Gopabandhu Jan Arogya Yojana (GJAY) Odisha

What was the need for GJAY?

Despite the remarkable progress in public health in the last few decades, Odisha still has a large population residing in the tribal areas, coastal areas and remote blocks, where access to specialist care is difficult and costly. At the time of its operation, BSKY had already spent ₹10,056 crore on treatment and admitted over 47.52 lakh people in hospital. That's how real the need was.

The new government, on assuming office, did not replace the existing scheme, but only expanded it. GJAY preserved the basic framework, allocated an outlay of ₹3,056 crore in 2024, and linked it to Ayushman Bharat to expand the cashless benefits beyond the state of Odisha. Because out-of-pocket health spending has historically been a significant contributor to poverty in rural areas, continuity and expansion were important to those areas of the state.

What Is The Eligibility Under GJAY?

GJAY is designed for economically weaker families across Odisha. To be eligible:

• Must be a permanent resident of Odisha.
• Must be covered under the National Food Security Act (NFSA) or the State Food Security Scheme (SFSA), as the holders of NFSA and SFSA ration cards are directly eligible.
• Existing BSKY smart card holders remain eligible under GJAY without fresh enrollment.
• All families listed in the GJAY beneficiary database are maintained by the state government.
• Rural families are covered up to ₹5 lakh per family per year.
• Urban families are covered up to ₹6 lakh per family per year.
• Women members receive an additional ₹5 lakh over and above the family limit.

All family members, regardless of age, are covered under the same family floater. There is no age restriction. A newborn and a 75-year-old grandparent are both covered under the same card.

Who is NOT eligible:

• Families not listed in the NFSA or SFSA database and not in the GJAY beneficiary list.
• Residents of other states

Registration Process

Most GJAY beneficiaries are already enrolled through the BSKY database. Fresh enrollment is done at the block level.

Offline Registration:

• Visit the nearest Mo Seva Kendra or Block Development Office (BDO)
• Carry your NFSA or SFSA ration card, Aadhaar card, and a recent photograph.
• The enrollment officer verifies documents and captures biometric details.
• A GJAY Smart Card is issued either on the same day or within a few working days.

Online Registration:

• Visit the official portal at gjay.odisha.gov.in.
• Check eligibility using your Aadhaar number or ration card details.
• If eligible, complete the online enrollment form and upload documents.
• Track application status and download the card once approved.

At an Empanelled Hospital:

• Approach the Swasthya Mitra help desk at any empanelled hospital.
• The Swasthya Mitra verifies eligibility against the GJAY database and can facilitate enrollment for first-time users.

What Are The Benefits and Coverage Under Gopabandhu Jan Arogya Yojana?

This is where GJAY genuinely stands apart. The coverage is comprehensive, gender-sensitive, and now nationally portable.

• ₹5 lakh per family per year for rural families is given as cashless claims at empanelled hospitals.
• ₹6 lakh per family per year for urban families.
• An additional ₹5 lakh for women members is given over and above the family limit; this provision is specifically designed to address women's higher healthcare burden.
• Pre-existing diseases covered from day one, no waiting period, no exclusions.
• Free treatment at all government health facilities across Odisha, starting from Sub Centres to district hospitals, for all residents, regardless of GJAY card status.
• Treatment at empanelled private hospitals without cash payment, and bills are paid directly to the plan and the hospital.
• The GJAY cardholders will be able to avail treatment from any Ayushman Bharat empanelled hospital in the country from April 2025 onwards.
• Since the launch, the specific claims processed include 7.34 lakh cataract surgeries, 5.19 lakh dialysis cases, 2.88 lakh cancer claims, 3.98 lakh obstetrics and gynaecology cases, 414 organ transplant cases, among others, highlighting the real-world application of the system.

Women who availed of the GJAY benefits for hospitalisation for delivery can also avail of both the Janani Suraksha Yojana (JSY) for delivery incentives and the Pradhan Mantri Matru Vandana Yojana (PMMVY) for maternity cash support. Antenatal care also supports Surakshit Matritva Aashwasan Yojana (SUMAN), which provides for specialist consultations and delivery assistance at government facilities without any charges. TB patients receiving hospitalisation under GJAY can simultaneously access ₹1,000 per month through the Nikshay Poshan Yojana. Where treatment costs exceed the GJAY limit, Rashtriya Arogya Nidhi (RAN) provides additional one-time financial assistance of up to ₹15 lakh at government super-specialty hospitals.

