Ayushman Bharat PMJAY: Health Insurance Scheme

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) is the worlds largest health insurance scheme launched in September 2018 by the Ministry of Health and Family Welfare. The scheme provides health coverage of Rs 5 lakh per family per year for secondary and tertiary hospitalization to over 55 crore beneficiaries, making it the most ambitious healthcare initiative in the world. The scheme targets the poorest and most vulnerable families identified through the SECC database.

Coverage and Benefits

The scheme covers up to Rs 5 lakh per family per year for medical treatment. This includes hospitalization expenses, surgeries, diagnostic tests, medicines and follow-up care. Pre-existing diseases are covered from day one of the policy with no waiting period. The coverage is cashless at all empaneled public and private hospitals across India. Over 1,600 medical procedures are covered under the scheme.

Eligibility

The scheme is based on the SECC 2011 database. Families identified as deprived in rural areas and specified occupation categories in urban areas are eligible. There is no age limit or family size restriction. All family members including newborn babies are automatically covered. The scheme is portable across India meaning beneficiaries can get treatment in any empaneled hospital anywhere in the country.

How to Get the Card

Beneficiaries can check their eligibility by visiting pmjay.gov.in and clicking on Am I Eligible. If eligible, they can visit any empaneled hospital with their Aadhaar card. The hospital will verify the eligibility through the PMJAY portal and issue an e-card immediately. No physical card is required as the treatment can be availed using Aadhaar-based verification.

Documents Required

• Aadhaar Card of all family members
• Ration Card
• Mobile number