Pradhan Mantri Jan Arogya Yojana: All You Need to Know

As healthcare expenses in India continue to rise, economically weaker families often find themselves financially vulnerable. To address this challenge, the Government of India launched the Pradhan Mantri Jan Arogya Yojana (PMJAY) in 2018 under the Ayushman Bharat health scheme. PM-JAY aims to provide health coverage of up to INR 5 lakhs per year to over 12 crore low-income families, thus making it one of the world’s largest government-funded healthcare programs.

In this article, we’ll explore what PM-JAY is, along with its benefits, eligibility criteria, and registration process. We’ll also discuss how a personal loan for medical purposes can offer additional financial support for healthcare costs beyond the scheme’s coverage.

What Is the Pradhan Mantri Jan Arogya Yojana?

The PM-JAY is a government-funded health insurance scheme designed to provide financial protection for secondary and tertiary care hospitalisations. Under this scheme, each eligible family receives coverage of up to INR 5 lakhs annually for treatments, including cancer care, cardiac surgeries, and organ transplants.

Beneficiaries of the PM-JAY can access cashless healthcare services at over 29,000 empanelled hospitals across India. This scheme primarily targets vulnerable sections of society, ensuring access to quality medical care without the burden of high expenses. For costs beyond this limit, a personal loan for medical expenses can serve as an essential backup to cover additional treatments.

What Are the Benefits of the PM-JAY Scheme?

There are several PM-JAY benefits and features that make healthcare accessible and affordable, such as:

High Coverage Limit: Each eligible family is entitled to coverage of up to INR 5 lakhs annually, which helps cover a wide range of treatments, from minor surgeries to critical illnesses like cancer and heart disease. 

Cashless Treatment: Beneficiaries can avail of cashless treatment at any empanelled hospital, eliminating the need for upfront payments and reducing financial stress during emergencies.

Wide Network of Hospitals: PM-JAY has partnered with over 29,000 public and private hospitals across the country, ensuring beneficiaries have access to quality healthcare facilities regardless of their location.

No Premium Costs: Unlike traditional health insurance, PM-JAY is fully funded by the government. Eligible families do not have to pay any premiums or deductibles to access the scheme’s benefits.

Comprehensive Medical Coverage: PM-JAY covers over 1,500 medical procedures, including surgeries, diagnostics, and post-hospitalisation care.

Eligibility for the PM-JAY Scheme

The eligibility criteria for the Pradhan Mantri Jan Arogya Yojana scheme vary based on factors such as location and socio-economic status. Let us take a closer look at the different eligibility requirements to avail of this scheme:

1. Rural Areas

In rural areas, eligibility for the PM-JAY scheme primarily involves households facing deprivation. This includes families without an adult member between the ages of 16 and 59, households without any adult male member aged between 16 to 59, landless households dependent on manual labour, or those living in inadequate housing. Vulnerable groups like disabled individuals or families without able-bodied adults are also prioritised when it comes to selecting beneficiaries.

2. Urban Areas

In urban areas, eligibility focuses on low-income workers, including street vendors, construction workers, sanitation staff, and domestic workers. These groups, often engaged in informal or manual labour, are given priority based on the 2011 Socio-Economic Caste Census (SECC).

3. Senior Citizens

PM-JAY has recently expanded to provide health insurance coverage of INR 5 lakhs per year to all senior citizens aged 70 and above. This update aims to ease the financial burden of healthcare for the elderly, especially those facing rising medical expenses.

Additionally, families already enrolled in PM-JAY receive an extra INR 5 lakhs top-up specifically for senior citizens. 

How to Register for the PM-JAY Scheme?

You can follow these steps to proceed with the PM-JAY Ayushman Bharat Yojana registration process:

Check Eligibility: Visit the official PM-JAY portal. Find and click on the "Am I Eligible" tab on the homepage. Enter your mobile number and the displayed captcha code. Click "Generate OTP." Once you have verified the OTP, enter the required details like your name, state, and family details to check if you’re eligible.

Visit a Common Service Center (CSC): If eligible, you can visit a nearby CSC or empanelled hospital to register. Carry essential documents like your Aadhaar card, ration card, and income certificate to complete the registration process.

Verification and Issuance of PM-JAY e-Card: Once your details are verified against the SECC database, you will receive a PM-JAY e-card. It will grant you access to cashless healthcare services at registered hospitals.

*This is the general application process for PM-JAY registration and is subject to change. It is advisable to check the official PM-JAY website for the most up-to-date information on the registration process.

Summing Up

The Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a vital healthcare initiative aimed at providing financial protection for secondary and tertiary healthcare needs. With its extensive coverage, cashless treatments, and a wide network of empanelled hospitals, it can significantly reduce the financial burden of medical emergencies.

However, there may be instances where healthcare expenses exceed the coverage limits of PM-JAY. In such cases, a personal loan for medical purposes can offer additional financial support. SMFG India Credit provides personal loans of up to INR 30 lakhs* with reasonable interest rates and flexible repayment tenures of up to 5 years. For a smooth online application process, check your eligibility and estimate your EMIs before applying. Feel free to contact us or visit your nearest SMFG India Credit branch for more details.