Everything About Ayushman Bharat Yojana

What is Ayushma Bharat Scheme or PMJAY Scheme?: Introduced by the government of India, Ayushman Bharat Yojana or Pradhan Mantri Jan Arogya Yojana (PMJAY) is one of the largest government insurance schemes in the world. Ayushman Bharat Scheme offers Rs.5 Lakh insurance coverage per year per family to rural and urban India’s poor and needy families.

  • Launching: Prime Minister of India, Shri Narender Modi announced the Ayushman Bharat Scheme in his Independence day speech of 2018, and then he launched the Ayushman Yojana on September 23, 2018.
  • Coverage: Ayushman Bharat covers the cost of 3 days of pre-hospitalization and 15 days of post-hospitalization. It also covers the cost of medicines, medical examinations, and consultation during treatment. This has been possible with a 60:40 cost-sharing agreement between the center and state governments respectively.
  • Eligibility: Pradhan Mantri Ayushman Yojana offers Rs.5 Lakh insurance coverage per year to the bottom 40% of the Indian population which is approximately 50 crore individuals. Ayushman Bharat Yojana covers the 10 crores of Indian families for secondary and territory care hospitalization.
    These 10 crore Indian families are included based on the Socio-Economic Caste Census (SECC) of 2011 for rural and urban areas respectively. Ayushman Yojana has been merged with the erstwhile Rashtriya Swasthya Bima Yojana (RSBY) which was launched in 2008.
  • How to Avail: To avail of free treatment under PMJAY (Pradhan Mantri Jan Aarogya Yojana), you just need to visit your nearest or any empanelment government or private hospital with your Ayushman Bharat Golden Card.
  • Rechristening: The Ayushman Bharat Jan Arogya Yojana, also known as Ayushman Bharat Scheme, was earlier known as National Health Protection Scheme (NHPS). It was then renamed Ayushman Bharat, and finally Pradhan Mantri Jan Arogya Yojana (PMJAY) OR Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
  • ProgressA total of 2,89,23,388 patients have been admitted to empanelled hospitals as of January 17, 2023, and 17,69,03,501 Ayushman Golden Cards had been issued. The PMJAY scheme offers more than 1670 procedures, and over 27,000 hospitals have been empanelled with it, to provide free healthcare services to needy individuals.

Features of Ayushman Bharat Yojana

Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana’s main motive is to provide accessible and affordable healthcare services to the lower middle-income group of India. Here is the list of features for Ayushman Bharat Yojana Online.

  • Financing: AB PMJAY is fully funded by the government of India and the state government with a cost-sharing of 60:40 respectively.
  • RSBY Families: Families included in RSBY but not in the SECC 2011 database are also included in PMJAY.
  • Family Floater: Ayushman Bharat is a family floater scheme that covers the entire family with a single insurance plan.
  • World’s Largest: Ayushman Bharat Scheme is one of the largest insurance schemes in the world.
  • Insurance Coverage: Aayushman Bharat provides Rs.5 lakh insurance coverage to the middle-income group of India.
  • Population Covered: Ayushman Bharat Scheme covers 50 crores Indian population.
  • Poverty Upliftment: The Ayushman Bharat Yojana is helping to lift 6 crores of Indians out of poverty.
  • Family Size: There is no restriction on the family size in the PMJAY Scheme.
  • Hospitalization: Ayushman Bharat covers the cost of 3 days of pre-hospitalization and 15 days of post-hospitalization.
  • Cost Covered: PMJAY also covers the cost of consultation, drugs, supplies, diagnostic services, physician’s fees, room charges, surgeon charges, and medical tests during hospitalization.
  • Insurance From Day One: It also covers the insured from day one, which means pre-existing diseases are also covered under this scheme.
  • All India Service: An eligible beneficiary can take the services of Pradhan Mantri Jan Arogya Yojana (PMJAY) across the country in any empanelled public or private hospital.
  • Cashless Hospitalization: AB-PMJAY provides cashless hospitalization, which means you don’t have to pay any fee during the hospitalization of an eligible beneficiary.
  • Free Insurance: Ayushman Bharat Scheme provides free insurance coverage which means you don’t have to pay any premium for this insurance policy to remain active.
  • Empanelment: Beneficiaries can visit any empanelled public or private hospital in India to avail of cashless treatment.

Ayushman Card Benefits

Ayushman Bharat Scheme has lots of benefits, some of which are listed below, including free cashless treatment to the bottom 40% of the Indian population.

