Ayushman Bharat (PM-JAY) Scheme
Ayushman Bharat (PM-JAY) Scheme
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) is India’s flagship health insurance scheme, launched by the Government of India on 23rd September 2018.
Hon’ble Prime Minister Shri Narendra Modi ji rolled out the PMJAY healthcare scheme to provide free healthcare coverage of up to ₹5 lakh per family per year for secondary and tertiary hospitalization.
PMJAY is considered to be the world’s largest government-funded healthcare program, targeting India’s economically weaker sections of society.
PMJAY is also known as the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) Scheme, one of the biggest healthcare schemes that are sponsored by the Government of India. Hon’ble Prime Minister, Shri Narendra Modi rolled out the Pradhan Mantri Jan Arogya Yojana (PM-JAY) healthcare scheme with an aim to reduce the financial burden on poor and vulnerable groups arising out of catastrophic hospital episodes and ensure their access to quality health services.
SGVP Holistic Hospital empanelled with Ayushman Bharat (PM-JAY) Scheme with all the following clusters:
To check eligibility, beneficiaries can contact the helpline (14555/1800111565), visit nearest Common Service Centres (CSC) or logon to https://mera.pmjay.gov.in.
The key differences between regular health insurance plans and government health insurance schemes like PMJAY are as follows
Features | Regular Health Insurance Plans | PMJAY (Government Health Insurance Scheme) |
Eligibility | Open to all who can afford premiums | Targeted at economically weaker sections |
Sum Insured | Varies and can be substantial | Up to ₹5 lakh per family per year |
Premiums | Paid by the policyholder | Fully funded by the government |
Network Hospitals | Limited to insurer’s network | Extensive network of empaneled hospitals |
Pre-existing Conditions | May have waiting periods | Covered from the start |
Cashless Treatment | Available in network hospitals | Fully cashless across empaneled hospitals |
Tax Benefits | Available under Section 80D of IT Act | Not applicable |
Pradhan Mantri Jan Arogya Yojana (PMJAY) provides medical access to approximately 40% of India’s population, covering various segments. The key benefits of this scheme include:
Eligibility criteria for PMJAY are based on data obtained from the Socio-Economic and Caste Census 2011 (SECC-2011). The eligibility criteria for rural and urban households are as follows:
Families that meet one or more of the following criteria are eligible for PMJAY:
PMJAY coverage extends to people employed in the following occupations:
All senior citizens above 70 years of age are eligible for PMJAY coverage of up to INR 5 lakh, irrespective of their Socio-Economic status.
Senior citizens who belong to families already covered under PMJAY will receive an additional top-up coverage of up to INR 5 lakh per year for themselves.
PMJAY provides comprehensive coverage of up to INR 5 lakh per family annually for secondary and tertiary hospitalization care. The following facilities are covered under the scheme:
Like other health insurance policies, PMJAY also has its exclusions. The following costs are not covered under the scheme:
To check if you qualify for PMJAY online, follow these steps:
Alternatively, to check eligibility for PMJAY, beneficiaries can contact the helpline (14555/1800111565) or visit the nearest Common Service Centers (CSC).
