Ayushman Bharat Health Insurance Scheme Card Registration [Pm Jan Arogya Yojana] : Ayushman Bharat Card, Scheme Eligibility, How to Enroll

Ayushman Bharat Health Insurance Scheme Card Registration [Pm Jan Arogya Yojana] : Ayushman Bharat Card, Scheme Eligibility, How to Enroll – Check

Ayushman Bharat Health Insurance Scheme Card

About 50 crore Indian individuals are to covered by the Ayushman Bharat Yojana, which is regarded as one of the largest healthcare programs in the world. It is specifically made for the nation’s economically disadvantaged regions. The PMJAY was launched in September 2018 giving health insurance policies of a maximum sum insured amount of Rs.5 lakh.

The majority of medical treatment expenditures, prescription drugs, diagnostic fees, and pre-hospitalization costs are covered by the government health insurance program. Furthermore, the program provides cashless hospitalization services via the Ayushman Bharat Yojana e-card, which may used to receive medical care at any facility in the nation that has been accredited. Scheme participants can receive hospitalization for required care by presenting their PMJAY-e-card.

As recommended by the National Health Policy 2017, the Government of India launched Ayushman Bharat, a flagship program, to achieve the aim of Universal Health Coverage (UHC). This project aims to address the Sustainable Development Goals (SDGs) and their central pledge to “leave no one behind”.

Ayushman Bharat aims to replace the sectoral and segmented health service delivery model with a comprehensive, need-based strategy. To address the healthcare system holistically—addressing ambulatory care, promotion, and prevention—at the primary, secondary, and tertiary levels, this program intends to implement ground-breaking interventions.

Ayushman Bharat is made up of two interrelated parts that work together using the continuum of care method:

1. Health and Wellness Centers (HWCs):

The Indian government stated in February 2018 that 1,50,000 Health and Wellness Centers (HWCs) would replace the country’s Sub Centers and Primary Health Centers. By offering Comprehensive Primary Health Care (CPHC), these facilities will enable individuals to receive medical care closer to their homes. They include services linked to non-communicable diseases, maternity and child health, and free required drugs and diagnostic services.

2. Pradhan Mantri Jan Arogya Yojana (PM-JAY):

The second component of Ayushman Bharat is the PM-JAY or Pradhan Mantri Jan Arogya Yojana. This plan was introduced on 23rd September 2018 in Ranchi, Jharkhand by the Hon’ble Prime Minister of India, Shri Narendra Modi.

With over 12 crore poor and vulnerable families (roughly 55 crore beneficiaries), who make up the bottom 40% of the Indian population, Ayushman Bharat PM-JAY, the largest health assurance program in the world, aims to provide health coverage of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization. For both rural and urban areas, determine which families are included. The National Health Protection Scheme (NHPS) was the name of PM-JAY before it was rebranded.  The Rashtriya Swasthya Bima Yojana (RSBY), which had been implemented in 2008, was incorporated at that time. Consequently, the coverage described also includes families who were covered by RSBY but are not mentioned in the SECC 2011 database. The government entirely funds the PM-JAY program, and the Central and State governments share the implementation costs.

Key Features of PM-JAY:

The largest health insurance and assurance program in the world, PM-JAY is wholly funded by the government.

1. In India’s public and private hospitals, secondary and tertiary care hospitalization costs up to Rs. 5 lakhs per household every year.
2. These benefits are available to around 12 crore impoverished and vulnerable families, or over 55 crore beneficiaries.
3. The PM-JAY program provides the beneficiary with cashless access to medical treatments at the hospital, which is the point of service.
4. The goal of PM-JAY is to lessen the staggering medical costs that force around 6 crore Indians into poverty every year.
5. It pays for costs like diagnostics and medications for up to three days before hospitalization and fifteen days following admission.
6. There are no limitations on family size, age, or gender.
7. All pre-existing conditions covered right away.
8. The benefits of the program are transferable across the country, allowing a recipient to obtain cashless care at any recognized public or private hospital in India.
9. Approximately 1,929 procedures are covered in the services, which cover all treatment-related expenses such as medication, supplies, diagnostic tests, doctor’s fees, hotel costs, surgeon’s fees, OT and ICU fees, etc.
10. Public hospitals get paid the same as private hospitals for the medical services they provide.

Benefit Under PM-JAY:

In India benefits under various government-funded health insurance plans have historically capped at INR30,000 per family annually or INR3,00,000 nationwide, which has led to a disjointed system. Every qualifying household can receive a cashless cover of up to INR5,00,000 from PM-JAY annually for specified secondary and tertiary medical problems. The following therapy components have all associated expenses covered by the plan.

• Medical examination, treatment, and consultation
• Pre-hospitalization
• Medicine and medical consumables
• Non-intensive and intensive care services
• Diagnostic and laboratory investigations
• Medical implantation services (where necessary)
• Accommodation benefits
• Food services
• Complications arising during treatment
• Post-hospitalization follow-up care up to 15 days

Since the benefits are provided on a family floater basis, INR 5,00,000 may available for one or more family members to receive. Five family members could reside in an RSBY at most. However, based on the knowledge gained from previous programs, PM-JAY designed with no upper restriction on the number of family members or their ages. In addition, pre-existing condition coverage starts on the first day. This suggests that any eligible person with a sickness not previously covered by PM-JAY will also able to obtain treatment for that illness at the time of enrollment.