What is NOT covered:

• OPD consultations not leading to hospitalisation, though government facilities are free for everyone.
• Cosmetic and elective procedures not on the approved list.
• Treatment at non-empanelled private hospitals.

Documents Required

Keep these ready before visiting the enrollment centre or hospital:

• Aadhaar card- for identity and biometric verification.
• NFSA or SFSA ration card- primary eligibility document.
• BSKY card- if already enrolled under the earlier scheme.
• Recent photograph of the applicant.
• Mobile number- for updates and notifications.

Card Download Process

Once enrolled, the GJAY Smart Card can be accessed digitally:

• Visit the official portal at gjay.odisha.gov.in.
• Click on "Card Download" or "Beneficiary Search".
• Enter your Aadhaar number or ration card number.
• Verify via OTP on your registered mobile number.
• Download the e-card in PDF format.

The card is also available through the Mo Sehat App which is the official Odisha health app available on Google Play Store. Always carry your card and Aadhaar when visiting an empanelled hospital.

What Is The Claim Process Under Gopabandhu Jan Arogya Yojana?

GJAY works on a fully cashless model at empanelled hospitals. No advance payment, no reimbursement paperwork.

• Visit any empanelled government or private hospital with your GJAY Smart Card and Aadhaar card.
• Approach the Swasthya Mitra help desk for eligibility verification.
• The hospital submits a pre-authorisation request online for planned procedures.
• In emergencies, treatment begins immediately, and pre-authorisation follows.
• All bills are settled directly between the empanelled hospital and the State Health Assurance Society (SHAS)
• Post-discharge, the beneficiary's record is updated on the portal.

Post AB-PMJAY integration in April 2025, GJAY cardholders can walk into any Ayushman Bharat empanelled hospital outside Odisha and access cashless treatment using the same card, a significant benefit for migrant workers and those travelling to other states for specialist care.

Families with members having Autism, Cerebral Palsy, or Multiple Disabilities can additionally explore the Niramaya Health Insurance Scheme for specialised disability coverage beyond what GJAY provides. Children in institutional care under Mission Vatsalya who are Odisha residents can access GJAY hospitalisation benefits. Adolescent girls enrolled under the Scheme for Adolescent Girls (SAG) at Anganwadi Centres can transition into GJAY coverage as their families qualify. Residents of Tamil Nadu, Andhra Pradesh, and Telangana can explore parallel schemes, CMCHIS, Dr YSR Aarogyasri, and Rajiv Aarogyasri, respectively.

Helpline Details

For any issue, at the hospital, during enrollment, or with the card:

• General Helpline: 104, for scheme queries in the local language, available 24 hours.
• Smart Card Support: 155369.
• Additional Support: 0674-2620500.
• Official Portal: gjay.odisha.gov.in.
• Mo Sehat App: Available on Google Play Store for card download, hospital search, and claim tracking.
• State Health Assurance Society (SHAS) Office: SHAS, Odisha, Bhubaneswar.

Any hospital that denies cashless treatment or demands out-of-pocket payment from a registered GJAY beneficiary must be reported immediately on the helpline.

Why Does GJAY Matters?

A scheme that has covered ₹10,056 crore in treatment costs, facilitated 47.52 lakh hospital admissions, processed over 2.88 lakh cancer claims and 5.19 lakh dialysis cases, that is not a scheme on paper. That is a scheme that has reached real people in real distress. The additional ₹5 lakh for women is a particularly thoughtful provision, recognising that women in lower-income households tend to delay their own treatment the longest. The April 2025 integration with Ayushman Bharat extends this coverage nationwide, a major step for Odisha's large migrant worker population.

If you are an Odisha resident with an NFSA or SFSA ration card, visit gjay.odisha.gov.in or the nearest Mo Seva Kendra. The card is free. The coverage is real. And for a state where healthcare access has historically been deeply unequal, it could matter more than you expect.