  • Cashless: Each eligible family is given Rs.5 lakh cashless coverage per year by PMJAY.
  • Post-hospitalization: The post-hospitalization expenses of up to 15 days are borne by the Pradhan Mantri Jan Aarogya Yojana.
  • Pre-hospitalization: It also covers the cost of 3 days of Pre-hospitalization cost.
  • Surgeries: If a patient needs more than one surgery, the first one should be covered by the highest package, and the second and third surgeries should be covered by 50% and 25%, respectively.
  • Speciality: Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) offers almost 26 specialties including oncology and neurosurgery.
  • Cancer Types: Aayushman Bharat Yojana offers treatment for almost 50 types of cancer.
  • Cost Covered For: Ayushman Yojana also covers all the expenses related to the following treatments.
    • Medical examination
    • Pre-hospitalization
    • Medicine
    • Services related to the Intensive and Non-intensive care
    • Laboratory investigations
    • Medical implantation
    • Accommodation
    • Food-related services
    • Medical problems that develop during treatment

Ayushman Card Eligibility

Pradhan Mantri Ayushman Yojana covers the bottom 40% of the Indian population. It is almost 50 crore individuals.

The Socio-Economic Caste Census (SECC) 2011 has been used to identify the beneficiaries of the Ayushman Bharat Yojana. All these beneficiary families are included in the SECC database based on the deprivation and occupational criteria for rural and urban areas, respectively.

Families that were part of the Rashtriya Swasthya Bima Yojana (RSBY) but absent from the SECC 2011 database are also included in the PMJAY scheme.

Ayushman Card Eligibility for Rural India

PMJAY Scheme covers those families who meet at least one of the following eligibility criteria.

  • SC/ST families.
  • Living on Alms
  • Manual scavengers
  • Primitive tribal groups
  • Legally released bonded labor
  • Families without land whose primary source of income is manual labor.
  • Families who have only one room with a kutcha roof or kutcha walls.
  • Families with no adult members between the age of 16 to 59 years.
  • Families who don’t have a single adult male member between the age of 16 to 59 years.

Ayushman Card Eligibility for Urban India

The people who qualify for the Ayushman Bharat Yojana or PMJAY Scheme are listed below.

  • Beggar
  • Ragpicker
  • Domestic worker
  • Washer-man/ Chowkidar
  • Sweeper/ Sanitation worker/ Mali
  • Electrician/ Mechanic/ Assembler/ Repair worker
  • Home-based worker/ Artisan/ Handicrafts worker/ Tailor
  • Street vendor/ Cobbler/hawker / other service provider working on streets
  • Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart puller/ Rickshaw puller
  • Shop worker/ Assistant/ Peon in small establishment/ Helper/Delivery Assistant / Attendant/ Waiter
  • Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard/ Coolie and other head-load workers

Who are not Eligible for Ayushman Bharat Yojana

These people are not entitled to have an Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) Card.

  • Kisan Card holders
  • Government Employee
  • People who own a vehicle.
  • Those who have a pucca house.
  • Those who have electrical equipment
  • Households earning more than Rs.10,000 per month.
  • Households having more than 5 Acre agricultural land.
  • Those families in which any family member has a motorized fishing boat.

How to Check Your Eligibility in Ayushman Bharat Yojana

If you want to check Ayushman Bharat Eligibility, follow the steps mentioned below.

Step 1: Go to the official website of PMJAY i.e. pmjay.gov.in. Now Click on the “Am I Eligible” button.

pmjay

Step 2: Enter your mobile number and captcha code as shown in the below picture. Finally, click on the “Generate OTP” button.

pmjay

Step 3: Select your state.

pmjay

Step 4: By selecting your name, mobile number, or family id under the “Select Category” box, you can find your eligibility for the Ayushman Bharat Yojana.

We have selected the “Search By Name” option for this demonstration.

pmjay

Step 5: Fill in all the details like Your Name, Father’s Name, Age, etc, and then click on the “Search” button.

pmjay

Thus you can check your name in the Ayushman Bharat Yojana.

Documents Required for Ayushman Bharat Card

You can not enroll for the Pradhan Mantri Jan Arogya Yojana (PM-JAY) because currently there is no process for the Ayushman Bharat Registration.

All the eligible candidates who have to issue an Ayushman Bharat Card are taken from the Socio-Economic Caste Census (SECC) 2011 database.