Seniors Over 70 Can Now Access Ayushman Bharat Health PM-JAY:

Because they are older, most seniors do not have health insurance. The announcement that the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana will cover individuals over 70 regardless of their family income the cabinet members’ most significant political move. More than six crore seniors with family health coverage up to ₹5 lakh expected to benefit from the initiative. Participants in other government programs can transfer to AB PM-JAY.

Eligibility Standards for Rural and Urban Population under Ayushman Bharat Yojana PM-JAY:

The PM-JAY program introduced to assist the nation’s lowest 40% of impoverished and economically disadvantaged citizens.

For Rural Population:

Alms-giving families, bonded laborers, primitive tribal groupings, and impoverished families that work as manual scavengers all automatically included in the program.

• Houses with a single room and Kucha-style roofing and walls.
• From 16 to 59 years old, there isn’t a single adult participant.
• The 16–59 age group has no adult male participants at all.
• There one disabled member and one non-disabled member living together.
• ST and SC
• For households without land, physical labor is a primary source of income.

Por Urban Population:

The layout categorizes urban households into categories according to the family members’ occupations.Employees who fall into any of the 11 occupational categories below are eligible for the Ayushman Bharat Yojana Scheme:

• Beggar
• Housekeeper
• Rag Picker
• Cobbler/Street Vendor/Hawker/Other service providers on the street.
• Mason, Painter, Plumber, Laborer, Welder, Security Guard, and Coolie
• Sweeper, Mali, and Cleaning Employee
• Craftsperson, Tailor, Artist, and Home-Based Employee
• Workers in transportation, conductors, rickshaw or cart pullers, and assistants to conductors and drivers
• Workers in small enterprises include attendants, peons, assistants, shop employees, delivery assistants, and servers.
• Repair worker/mechanic/electrician/assembler
• Chowkidar/Man-Washer

List of Serious Illnesses or Diseases Including in Ayushman Bharat Yojana PMJAY:

• Carotid angioplasty with stent
• Prostate cancer
• Coronary artery bypass grafting
• COVID-19
• Skull base surgery
• Pulmonary valve surgery
• Double valve replacement surgery
• Anterior spine fixation
• Tissue expander for disfigurement following burns

Ayushman Bharat PM-JAY Required Documents:

• Age and Identity Verification (Aadhaar Card/PAN Card)
• Information about your home address, email address, and cell phone number.
• Caste certificate
• Income Declaration
• Documents attesting to your current family status.

Ayushman Bharat PM-JAY Enrollment Process:

For the disadvantaged and well-respected groups in society, the Indian government launched the entitlement-based policy. Thus, there isn’t a registration procedure. Those who enrolled in the RSBY program and meet the SECC 2011 requirements chosen as beneficiaries. Take the following actions to determine if you are eligible for the program:

1. Go to the government website dedicated to the PMJAY program, and select the “Am I Eligible” button.
2. Generate an OTP by entering your contact information.
3. Select the state.
4. Use your name, cellphone number, HHD number, or ration card number to start your search right now.
5. The outcome will inform you of whether you fall under the eligibility criteria or not.

Additionally, you can reach the customer support line for the Ayushman Bharat Yojana at 1800-111-565 or 14555, or any Empanelled Health Care Provider (EHCP).

Ayushman Bharat PM-JAY  Check List:

You can verify your name on the Pradhan Mantri Jan Arogya Yojana (PMJAY) beneficiary list using several different techniques. Some of them are:

• Online Method: A list of the Ayushman Bharatis is present online.All you need to do is visit the official Ayushman Bharat Yojana website of the National Health Authority and complete the required fields.
• Common Service Centers (CSC): You can visit the nearest Common Service Center if you are an Ayushman Bharat Yojana beneficiary. If this is not possible, you can visit any accredited hospital to pick up the information form. On their website, you may also confirm the hospital list.
• Dial the Helpline Number: To check if your name is on the beneficiary list, you can contact customer service by calling PMJAY’s toll-free number, 14555.
  If your name is on the list, only you will get the Ayushman Bharat Card.

Ayushman Bharat PM-JAY Card Download:

The Ayushman Bharat Yojana Golden Card, which ensures cashless, paperless, and portable transactions, will given to PM-JAY scheme beneficiaries. To obtain the card, adhere to the instructions.

1. Go to the PMJAY website, then enter your registered mobile number to log in.
2. Enter the “Captcha Code” and get OTP.
3. Select the HHD code
4. Deliver the HHD code to the Common Service Center (CSC) so they may verify it along with further information.
5. The CSC representatives will carry out the remaining steps, also called Ayushman Mitra.
6. The Ayushman Bharat card costs Rs. 30, which required.

Hospitalization Procedure for the Ayushman Bharat Scheme:

Ayushman Bharat Yojana program beneficiaries covered by health insurance while in the hospital and not required to pay a premium. The Ayushman Bharat program pays for inpatient treatment costs as well as pre-and post-hospitalization costs.

Under the PMJAY Scheme, all hospitals that accredited have Pradhan Mantri Arogya Mitras on staff who assist patients by working with the hospital to reduce costs. These Arogya Mitras may found at their assistance desk, where they will check paperwork, eligibility requirements, and the enrollment procedure. Every beneficiary receives a letter from them along with their unique QR code.

This QR code also scanned and verified to determine a person’s eligibility for Ayushman Bharat Yojana benefits.

Highlights:

PMJAY Address and Toll-free Number:

People can call the helpline number of the PM Ayushman Bharat scheme with any questions, concerns, or problems. The numbers toll-free are 1800111565 and 14555.

Address: 9th Floor, Tower-I, Jeevan Bharati Building, Connaught Place, New Delhi – 110001

Click Here to visit the official website of PM-JAY.