AB PM-JAY is a health insurance scheme for low-income families in rural and urban areas. The scheme aims to provide affordable healthcare facilities to the Poor. It is the largest health assurance scheme in the world which aims at providing a health cover of ₹5,00,000/- per family per year.
AB PM-JAY is a health insurance scheme for low-income families in rural and urban areas. The scheme aims to provide affordable healthcare facilities to the Poor. It is the largest health assurance scheme in the world which aims at providing a health cover of ₹5,00,000/- per family per year.
भारत सरकार के स्वास्थ्य और परिवार कल्याण मंत्रालय के तहत राष्ट्रीय स्वास्थ्य प्राधिकरण (एन. एच. ए.) द्वारा लागू की गई योजना "आयुष्मान भारत-प्रधानमंत्री जन आरोग्य योजना" का उद्देश्य गरीब और कमजोर परिवारों को माध्यमिक और तृतीयक स्वास्थ्य सेवाओं के लिए प्रति वर्ष ₹ 5,00,000 का नकद रहित अस्पताल में भर्ती कवरेज प्रदान करना है। इसका शुभारंभ 23 सितंबर 2018 को झारखंड के रांची में भारत के माननीय प्रधानमंत्री द्वारा किया गया था। आयुष्मान भारत स्वास्थ्य सेवा वितरण के लिए एक क्षेत्रीय और विभाजित दृष्टिकोण से एक व्यापक आवश्यकता-आधारित स्वास्थ्य देखभाल सेवा की ओर बढ़ने का एक प्रयास है। इस योजना का उद्देश्य प्राथमिक, माध्यमिक और तृतीयक स्तरों पर स्वास्थ्य सेवा प्रणाली (रोकथाम, संवर्धन और एम्बुलेटरी देखभाल को शामिल करते हुए) को समग्र रूप से संबोधित करने के लिए पथप्रदर्शक हस्तक्षेप करना है। आयुष्मान भारत देखभाल दृष्टिकोण की निरंतरता को अपनाता है, जिसमें दो परस्पर संबंधित घटक शामिल हैं-* * स्वास्थ्य और कल्याण केंद्रोंों (एचडब्ल्यूसी): * इस योजना का उद्देश्य व्यापक प्राथमिक स्वास्थ्य सेवाएं प्रदान करना है, जिसमें मातृ और बाल स्वास्थ्य, गैर-संचारी रोग देखभाल, नि:शुल्क आवश्यक दवाएं और निदान, लोगों के घरों के करीब शामिल हैं। ये केंद्रोंों पुरानी बीमारियों के जोखिम को कम करने के लिए निवारक स्वास्थ्य सेवा और स्वस्थ व्यवहार को बढ़ावा देते हैं। - * प्रधान मंत्री जन आरोग्य योजना (पीएम-जेएवाई): * आयुष्मान भारत के तहत दूसरा घटक प्रधान मंत्री जन आरोग्य योजना या पीएम-जेएवाई है क्योंकि यह लोकप्रिय है। इसका उद्देश्य गरीब और कमजोर परिवारों को माध्यमिक और तृतीयक अस्पताल में भर्ती होने के लिए प्रति वर्ष प्रति परिवार ₹ 5,00,000 तक का नकदी रहित स्वास्थ्य बीमा कवरेज प्रदान करना है। <बीआर>
> * वित्तीय स्वास्थ्य बीमा कवरः * *-* वार्षिक अस्पताल में भर्ती कवरेजः * प्रति वर्ष प्रति परिवार ₹ 5,00,000 तक नकद रहित कवरेज। * व्यापक उपचार लागतः * परामर्श, दवाएं, निदान, सर्जरी, आई. सी. यू., प्रत्यारोपण, आवास और भोजन शामिल है। * अस्पताल में भर्ती होने से पहले और बाद का समर्थनः * अस्पताल में भर्ती होने से पहले 3 दिन और अस्पताल में भर्ती होने के बाद 15 दिन का खर्च शामिल है। कवरेज की विशेषताएंः पहले से मौजूद रोग कवरेजः पहले दिन से ही सभी पहले से मौजूद बीमारियों को कवर करता है। * परिवार के आकार की कोई सीमा नहीं हैः * उम्र, लिंग या परिवार के आकार पर कोई प्रतिबंध नहीं है। * राष्ट्रव्यापी पोर्टेबिलिटीः * पूरे भारत में सूचीबद्ध अस्पतालों में उपलब्ध लाभ। * व्यापक प्रक्रिया कवरेजः * लगभग 1,929 चिकित्सा प्रक्रियाओं को कवर करता है। <बीआर>
चरण 1: Offline — Step 1
Potential AB-PMJAY beneficiaries are to submit the PM letter/ RSBY URN/ RC Number/ Mobile Number - The operator (commonly known as the Arogya Mitra) searches the available list of beneficiaries. The operator does this by entering details such as name, location, Ration Card number, mobile number, or even RSBY URN of the beneficiary.