But for getting the Ayushman Bharat Card, you have to go to the CSC center nearest to you and where you require some documents to verify your identity.

So below is the list of documents required for the Ayushman Bharat Golden Card.

  • Aadhar Card
  • Family Id or House Hold ID (HHD id)
  • Mobile Number
  • Ration Card

PMJAY Registration

Currently, there is no process for Ayushman Bharat Registration or PMJAY Registration which means you can’t apply for the Ayushman Bharat Card by yourself.

If you don’t have an Ayushman Bharat Golden card and you are not on the list of beneficiaries also, then there is no way for Ayushman card registration at this time, so that you can make your Ayushman card.

But to register as a self-user on the PMJAY website, see below. After signing up as a self-user, you can easily download your Ayushman card, view the beneficiaries’ list, perform e-KYC, and much more.

Step 1: Go to the official website of PMJAY which is setu.pmjay.gov.in.

pmjay registration

Step 2: Register yourself using the “Register” button shown in the above picture. In the registration process, you have to submit your basic details.

Step 3: In the next step, you have to do your KYC by using the “Do Your KYC” button. In this process, you have to submit your Aadhar details and an OTP will be sent to your registered mobile number to verify your identity or KYC.

After successful verification of your KYC process, a new dashboard will open where you can download your Ayushman Card and see the beneficiary details.

Ayushman Card Download

You can download your Ayushman Card from your home easily with the help of your smartphone. Follow the below steps for Ayushman Bharat Card Download.

Step 1: Open your chrome browser on your mobile phone and go to the official website of PMJAY which is bis.pmjay.gov.in. Click on the three-dot which is available in the top right corner of your mobile screen.

pmjay card download

Step 2: Now click on the “Desktop Button” as shown in the below picture.

pmjay card download

Step 3: Click on the “Download Ayushman Card” button to download the Ayushman Bharat Golden Card.

pmjay card download

Step 4: Select the “Aadhar Card” option to proceed further.

pmjay card download

Step 5: Enter your Aadhar card number after choosing PMJAY in the “Scheme” option and selecting your state.

After selecting the Aadhar consent box, click the “Generate OTP” button as shown in the below picture.

pmjay card download

Step 6: Enter the OTP received on your registered mobile number and click on the verify button.

Step 7: On the next screen, you will see the “Download Ayushman Card” button click on it to Download Ayushman Card. Thus you can Download Ayushman Card easily.

Ayushman Bharat Yojana Hospitalization Process

pmjay hospitalization process

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a cashless medical facility that provides 5 lakh insurance coverage per year per family to the needy ones.

Anyone who wants to avail of the benefits under the PMJAY Yojana can go to any empanelled hospital all over India and get treatment free of cost.

For getting the treatment at any empanelled public or private hospital, the eligible beneficiaries should go through a 5-step process which you can see in the above picture. For a detailed view, continue your reading.

Step 1: Beneficiary Verification

The first step towards PMJAY hospitalization is to verify the identity of the entitled beneficiary so that it can be ensured that the benefits under the PMJAY Yojana are being taken by the real beneficiaries.

When a person goes to an empanelled hospital for treatment, he/she will be asked to give Ayushman Card so that they can start the identity verification of the beneficiary.

Step 2: Admission and Pre-Authorization Request

There is a Pradhan Mantri Arogya Mitra (PMAM) in every empanelled hospital, who assists the beneficiary with every aspect of the scheme and in the hospitalization process.

When a person goes to an empanelled hospital for treatment, Pradhan Mantri Arogya Mitra (PMAM) helps him in the admission process and starts the Pre-Authorization request for that person, if required.

What is Pre-Authorization: Under a health insurance plan, some treatments required approval from your health insurer before you receive treatment.

So the process of demanding consent from your insurer for the treatment is called Pre-Authorization.

Step 3: Pre-Authorization Approval and Treatment

As soon as the Pre-Authorization request is approved, the treatment of the beneficiary starts.

Step 4: Feedback at Discharge

When the treatment of the beneficiary is completed, then Pradhan Mantri Arogya Mitra helps the beneficiary in the discharge process and in the post-discharge medication also.

After the treatment, PMAM collects a Discharge Satisfaction Letter duly filled out by the beneficiary or any other relative of the discharged person.

In this Discharge Satisfaction Letter, you will be asked about the cleanliness of the hospital, the behavior of the hospital staff, and the amount charged by the hospital, if any.

