Ayushman Bharat Yojana

The National Health Protection Scheme, namely Ayushman Bharat Yojana, was launched by the Prime Minister of India Shri Narendra Modi, on 23^rd September 2018. ‘Ayushman Bharat Yojana’ was launched on the recommendation of National Health Policy 2017 basically to achieve the vision of Universal Health Coverage.

Initially, launched under the name ‘Ayushman Bharat Yojana’ is now renamed to ‘Pradhan Mantri Jan Arogya Yojana’.

Features of Ayushman Bharat Yojana; eligibility and ineligibility under the Yojana; steps for checking the eligibility under the Yojana and documents list for applying under the Yojana are the important points being discussed in the present article.

Features of the Ayushman Bharat Yojana-

Important features of the Ayushman Bharat Yojana are discussed hereunder-

1. It is the world’s largest health insurance scheme which is financed by the Government.

2. It aims to cover more than 50 crore citizens of India comprising of over 10 crore underprivileged families.

3. It aims to provide a health cover amounting to INR 5 Lakhs per family per year for tertiary and secondary hospitalization expenses.

4. It is a paperless scheme.

5. It offers cashless hospitalization covers. Such cover is available at public hospitals as well as network private hospitals.

6. It covers the following costs which are applicable to all the tertiary and secondary care procedure-

a. Cost of hospitalization;

b. Cost of medication;

c. Cost of 3 days of pre-hospitalization; and

d. Cost of 15 days of post hospitalization expenses.

7. It covers around 1400 treatments some are listed hereunder-

a. Knee replacements;

b. Skull surgery;

c. Prostate cancer;

d. Double valve replacement surgery;

e. Anterior spine fixation; etc.

Eligibility to avail benefit under Ayushman Bharat Yojana-

The two basic eligibility to avail the benefits under Ayushman Bharat Yojana are-

1. The name of the person is mentioned under ‘Socio Economic Caste Census 2011’ data; and

2. They should be an active RSBY (i.e., Rashtriya Swasthya Bima Yojana) card holder.

Once the basic eligibility is cleared, another eligibility depends on the rural area or urban area. The same is highlighted hereunder-

Rural area eligibility criteria	Urban area eligibility criteria
The family residing in one room having kutcha walls and roof; Family with no adult/ male/ earning member between the age group of 16 to 59 years; Households having no lands and earning majorly from manual labour; Manual scavenger families; Family not having any healthy adult member and having one disabled member; or The family having no members within the age group of 16 to 59 years.	Beggar; Domestic worker; Home based artisan or worker or tailor or handicraft worker etc.; Ragpicker; Plumber or construction worker or mason or painter or welder or security guard or coolie or other head-load workers; Mechanic or electrician or repair worker or assembler; Rickshaw puller or conductor or cart puller or transport worker; Street vendor or cobbler or hawker; Washer man or chowkidar.

Categories of the person not eligible to avail benefit under Ayushman Bharat Yojana-

The following categories of person/ entities are not eligible to avail the benefit under the Scheme-

1. Any government employees,

2. Any person having a monthly income of more than INR 10,000,

3. Any person owning a vehicle like a two-wheeler, three-wheeler, car etc.

4. Any person owning a motorized fishing boat.

5. The person having an agricultural land of more than five acres.

6. A person having farming machinery and/ or equipment.

7. Holder of Kisan card.

8. A person having refrigerators and/ or landline phones.

9. The person living in a properly built-up house.

Online steps for checking the eligibility under the Ayushman Bharat Yojana-

By following below mentioned simple steps, one can easily verify their eligibility under the scheme-

STEP 1 – Visit https://pmjay.gov.in/;

STEP 2 – Click ‘Am I Eligible’;

STEP 3 – Enter Mobile Number and captcha.

STEP 4 – Click Generate OTP;

STEP 5 – Enter the 6-digit OTP received on the entered mobile number;

STEP 6 – Select State and category (i.e. Search by Name or HHD number or Ration card number or mobile number) from the drop-down list;

STEP 7 – Provide additional details, based on the category selected at STEP 6 above;

STEP 8 – Click Search.

List of documents necessary to apply under Ayushman Bharat Yojana-

The applicant needs to compile the following documents in order to apply under Ayushman Bharat Yojana-

1. Age and Identity proof (i.e., Aadhaar card or PAN card);

2. Address proof;

3. Caste certificate;

4. Income certificate;

5. Ration card;

6. Document reflecting the current status of the family (joint or nuclear) which is to be covered under the scheme.