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    Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana

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    Rishitha Naveenkumar
    Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is India's flagship public health insurance scheme launched nationally on September 23, 2018. The objective is to reduce out-of-pocket healthcare costs for poor and vulnerable families. It provides a coverage of Rs. 5 lakhs per family per year for secondary and tertiary care at empanelled public and private hospitals. Over 10.74 crore families are eligible for cashless access to healthcare under the scheme's 1,650 medical packages. Eligibility is based on the Socio-Economic Caste Census of 2011 and beneficiaries can check status online or submit applications at PMJAY

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    Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana

    Uploaded by

    Rishitha Naveenkumar
    58 views3 pages
    Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is India's flagship public health insurance scheme launched nationally on September 23, 2018. The objective is to reduce out-of-pocket healthcare costs for poor and vulnerable families. It provides a coverage of Rs. 5 lakhs per family per year for secondary and tertiary care at empanelled public and private hospitals. Over 10.74 crore families are eligible for cashless access to healthcare under the scheme's 1,650 medical packages. Eligibility is based on the Socio-Economic Caste Census of 2011 and beneficiaries can check status online or submit applications at PMJAY

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    Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is India's flagship public health insurance scheme launched nationally on September 23, 2018. The objective is to reduce out-of-pocket healthcare costs for poor and vulnerable families. It provides a coverage of Rs. 5 lakhs per family per year for secondary and tertiary care at empanelled public and private hospitals. Over 10.74 crore families are eligible for cashless access to healthcare under the scheme's 1,650 medical packages. Eligibility is based on the Socio-Economic Caste Census of 2011 and beneficiaries can check status online or submit applications at PMJAY

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    © All Rights Reserved
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    58 views3 pages

    Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana

    Uploaded by

    Rishitha Naveenkumar
    Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is India's flagship public health insurance scheme launched nationally on September 23, 2018. The objective is to reduce out-of-pocket healthcare costs for poor and vulnerable families. It provides a coverage of Rs. 5 lakhs per family per year for secondary and tertiary care at empanelled public and private hospitals. Over 10.74 crore families are eligible for cashless access to healthcare under the scheme's 1,650 medical packages. Eligibility is based on the Socio-Economic Caste Census of 2011 and beneficiaries can check status online or submit applications at PMJAY

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    “Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana”

    (AB-PMJAY)

    The flagship scheme of Hon’ble Prime Minister of India was launched in the
    State of Goa on 23rd September 2018, along with National launch.

    Objective of the Scheme:


    The objective of AB-PMJAY is to reduce catastrophic health expenditure,
    improve access to quality health care, reduce unmet needs and reduce out
    of pocket healthcare expenditures of poor and vulnerable families of the
    Socio-Economic Caste Census (SECC) 2011 database of the State/ UT along
    with the estimated existing RSBY Beneficiary Families not figuring in the
    SECC database.

    Salient features of the scheme:


    a. AB-PMJAY is the world’s largest health insurance/ assurance scheme
    fully financed by the government.
    b. It provides a cover of Rs. 5 lakhs per family per year for secondary and
    tertiary care hospitalization across public and private empanelled
    hospitals in India.
    c. PM-JAY has defined 1,650 medical packages in Goa.
    d. Over 10.74 crore poor and vulnerable entitled families (approximately
    50 crore beneficiaries) are eligible for these benefits.
    e. PM-JAY provides cashless access to health care services for the
    beneficiary at the point of service, that is, the hospital.
    f. There is no restriction on the family size, age or gender.
    g. Benefits of the scheme are portable across the country i.e. a
    beneficiary can visit any empanelled public or private hospital in India
    to avail cashless treatment.
    Eligibility Criteria:
    The households included are based on the deprivation and occupational
    criteria of Socio-Economic Caste Census 2011 (SECC 2011) for rural and
    urban areas respectively. It also includes families that were covered in
    RSBY but are not present in the SECC 2011 database. Any individual can
    check his/her eligibility under AB-PMJAY scheme by visiting the website i.e.
    mera.pmjay.gov.in or www.pmjay.gov.in.

    Requirement of Documents to avail the scheme:


    a. Ration Card/ PMO letters- Mandatory
    Any one document mentioned below:
    b. Aadhaar card
    c. Adoption Certificate
    d. Birth Certificate
    e. Certificate of Identity having photo issued by Gazetted Officer or
    Tehsildar on letterhead
    f. Disability ID Card/handicapped medical certificate
    g. Driving License
    h. Freedom Fighter Photo Card
    i. Kissan Photo ID
    j. Passbook
    k. Marriage Certificate issued by the Government issued by the
    respective State/UT Government/Administration
    l. MNREGA Job Card
    m. Other Government id with Photograph
    n. PAN Card
    o. Passport
    p. Pensioner Photo Card
    q. Voter ID Card
    Mode or Procedure to avail the benefit of the Scheme:

    BENEFICIARY CLAIM
    PRE
    PATIENT IDENTIFICATION REQUEST
    AUTHORIZATION TREATMENT DISCHARGE
    HOSPITALISATION AND AND
    AND APPROVAL
    REGISTRATION SETTLEMENT

    Discharge
    Confirm person
    summary
    is an eligible Hospital selects
    and post
    Beneficiary package, checks
    treatment
    under PM-JAY balance.
    evidence
    using software.
    submitted.

    Confirm Submits
    identity supporting
    Electronic
    through evidence
    Payments.
    individual and required for
    family ID proof. treatment.
    Beneficiary
    feedback.

    Officer to be contacted:
    Designation: Operations Manager Medical Management & Quality Manager
    Address: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana cell,
    Ground floor, Directorate of Health Services, Campal, Panaji.
    Phone No.: 0832-2225540
    Email: pmjaygoa@gmail.com
    Website: https://www.pmjay.gov.in/

    Details of Office where the application to be submitted:


    PMJAY Kendra’s set up by Goa electronics limited and at all public & private
    pmjay empanelled hospitals.

    **************

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