To Download the Discharge Satisfaction Letter in PDF form, Click Here.

Step 5: Post-Discharge Feedback

Post-Discharge Feedback is very important for a corruption-free PMJAY, it enables National Health Authority or State Health Authority to make the necessary improvements so that the beneficiaries can benefit from the Pradhan Mantri Jan Arogya Yojana Scheme.

Within 7 days of the discharge, a letter from the Chief Minister is sent to the beneficiary in which the CM asks about the health of the individual and also requests to fill out the Post-Discharge Feedback Form enclosed with the CM letter.

In the Post-Discharge Feedback Form, you are asked about the services provided by the PMAM during the treatment, your satisfaction with hospital treatment, and money paid by you, if any.

To Download the Post-Discharge Feedback Form in PDF, Click Here.

Financial Assistance During the Hospitalization

Ayushman Bharat Scheme is the world’s largest insurance scheme which provides financial assistance of Rs.5 lakh per year per family to 50 crore Indians.

The main motive of the Pradhan Mantri Jan Arogya Yojana (PMJAY) is to provide safe and quality hospitalization to the poor and vulnerable households in the country.

According to Ayushman Bharat Dashboard, AB-PMJAY has provided treatment worth Rs.51,892 crore and more than 4 crore individuals have been admitted to the empanelled hospitals.

What is Covered under the P M Ayushman Yojana

Cardiology, neurosurgery, and oncology are some of the almost 26 specialties that are covered by the Ayushman Bharat treatment plans. This health insurance policy also covers 1670 procedures and 920 packages.

PMJAY covers the 3 days of pre-hospitalization expenses and post-hospitalization expenses for up to 15 days.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) also covers the cost of medicines, medical examinations, daycare treatment, follow-up care, and newborn child expenses.

The following charges are also included in the Ayushman Bharat Yojana.

  • Registration and Bed Charges
  • Nursing Charges
  • Surgeons, Anaesthetists, Medical Practitioners, Consultant’s Fees
  • Anaesthesia, Blood Transfusion, Oxygen, O.T. Charges, Cost of Surgical Appliances
  • Medicines and Drug Charges
  • Implantation Cost
  • Cost of Prosthetic Devices
  • Pathology and Radiology Tests
  • Food Services
  • Any other expenses related to the patient in the hospital
  • Day Care Treatment Charges
  • Accommodation Charges
  • Covid-19 Treatment

What is not Covered under the Ayushman Bharat Yojana

Like other health insurance schemes, Ayushman Bharat Health Insurance has also some exceptions that aren’t covered under it. Here is the list of treatments that are not covered under the Aayushman Bharat Yojana.

  • Out-Patient Department (OPD) Treatments
  • Disease that does not require hospitalization
  • Dental treatments like cosmetic procedure, filling of tooth cavity, dental implants, etc.
  • Procedures related to the infertility
  • Vaccination
  • Cosmetic procedures like fat grafting
  • Circumcision of Children
  • Persistent Vegetative State
  • Organ Transplant

List of Disease Covered Under Ayushman Bharat Yojana

There is a variety of diseases that are covered under the PMJAY Yojana. Here is the list of popular diseases that are covered under this scheme.

  • Different types of Cancer
  • Heart Disease including angioplasty
  • Gout
  • Snake Bite
  • Mental Disorders
  • Neonatal Care
  • Meningitis
  • Rickets
  • Cervical spine fixation
  • Gastrectomy
  • Biopsy
  • Covid-19
  • High-risk delivery

To Download the Complete List of Diseases in PDF form, Click Here.

P M J A Y Hospital List

More than 27,000 hospitals participate in this health insurance scheme, covering 1670 procedures across 26 specialties.

The three days of pre-hospitalization costs and up to 15 days’ worth of post-hospitalization costs are covered by PMJAY.

If someone wants to download Ayushman Bharat Hospital List PDF, see the process below.

Step 1: Go to the official website of the PMJAY i.e HOSPITAL PMJAY GOV IN. When you visit the official website, you will see the interface as shown in the below picture.

p m j a y hospital list

Step 2: To find the PMJAY Hospital List, you have to enter some basic details like your state, district, etc in the given fields and then click on the Search button.

Then a list of the empanelled hospitals will come out on the screen, thus you can find the P M J A Y hospital list in 2 simple steps.

