• ₹5 Lakh Cover Per Year: Offers coverage of up to ₹50 Lakh per year per family member, on a floater basis without any limit on the number of family members and age.
• Separate Cover for Senior Citizens: Offers a separate or additional cover of ₹5 Lakh per year for senior citizens above 70 years old using the Ayushman Vay Vandana Card.
• No Out-of-the-Pocket Expenses: Treatment is absolutely cashless and paperless in all empanelled public and private hospitals.
• Coverage of Pre-Existing Diseases: Offers coverage for all pre-existing diseases from the very first day without any waiting period.
• Pre & Post Hospitalisation: Coverage of cost of treatment, including medicines and diagnosis expenses, 3 days before and 15 days after discharge.
• Maternal & Child Healthcare: Normal and C-Section deliveries, NICU care, and pediatric care.
• Mainland Medical Referrals: It offers services of secondary and tertiary care at the empanelled super-speciality hospitals on the mainland (like Kochi in Kerala State), where special facilities may not be available on the islands.
• National Portability: The cardholder has access to treatment at more than 30,000 empanelled hospitals in India.

Documents Required to Apply for PM-JAY Lakshadweep

• Aadhar Card (Compulsory): Aadhar card for biometric or e-KYC authentication. (Should have an active mobile number for OTP validation).
• Active Mobile Number: An active mobile number is needed for OTP authentication.
• Valid Lakshadweep Island Ration Card or DSY Certificate: For composition and members of the family to have a valid Lakshadweep Island ration card or Dweep Suraksha Yojana certificate.
• Eligibility Letter from Government: Welcome letter for PM-JAY issued by the government or beneficiary ID, if any.
• Residence or Domicile Certificate: Certificate for island domicile (e.g. Identity certificate issued by Lakshadweep UT Administration).
• Alternate Address Proof: Voter ID, passport or utility bill if the address is different from the Aadhar address.

Supporting Documents for Specific Category

• Senior Citizen (More than 70 Years Old): Aadhar Card with proof of date of birth (for Ayushman Vay Vandana Card).
• Grassroot Worker (ASHA/Anganwadi Worker): Official identity card or a letter from the Department of Health Services/Social Welfare.
• Caste/Community Certificate: Only when the application is made under certain SC/ST categories of social welfare.

How to Apply Step by Step for PM-JAY Lakshadweep

1. Method 1: Online Application

   Step 1: Visit the Beneficiary's Official Portal

   Open beneficiary.nha.gov.in.

   Under the Beneficiary tab, enter your 10-digit mobile number, click Verify, and log in using the OTP sent to your mobile.

   Step 2: Search Beneficiary's Record

   Select Lakshadweep as the State/UT.

   Select PMJAY as the scheme.

   Step 3: Choose Your Search Mode

   Search for your record using your Aadhaar Number, Family ID / Ration Card, or Name.

   Step 4: Starting e-KYC

   Search for your name or surname in the search results.

   When you see that the status is Unverified or Action Required, click on it to start the e-KYC procedure.

   Step 5: Verification

   Choose the OTP via the Aadhaar method.

   Enter the OTP you received on the registered mobile number of your Aadhaar.

   Step 6: Download Ayushman Card

   Once e-KYC is successfully verified and approved, click Download Ayushman Card to save the PDF version of your Ayushman Card.

2. Method 2: Offline Process

   In case you don't have any access to the internet, or if your Aadhaar has not been synced with your phone number:

   • Visit the Enrolment Desk: This is located at the Ayushman Mitra desk in any of the government healthcare centres of Lakshadweep, such as Government Indira Gandhi Hospital (Kavaratti), Government Hospital (Minicoy) or CHCs of Amini/Androth/Agatti. Alternatively, visit your nearest Common Service Centre (CSC).
   • Submit your Identification: Provide your Aadhaar Card and Ration Card.
   • Biometric e-KYC: Authentication through biometric verification (fingerprint or iris).
   • Get Printout: Your application will be processed, and you will receive your printed Downloaded Ayushman Card.

Helpline and Support

Other Government Health Insurance Schemes of Lakshadweep

State Government Schemes

• Dweep Suraksha Yojana: Local Health Schemes, which were later integrated with AB PM-JAY, to expand financial coverage of up to ₹5 lakh per family per year to over 12,000 island households for secondary and tertiary care.

Central Government Schemes

• Pradhan Mantri Suraksha Bima Yojana: It is a health insurance scheme which covers accidental death and disability.
• Ayushman Bharat Scheme: a centrally-sponsored health insurance scheme, which covers 5 lakhs rupees per family each year on a floater basis for secondary and tertiary hospitalisation.
• Employee State Insurance Scheme: This provides a health insurance scheme for Indian employees whose salary is up to 21,000 and 25,000 for disabled people.
• Central Government Health Scheme: It is a health insurance scheme sponsored by the central government for providing medical coverage to central government employees, freedom fighters, and pensioners.