Ayushman Bharat Scheme is a health protection scheme to provide health insurance to citizens. It provides insurance coverage of up to Rs.5 lakh on a family floater basis to beneficiaries every year in order to receive primary, secondary, and tertiary healthcare services. The Ayushman Bharat Scheme was earlier referred to as AB-NHPS as it is an initiative under the existing National Health Protection Scheme (NHPS). Currently, it is known as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY). The government plans to distribute this scheme through national insurance companies. The scheme subsumes the existing senior citizen health insurance scheme as well as the Rashtriya Swasthya Bima Yojana.
Basic Features of PMJAY
Regarded as the world’s largest and most successful National Health Protection Scheme, the PMJAY was launched with the objective of making secondary and tertiary healthcare entirely cashless. The plan comes with a maximum sum assured of ₹500,000 per family, per annum. It is designed to help economically disadvantaged individuals avail easy access to a host of healthcare services.
Beneficiaries under this scheme are provided with an e-card which they can use to avail themselves of healthcare services at any impaneled hospital, anywhere in the country. Hospitals from both public and private sectors feature in the Government’s list of impaneled hospitals. Beneficiaries can walk into their nearest or preferred hospitals and seek the necessary treatment, just by showing their PMJAY e-card.
Under the PMJAY scheme, beneficiaries can avail of the necessary course of treatment along with 3 and 15 days or pre and post-hospitalization expenses. Furthermore, approximately 1,400 procedures and the costs related to them, for instance, OT expenses are covered under this plan.
Ayushman Bharat Scheme Eligibility criteria for rural families
There are six deprivation criteria to identify the rural families that are eligible for the benefits of the scheme. They are:
- Families that do not have an earning adult member aged between 16 and 59 years.
- Households headed by female members having no adult male members aged between 16 and 59 years.
- Households with a single room having makeshift walls and roofs.
- Households belonging to the Scheduled Castes and Scheduled Tribes categories.
- Households that have disabled members with no able members offering support.
- Landless households with manual labor as their basic source of income.
In addition, the following households are automatically eligible:
- Destitute families who rely on alms.
- Families of manual scavengers.
- Households without proper shelter.
- Families of bonded labor.
- Primitive and particularly vulnerable tribal groups.
Urban PMJAY: Ayushman Bharat Yojana Eligibility
With a ₹ 5 lakh insurance cover per family, the Ayushman Bharat scheme shall benefit the following category of people in the urban regions –
- Rag Pickers
- Beggars
- Domestic Workers
- Street vendors, cobblers or hawkers, or other individuals providing services on the pavements.
- Construction workers, plumbers, Labourer, painters, welders, security guards
- Sweepers and sanitation workers
- Individuals who offer transport services like drivers, conductors, helpers, cart or rickshaw pullers along with head load workers.
- Home-based workers, artisans including tailors and handicraft workers.
- Shopworkers, assistants or peons in small establishments, delivery boys, and waiters.
- Washer-men or chowkidars.
Who is excluded under the PMJAY: Ayushman Bharat Yojana?
The following individuals or households shall be excluded from PMJAY –
- Any household falling under the bracket and paying income taxes or professional taxes.
- Those households with a government employee as a member.
- Those who are employed in non-agricultural enterprises registered with the government.
- Any member of the family earring more than ₹ 10,000 per month.
- Those households who have Kisan Cards with a credit limit of ₹ 50,000.
- Individuals who own a two, three, or four-wheeler or a motorized fishing boat.
- Households that have refrigerators and landline phones.
- Those who own more than 2.5 acres of land with irrigation equipment.
- Those who reside in permanent house structures.
How to apply online for Ayushman Bharat Yojana?
Here is a step-by-step guide on how you can apply for Ayushman Bharat Yojana.
Step 1: Visit Ayushman Bharat Pradhan Mantri Jan Arogya Yojana’s official website, mera.pmjay.gov.in.
Step 2: Now you have to log on to the government website.
Step 3: On the home page enter your mobile number.
Step 4: Just below that you will see the captcha, enter the captcha in the empty box.
Step 5: After that click on Generate OTP option.
Step 6: An OTP number will be sent to your mobile, by which you can go to the website and verify.
Complete the necessary detail to get the most benefits out of this scheme.
Note: After your name is registered on the Pradhan Mantri Jan Arogya Yojana(PM-JAY) website, with the help of your ration card or mobile number, you can know that you are not getting the benefit of this scheme.
