Previously known as the Ayushman Bharat Yojana, the Pradhan Mantri Jan Arogya Yojana or the PM-JAY is an active national-level public health insurance fund. This is a public service scheme under the Ministry of Health and Family Welfare of the Government of India. It was launched in September of 2018 with the aim of providing free access to the coverage of health insurance for the lower income group of the nation. It is targeted towards helping the economically weaker and vulnerable citizens of India who need healthcare facilities but are unable to afford the same. It has been more than three years since it was launched; however, there is still a majority of the population that does not know what the scheme is and how they can benefit from it. It is therefore important to understand what the PM-JAY entails.
How does the PM-JAY work?
The Yojana is an approximately ₹8,088 crore budgeted fund for providing healthcare support and aid to close to the bottom 50% of the citizens of the country. It can provide coverage for ten crore households or close to 50 crore Indians. In this program, any primary or initial care services that are required are sought out on their own either through a family doctor or a nearby clinic or hospital. In case there is any additional care needed, that is when this fund comes into the picture. The secondary or tertiary care required for specialist treatment or hospitalization is provided freely through the PM-JAY fund. There is a provision of 5 lakhs per family per year for the treatment in both public and private hospitals. There are more than 15,000 hospitals that have been registered under this scheme. The citizen just needs to check online on the website of PM-JAY, where the hospitals have been listed. The scheme offers around 25 speciality categories and covers a range of more than 1,300 treatments. It also covers three days of pre-hospitalization expenses, 15 days of post-hospitalization expenses, hospital accommodation charges, food service charges and any expenses incurred in case of any complications arising during the medical procedures. This includes medical costs and diagnostic care, thereby giving an overall support to the needy. These beneficiaries can also avail coverage for the required follow-up treatments under this scheme.
Who are eligible for PM-Jay?
The following individuals, families and households living in the rural areas are eligible to be covered under the PM-JAY scheme.
- A household with no adult/male/earning member who comes in the age group of 16-59 years
- A family living in a one-room with house with no proper walls or roof
- A family having at least one physically challenged member without any able-bodied adult member
- Individuals living in scheduled caste and scheduled tribe families or primitive tribal communities
- Families who don’t own any land, where the income is earned through casual manual labour
- Previously bonded labourers who have been released
- Manual scavenger families
- Individuals who are beggars or who survive on alms and begging
The following people living in the urban areas are eligible to be covered under the PM-JAY scheme.
It involves domestic help, washermen, ragpickers, mechanics, electricians, repair workers, sanitation workers, gardeners, sweepers, tailors, plumbers, masons, construction workers, porters, welders, painters, security guards, transport workers, assistants, peons in small scale establishments, delivery boys, shopkeepers, waiters, cobblers, hawkers, and others providing services on streets and pavements.
Who are not eligible?
The following groups of people are not eligible to be covered under the health coverage fund in the Jan Arogya Yojana.
- People who own a two-wheeler, three-wheeler or four-wheeler vehicle or any vehicle are entitled to coverage under this scheme.
- Government employees are not eligible to claim coverage.
- People whose monthly income is more than ₹10,000
- People who have a properly built house with a proper and unbroken roof
- People who own farming equipment and machinery
- People who own agricultural land or farming land of more than 5 acres
- People who hold a Kisan Card – A credit card under the government’s Kisan Credit Card scheme to provide term loans for farmers’ agricultural needs
- People who own a motorized fishing boat
- People who are employed in any non-agricultural enterprise run by the government
- People who have refrigerators and landline phones in their house
It is very important that schemes especially made to benefit and help the ones who need them the most are made aware to them. The PM-JAY is one such scheme. To know all the details about the program, citizens can visit the official website: pmjay.gov.in