Ayushman Bharat Yojana Benefits, Eligibility Criteria: The National Health Protection Mission guarantees a benefit cover of Rs. 5 lakh per family annually.

The scheme allows beneficiaries to access cashless benefits nationwide at any public/private empanelled hospital. Entitlement under the scheme is determined based on deprivation criteria in the SECC database. Needy can utilize benefits in government, public, and impaneled private hospital facilities.

Ayushman Bharat Yojana Benefits, Eligibility Criteria

Treatment payments will be based on predefined package rates to control costs. The scheme promotes cooperative federalism and flexibility to states. The Ayushman Bharat National Health Protection Mission Council will be established at the apex level to provide policy directions and coordinate between the Centre and States. States must have a State Health Agency to implement the scheme. Funds will be transferred from the Central Government to State Health Agencies through an escrow account to ensure timely disbursement. An IT platform developed in collaboration with NITI Aayog will facilitate paperless, cashless transactions.

Features of Ayushman Bharat PM-JAY

It is the largest medical insurance scheme in the world, funded by the Government of India. It encompasses approximately 1,393 procedures, including treatment costs, room charges, doctor’s fees, operation theatre expenses, ICU services, diagnostic tests, surgeon fees, and more. Pre-hospitalization coverage lasts for 3 days, while post-hospitalization coverage extends to 15 days, encompassing medication and diagnostics. The coverage amount reaches up to Rs 5 Lakh, and both secondary and tertiary care hospitalization are included. The scheme provides hospitalization coverage in private and public panel hospitals across India, offering cashless hospitalization to beneficiaries. There are no restrictions on age, family size, or gender, and pre-existing diseases are covered from day one. The scheme’s benefits are available nationwide, allowing for cashless treatment at any empanelled public or private hospital in India.

PMJAY Critical Illness Coverage

The program supports families by providing access to healthcare services and offering help with day care procedures, including pre-existing conditions. It includes around 1,350 medical packages at public and private network hospitals throughout India.

PMJAY to Apply Process

Documents Required to Apply For Ayushman Bharat Yojana Scheme: The program is a government initiative in India designed for the underprivileged and vulnerable members of society. As a result, there is no registration process. Eligible individuals are chosen based on the SECC 2011 and those who are part of the RSBY plan. To check your eligibility for the program, please follow these instructions:

Step 1: Go to the official PMJAY scheme website (https://pmjay.gov.in/) and click on the “Am I Eligible” section.

Step 2: Provide your contact information and generate an OTP.

Step 3: Select your state.

Step 4: Search using your name, mobile number, HHD number, or ration card number.

Step 5: The outcome will indicate if you qualify for the PMJAY scheme.

You can also contact Ayushman Bharat Yojana customer service at 1800-111-565 or 14555, or get in touch with any of the Empanelled Health Care Providers (EHCP).

Documents Required to Apply For Ayushman Bharat Yojana Scheme

1. The following documents are necessary for the application of the PMJAY scheme:

– Proof of Identity and Age (Aadhaar Card/PAN Card)

– Information regarding your mobile number, email address, and residential address

– Certificate of Caste

– Certificate of Income

– Documents confirming your current family status.

To download the Ayushman Bharat Yojana Card online, beneficiaries can follow these steps

Step 1: Log in to the PMJAY website using your registered mobile number.

Step 2: Generate OTP by entering the ‘Captcha Code’.

Step 3: Choose the HHD code.

Step 4: Provide the HHD code to the Common Service Centre for verification.

Step 5: Ayushman Mitra representatives at the CSC will assist in completing the process.

Step 6: Pay Rs.30 to receive the Ayushman Bharat card.

Hospitalization Process in Ayushman Bharat Scheme (PMJAY)

1. In case any of your family members or yourself need hospitalization, you will not have to make any payments under the PMJAY scheme as long as you are admitted to one of the approved public or private hospitals. The hospitalization and treatment procedures are completely cashless due to a cost-sharing ratio of 60:40 between the central and state governments, respectively.
2. If you or any of your family members require hospitalization, you will not be required to make any payments under the PMJAY scheme as long as you are admitted to one of the empanelled public or private hospitals. The entire hospitalization and treatment process is cashless thanks to a cost-sharing ratio of 60:40 between the central and state governments, respectively.

How to Find PMJAY Hospital List

Step 1: Go to the official PMJAY website and navigate to the Hospitals list section. (https://hospitals.pmjay.gov.in/Search/empnlWorkFlow.htm?actionFlag=ViewRegisteredHosptlsNew).

Step 2: Choose your state and district from the options provided.

Step 3: Select the type of hospital you are interested in (public/private-for-profit/private and not for profit).

Step 4: Specify the medical specialty you require.

Step 5: Enter the “Captcha Code” and search button.

Upon completion, you will have access to the list of Ayushman Bharat Yojana hospitals, including their addresses, websites, and contact details. Additionally, you can also review the ‘Suspended Hospital List’ on the same webpage.

PMJAY Address and Toll-free Number

Helpline Number: 14555/1800-111-565

Location: National Health Authority of India, 3rd, 7th and 9th Floor, Tower-L, Jeevan Bharati Building, Connaught Place, New Delhi – 110001

Complaints Portal: https://grievance.abdm.gov.in/grievance/v3/

Click Here to learn about how to make an Instant Pan Card.

Ayushman Bharat Yojana: Quick FAQs

1. What is the coverage limit under Ayushman Bharat Yojana?
   The scheme provides an annual health cover of Rs. 5 lakh per family.
2. Who is eligible for the Ayushman Bharat Yojana?
   Eligibility is based on the deprivation criteria in the SECC 2011 database.
3. Is there any registration required for Ayushman Bharat Yojana?
   No, eligible families are automatically identified based on SECC data.
4. Can beneficiaries access private hospitals under this scheme?
   Yes, beneficiaries can receive cashless treatment at any empanelled public or private hospital in India.

5. Are pre-existing conditions covered under Ayushman Bharat Yojana?
   Yes, pre-existing conditions are covered from the first day of enrollment.