चरण 2: Offline — Step 2
Search in the BIS Application - The operator searches for the potential beneficiary in the entitled SECC, RSBY, State Health Scheme, Additional Data Collection Drive databases.
चरण 3: Offline — Step 3
Individual Identification - The identification process is carried out if the name is found in the list. For this, documents like Aadhaar or any government ID and a Ration Card or an alternative family ID are required to validate against the details available in the system. Scanned documents are then uploaded.
चरण 4: Offline — Step 4
Family Identification - The Arogya Mitra then identifies the family records through the ration card and the scanned documents are then uploaded. The Arogya Mitra then submits the individual and family records to the trust/insurance company for approval.
चरण 5: Offline — Step 5
Approval or Rejection - The Health insurance company or trust may then approve or recommend rejection for the submitted beneficiaries. The cases that are recommended for rejection will be finally verified for approval or rejection by the State Health Agency (SHA).
चरण 6: Offline — Step 6
E-card Issuance - On approval by SHA/insurance company/trust, an e-card will be issued to the beneficiary. <br> <br>
चरण 1: Online — Step 1
***** *Register on the UMANG Portal*** - Visit the official website of UMANG. In the top right corner of the landing page, click "Register." You will be taken to the Registration Page. *
चरण 2: Online — Step 2
***** *Mobile Number Verification and MPIN Creation*** - You will be redirected to the mobile number verification page. Enter your mobile number and get it verified via OTP. Create an MPIN to complete the registration process. You will be taken to the UMANG homepage. Login using your Mobile Number and MPIN. *
चरण 3: Online — Step 3
***** *Accessing Services on UMANG*** - In the tabs provided at the bottom of the page, click on the "All Services" tab. Select the service you want to apply for. You will be taken to the Online Application Form. *
चरण 5: Online — Step 5
***** *Completing the Application*** - In the application form, fill in all the mandatory fields and upload all the required documents in the specified format and size. *
चरण 6: Online — Step 6
***** *Review and Confirmation*** - Carefully review all the information provided and the documents uploaded. Make any necessary corrections, if required. Acknowledge and agree to the terms and conditions, declaration, and privacy policy, if any. *
चरण 7: Online — Step 7
***** *Submitting the Application*** - Click the "Submit" or "Apply" button to submit your application. You'll receive a confirmation message upon successful submission of the application. <br>
No. All eligible beneficiaries can avail free services for secondary and tertiary hospital care for identified packages under PM-JAY at public hospitals and empaneled private hospitals. Beneficiaries will have cashless and paperless access to health services under PM-JAY.
PM-JAY is an entitlement based mission. There is no enrollment process. Families who are identified by the government on the basis of deprivation and occupational criteria using the SECC database both in rural and urban areas are entitled for PM-JAY.
A dedicated PM-JAY family identification number will be allotted to eligible families. Additionally, an e-card will also be given to beneficiary at the time of hospitalization.
Yes. All existing medical conditions / Illnesses are covered under this scheme.
Yes. New born child can be provided treatment under this scheme. They can also be added into beneficiary family after providing necessary documents.
Any family that has an active RSBY card as of 28 February 2018 is covered under the Ayushman Bharat Pradhan mantra Jan Arogya Yojana.
Yes. Aadhar card is not mandatory for availing services under this scheme.
