Ayushman Bharat Uttar Pradesh

Ayushman Bharat Uttar Pradesh: Key Highlights

A quick overview of everything you need to know about the Ayushman Bharat scheme in Uttar Pradesh before you register online.

Why Was This Scheme Needed?

UP is one of the states with large out-of-pocket expenditure on health among all states in India, with a population of 24 crore. In 2011, millions of poor families were uncovered, as identified by the SECC data and the PM-JAY, launched in September 2018, did not reach out to them as they were not included in the SECC data. The gap has been filled by the UP state government by introducing MMJAA, the UP state-level scheme, which is one of the largest health schemes supported by the state in India. Till September 2024, as many as 5.38 crore Ayushman Cards were distributed across Uttar Pradesh from the 9 crore target beneficiaries; the highest in any state.

Eligibility

AB-PMJAY (Central Scheme):

• Families in the SECC 2011 database are classified into deprivation categories.
• Informal sector workers, construction workers, domestic workers, rag pickers, street vendors, sanitation workers and others.
• All the senior citizens above the age of 70 irrespective of their income levels will be provided a separate Ayushman Vay Vandana Card with an annual cover of ₹5 lakh (from 1st September 2024).

MMJAA (State Scheme):

The state scheme by UP Government provides coverage to the families entitled to get the benefits of PM-JAY but remained uncovered under PM-JAY due to lacunae in the SECC 2011 data. Presently, 8.43 Lakh such families are covered only under MMJAA having coverage same as PM-JAY beneficiaries to the tune of 5 lakh per annum. The Scheme is funded only by the State of U.P. (100% funding).

Ayushman Bharat Yojana Registration- Uttar Pradesh

How to register for Ayushman Bharat Yojana in Uttar Pradesh. Registration can be done through one of the following options:

• Online: Go to ayushmanup.in and click "Apply Online." Enter your Aadhaar details, mobile number or ration card to check if you are eligible, then fill in all details and submit documents and download Ayushman card Uttar Pradesh if your application is approved.
• At a Jan Seva Kendra (CSC): Visit a CSC in your locality with your Aadhaar card and mobile number. The operator will check your eligibility on the PM-JAY portal and issue you the card on the spot or after a few days.
• At a recognised hospital: Go to the Arogya Mitra desk. Eligibility can be verified on the spot, and card generation can be very fast. This facility is most useful in cases of medical emergencies.
• Health camps: Uttar Pradesh often organizes drives across the state where beneficiaries at home receive their cards through mobile enrollment units.

Benefits and Coverage

• Cashless Cover: 5 lakh per family per year at empanelled hospitals, on a floater basis, no upfront payment and no reimbursement required.
• Treatment Packages: More than 1,929 packages in 27 specialities that include cardiology, oncology, neurosurgery, orthopaedics, nephrology, paediatrics, burns, and emergency care.
• Pre-existing Diseases: Covered from day one without waiting period and no exclusions.
• Pre & Post-hospitalisation: Coverage for expenses incurred up to 3 days prior to hospitalization and follow up expenses up to 15 days after discharge from the hospital.
• Senior Citizens: Citizens over 70 years of age get a special cover of 5 lakh per year under Ayushman Vay Vandana card. Those already covered under PM-JAY get an additional top up of 5 lakh.
• Portability: The treatment is available in any empanelled hospital across India on a cashless basis, rather than just within Uttar Pradesh.
• Funding: There are no premiums payable by the beneficiaries; the Central and UP state governments would contribute in the ratio of 60:40.

Pregnant women can claim both Janani Suraksha Yojana (JSY) and Pradhan Mantri Matru Vandana Yojana (PMMVY) concurrently for maternity benefits. TB patients may receive additional payment of 1,000 per month via Nikshay Poshan Yojana. Families that exceed their limit of 5 lakh can apply for one time grant up to 15 lakh via Rashtriya Arogya Nidhi (RAN) in government super speciality hospitals.

What is NOT Covered:

• OPD consultations not leading to hospitalisation.
• Cosmetic procedures and fertility treatments.
• Drug de-addiction and rehabilitation.
• Injuries due to self-harm.
• Treatment at non-empanelled hospitals.

Documents Required

• Aadhaar card - Mandatory for identity and biometric verification.
• Ration card - For family identification and eligibility.
• Mobile number linked to Aadhaar - For OTP verification.
• SECC data printout - If already on the PM-JAY beneficiary list.
• Self-declaration form - For MMJAA registration where applicable.

Ayushman Card Check & Download - Uttar Pradesh

To do an Ayushman card check in Uttar Pradesh or download your card:

• Visit the official website → click "Download Ayushman Card" → enter Aadhaar or mobile number → verify via OTP → download e-card as PDF.
• For senior citizens, the Ayushman Vay Vandana Card is issued through the same portal after age verification.
• The card is also available on the Ayushman Bharat App on Google Play Store.

To check the Ayushman beneficiary list Uttar Pradesh, visit the official website, log in with your Aadhaar-linked mobile number and OTP to verify eligibility and check enrollment status.

Claim Process

1. Get your Ayushman Card and Aadhaar and visit any hospital that is empanelled with the government scheme.
2. Please approach the Arogya Mitra help desk for eligibility verification.
3. The hospital sends pre-authorisation to the SACHIS/NHA prior to planned treatment.
4. Treatment is initiated as soon as possible in emergencies and is followed by pre-authorisation.
5. No charges are made to the patient, only between the hospital and the SACHIS/NHA.
6. Up to 15 days post-discharge treatment is included with the same package.

Helpline Details

• International Number: 0086 (24 hours)
• UP State Helpline: 180018004444
• Download Ayushman Bharat App from Google Play Store.

Each hospital, which is not empanelled to offer cashless treatment or insist on payment in advance, should be notified on the helpline right away.

Why Ayushman Bharat UP Matters

A state like Uttar Pradesh, continues to hold the distinction in the country when it comes to distribution of Ayushman cards. The UP government has issued 5.38 crore of the 6 crore cards so far and 87% of eligible families have received one card under the scheme so far by September 2024. In UP, Ayushman Bharat Yojana is ensuring access to medical treatment without any compromise in finances, whether it is a rickshaw-puller from Lucknow in whose name the wife has to undergo kidney transplant surgery or a farmer in Jhansi, where the child has been diagnosed with cancer. The Ayushman Bharat Yojana is one such health initiative in India that has been most successful.