Ayushman Bharat Yojana, also known as Pradhan Mantri Jan Arogya Yojana (PMJAY), is a pioneering healthcare initiative launched by the Government of India in September 2018. The primary objective of this scheme is to provide financial protection and affordable healthcare to the economically vulnerable and marginalized sections of society. Ayushman Bharat Yojana has two components: Health and Wellness Centers (HWCs) and Pradhan Mantri Jan Arogya Yojana (PMJAY).
PMJAY is the flagship component of Ayushman Bharat Yojana, focused on providing health insurance coverage to around 10 crore poor and vulnerable families, which is approximately 50 crore individuals. The scheme aims to ensure that no family has to face financial hardship due to health-related expenses. It covers a wide range of medical treatments, including hospitalization, surgeries, diagnostics, and follow-up care.
Eligibility Criteria:
To avail the benefits of PMJAY, individuals and families need to meet certain eligibility criteria:
Socio-Economic Categorization: The eligibility is determined based on the Socio-Economic and Caste Census (SECC) 2011 data, which identifies specific categories of families that are economically disadvantaged.
Deprivation Index: The deprivation index is calculated based on various factors like household income, housing conditions, and educational status, among others. Families falling under certain deprivation criteria are eligible for the scheme.
Beneficiary Categories: PMJAY covers two main categories of beneficiaries: rural and urban. These categories are further divided into different groups based on economic and social criteria.
Household Ownership: Families owning a motorized vehicle, a mechanized fishing boat, three or more rooms with pucca walls and roof, a refrigerator, a landline phone, or possessing more than 2.5 acres of irrigated land are generally excluded from the scheme.
Inclusion and Exclusion Criteria: The eligibility criteria also take into account various inclusion and exclusion parameters to ensure that the scheme reaches those who need it the most.
Application Process:
Online Registration: Eligible beneficiaries can apply for PMJAY through the official website of Ayushman Bharat Yojana. The online application process involves providing personal and family details, as well as income-related information.
Offline Mode: In areas with limited internet access, beneficiaries can visit Common Service Centers (CSCs) to apply for the scheme. CSCs facilitate the application process and help beneficiaries enroll in the scheme.
Verification: After applying, the provided information is verified against the SECC database to determine the eligibility of the applicant.
Golden Card Issuance: Once the verification is complete, eligible beneficiaries receive a 'Golden Card' that serves as their health insurance card under PMJAY.
Hospitalization: When a beneficiary requires medical treatment, they can visit any of the empaneled hospitals under the scheme and present their Golden Card. The hospital then verifies the beneficiary's eligibility and provides the necessary treatment.
Benefits and Coverage:
PMJAY covers a range of medical treatments, including but not limited to:
Hospitalization expenses
Pre- and post-hospitalization expenses
Surgeries and procedures
Maternity and newborn care
Diagnostic tests
Follow-up care
The scheme provides a fixed amount of coverage per family per year, ensuring that families are protected from catastrophic health expenditures.
Ayushman Bharat Yojana's Pradhan Mantri Jan Arogya Yojana aims to transform India's healthcare landscape by providing essential medical coverage to millions of vulnerable families. By offering financial protection and enabling access to quality healthcare, the scheme contributes to the overall well-being of the nation's citizens. The eligibility criteria and application process are designed to ensure that the benefits reach those who need them the most, promoting inclusivity and equity in healthcare services.
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