An Ayushman Mitra (AM) is a certified frontline health service professional who is present at each of the EHCP and serves as a first contact point for beneficiaries. They will help in processing documents for Beneficiary identification as well as complete claim process along with Medical Coordinator. They are available at Ayushman Bharat Kiosk in every EHCP to assist patients.
Once patient is discharged from the EHCP, the claim submission process is initiated by raising request on online portal with patient's discharge summary along with other necessary clinical notes and investigation reports. EHCP is required to submit claims within 24 hours of discharge of patient.
Pradhan Mantri Jan Arogya Yojana(PM-JAY) is a pioneering initiative of Prime Minister Modi to ensure that the poor and vulnerable population is provided health coverage. This initiative is part of the Government's vision to ensure that its citizens - especially the poor and vulnerable groups have universal access to good quality hospital services without anyone having to face financial hardship as a consequence of using health services.
The health services covered under the program include hospitalization expenses, daycare surgeries, follow-up care, pre and post-hospitalization expense benefits, and newborn child/children services. The comprehensive list of services is available on the website.
Services under the scheme can be availed at all public hospitals and empaneled private healthcare facilities. Empanelment of the hospitals under PM-JAY will be conducted through an online portal by the state government. Information about empaneled hospitals will be made available at through different means such as government website, mobile app. Beneficiaries can also call the helpline number at 14555. Regular updates will also be provided through ASHAs, ANM and other specific touch points This information will be activated shortly.
No. All eligible beneficiaries can avail free services for secondary and tertiary hospital care for identified packages under PM-JAY at public hospitals and empaneled private hospitals. Beneficiaries will have cashless and paperless access to health services under PM-JAY.
The beneficiaries are identified based on the deprivation categories (D1, D2, D3, D4, D5, and D7) identified under the SECC (Socio-Economic Caste Census) database for rural areas and 11 occupational criteria for urban areas. In addition, RSBY beneficiaries in states where RSBY is active are also included.
In this phase, no additional new families can be added under PM-JAY. However, the names of additional family members can be added for those families whose names are already on the SECC list.
Once all claims documents are submitted, the claim must be approved within 15 days to SHA for final approval and payment processing. SHA will make payment of claims within 15 days after being authenticated by their internal team.
AB PMJAY has a three-tier grievance redressal structure to ensure the timely redressal of grievances. This section of the guidelines lays down these structures, their constitution, and their functions. District Grievance Redressal Committee (DGRC) - will be constituted by the SHA in each district and this is chaired by Head of the District or District Magistrate or District Collector or Deputy Commissioner. The State Grievance Redressal Committee (SGRC) is chaired by CEO of SHA / State Nodal Agency (SNA). The SGRC shall perform all functions related to handling and resolution of all grievances received either directly or escalated through the DGRC. The National Grievance Redressal Committee (NGRC) will be chaired by Deputy CEO of National Health Agency (NHA). The NGRC shall act as the final Appellate Authority at the national level. The NGRC shall only accept appeals and petitions against the orders of the SGRC of a State. The decision of NGRC will be final.
Applications are accepted only on the official government portal.
Open Official WebsiteThe Government of Tamil Nadu introduced "Assistance for Delivery/Miscarriage of Pregnancy/Termination of Pregnancy to Female Differently Abled Person.
The scheme provides financial assistance of a maximum of ₹ 1,00,000 from the Armed Forces Flag Day Fund (AFFDF) for the procurement of modified scooters, crutches and wheelchairs for Ex-Servicemen who are disabled after their retirement from service with a disability of 50% or more.
The "Assistance for Purchase of Aids/Appliances" scheme is to provide support to individuals with disabilities by facilitating access to assistive devices and appliances.
The scheme “Aravanaippu Illam" was launched by the Department of Social Welfare, Government of Puducherry. The objective of this scheme is to take care of persons who are lacking basic needs & proper care in society, and to maintain them in a safe living condition.
Aswasakiranam Scheme envisages assisting the caregivers of physically and mentally disabled bedridden patients, who are their family members or relatives. All those who have been providing caregiving service to patients since 02/08/10 will be paid monthly assistance with retrospective effect.
Chhattisgarh State Government started a scheme "Asangathit Karmakar Gambhir Bimari Chikitsa Sahayata Yojana" for unorganized worker on 28 April 2012.