COVID-19 Treatment under Ayushman Bharat Scheme

Like other health insurance, COVID-19 testing and treatment are also covered under the Aayushman Bharat Yojana. So any eligible beneficiary can avail of free COVID-19 treatment at any public or empanelled private hospital.

During the COVID-19 pandemic, the inclusion of this treatment under the PMJAY Scheme proved a blessing to the poor of the country.

How to See AB-PMJAY Dashboard for Ayushman Bharat Scheme

Using the PMJAY dashboard, you can see all the details about the total no of Ayushman cards issued, the total beneficiary, empanelled hospital count, and more about the scheme.

To visit the PMJAY dashboard, just go to their official website i.e dashboard.pmjay.gov.in and their you can see the dashboard of the AB-PMJAY.

pmjay dashboard

How to Give Your Feedback

To give your valuable suggestion, go to the official website of PMJAY i.e pmjay.gov.in, and click on the menu button as shown in the below picture.

pmjay feedback

Now click on the feedback option as shown in the below picture.

pmjay feedback

Fill the necessary details in this feedback form and then click on the “Request OTP” button.

How to Find More Information About the Ayushman Bharat Yojana

If you want to find more details related to the scheme, you can find them from the below-mentioned method.

Step 1: Go to the official website of PMJAY i.e pmjay.gov.in and click on the Menu button as shown in the below picture.

pmjay feedback

Step 2: Now click on the “Documents” option right below the Resources option.

view information about pmjay

Step 3: Now a new link will open on your mobile screen where you can see all the information related to the scheme.

view information about pmjay

PMJAY Grievance

1. How to File a Complain

You can make a complaint if you have any issues during your hospital stay, following your discharge, or if you have a complaint regarding the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

For a step-by-step guide on how to lodge a complaint with the Ayushman Yojana, see the section below.

Step 1: Go to the official website of grievance redressal for PMJAY i.e cgrms.pmjay.gov.in and click on the “Register Your Grievance” button as shown in the below picture.

pmjay grievance registeration

Step 2: Now you will see the “Grievance Registration For” option on your screen. Choose PMJAY from the menu and click on the “Register” button.

pmjay grievance registeration

Step 3: Now a Grievance Form will appear on your screen. In this form, you have to enter the basic details of the complainant and the details about the grievance. After filling out the form carefully, click on the “Submit” button.

pmjay grievance form

In the end, you will receive a UGN Number that you should keep with yourself for future use. 

How to See Your Complain

If you want to track your PMJAY complaint, you can do it with the below steps.

Step 1: Go to the official website of grievance redressal for PMJAY i.e cgrms.pmjay.gov.in and click on the “Track Your Grievance” button as shown in the below picture.

track PMJAY grievance

Step 2: Now enter the UGN Number that you received at the end of the Grievance Registration Step and then click on the “Submit” button. Thus you can see your PMJAY complaint status.

track PMJAY grievance

Ayushman Card Helpline Number

If you have any inquiries about the Ayushman Bharat Yojana, you can get in touch with PMJAY customer service using the ways listed below.

  • PMJAY Helpline Number: 14555
  • Ayushman Card Customer Care Number: 1800 111 565
  • Email Id: webmaster-pmjay@nha.gov.in
  • Address:
    9th Floor, Tower-l,
    Jeevan Bharati Building,
    Connaught Place, New Delhi – 110001

FAQs

Q: Is Ayushman card free?

Ans: Ayushman card is given to the entitled beneficiaries free of cost. It provides free medical treatment of Rs.5 lakhs per year per family.

Q: Is Ayushman card valid in a private hospital?

Ans: Ayushman card can be used at any empanelled private hospital or government hospital all over India.

Q: Is an Ayushman card for all family members?

Ans: Ayushman card is issued to all members of the entitled family.

Q: How many diseases cover in Ayushman card?

Ans: There are various diseases that are covered in the Ayushman Bharat Yojana. Here is the list of popular diseases that are covered under this scheme.

  • Different types of Cancer
  • Heart Disease including angioplasty
  • Mental Disorders
  • Neonatal Care
  • Meningitis
  • Cervical spine fixation
  • Covid-19
  • High-risk delivery

To Download the Complete List of Diseases in PDF form, Click Here.

Q: What is covered under PMJAY?

Ans: PMJAY Scheme provides Rs.5 lakh insurance coverage per year per family, it covers the cost of 3 days of pre-hospitalization and 15 days of post-hospitalization.

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