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How to Apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)?

Swollen lips can be a distressing and uncomfortable experience. They are often a result of an allergic reaction, and in India, where diverse allergens abound, it's crucial to understand the causes, symptoms, treatments and home remedies for this common issue.

Ayushman Bharat is a flagship initiative by the Indian government designed to provide comprehensive healthcare coverage to its citizens. It was introduced in alignment with the National Health Policy of 2017.
 

Under Ayushman Bharat, each eligible family can receive an annual healthcare coverage of ₹5 lakhs for secondary and tertiary hospitalisation expenses, which can be used in both public and private hospitals across India.

What is Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

The Pradhan Mantri Jan Arogya Yojana (PM-JAY), part of Ayushman Bharat, is a government-funded health insurance scheme. It is fully financed by the government with implementation costs shared between the Central and State Governments. 
 

The services covered by Ayushman Bharat health insurance include hospitalisation costs, daycare surgeries, post-hospitalisation care, pre-hospitalization benefits, and healthcare services for newborn children.
 

PM-JAY is known to have the overarching goal of transforming the healthcare system, including preventive measures, health promotion, and outpatient care.

Key Highlights of PM-JAY

  • PM-JAY offers comprehensive coverage of ₹5 lakhs per family each year for hospitalisation (secondary and tertiary), accessible through a network of approved public and private hospitals across India.

  • At the point of service, PM-JAY facilitates cashless access to healthcare services for the beneficiaries when they visit a hospital.

  • It includes coverage for up to 3 days of pre-hospitalisation and 15 days of post-hospitalization expenses, encompassing diagnostics and medication costs.

  • The PM-JAY scheme has no restrictions regarding family size, age, or gender.

  • From the very beginning, PM-JAY covers all pre-existing medical conditions.

  • The scheme's advantages are transferable across the entire nation, enabling beneficiaries to receive cashless treatment at any accredited public or private hospital in India.

  • Ayushman Bharat health insurance includes approximately 1,929 medical procedures, encompassing all expenses associated with treatment, including but not limited to medications, supplies, diagnostic services, physician fees, room charges, surgeon fees, operating theatre and intensive care unit expenses, and more.

  • Public hospitals are reimbursed for healthcare services at rates equivalent to those paid to private hospitals.

What is the ABHA Card?

The Indian government introduced the Ayushman Bharat Health Account (ABHA) in 2021, formerly known as the Ayushman Bharat Health ID, to equip the populace with a digital health identity.
 

The ABHA card is a distinctive health identifier employing a 14-digit identification code, which can be created using either your Aadhaar card or mobile number. 
 

This system empowers you to electronically share your medical records with healthcare facilities, clinics, insurance companies, and various other stakeholders.

How to Apply for the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

This initiative, established by the Indian government, is a rights-based program aimed at assisting underprivileged segments of society. 
 

As a result, there is no formal registration process; beneficiaries are enrolled based on the Socio-Economic Caste Census of 2011 and their inclusion in the Rashtriya Swasthya Bima Yojana (RSBY) plan. To check your eligibility for this scheme, please follow these steps:
 

  • Step 1: Visit the dedicated government website for the Pradhan Mantri Jan Arogya Yojana or PM-JAY scheme and click on the "Am I Eligible" icon.

  • Step 2: Provide your contact information and generate an OTP (One-Time Password). 

  • Step 3: Select your state.

  • Step 4: Perform a search using your name, mobile number, Household ID (HJD) number, or ration card number.

If your family is enrolled in the Ayushman Bharat Yojana, your name will be visible in the outcomes.
 

In addition, you can contact the Ayushman Bharat Yojana customer support at 1800-111-565 or 14555. Or, you may reach out to any of the Empanelled Health Care Providers (EHCP) for assistance.

Documents Required During The PM-JAY Ayushman Application Process

  • Proof of address

  • Age and identity proof (Aadhaar Card / PAN Card)

  • Caste certificate

  • Contact details (Mobile number, e-mail address, etc.)

  • Income certificate

  • Aadhaar Card

  • Documented proof of the current status of the family (joint or nuclear)

Conclusion

The Ayushman Bharat health card is a unique health identifier that allows you to access medical services and health records. There is no formal registration process to apply for the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. However, you can check your eligibility for this scheme online by visiting its official website
 

Some important documents that may be required are address proof, identity proof, caste certification, etc. You can easily search and download your ABHA card using either your Aadhaar card or mobile number. 

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A joint venture between Tata Sons Pvt. Ltd. and AIA Group Ltd. (AIA),  Tata AIA Life Insurance  is one of the leading life insurance providers in India. We post everything you need to know about life insurance, tax savings and a variety of lateral topics such as savings and investments in this space. You can access and read a host of different blogs, articles and pages at the Tata AIA Life Insurance Knowledge Center or get in touch with us with any queries or questions!

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Frequently Asked Questions (FAQs)

Are there any costs for beneficiaries to enrol in this program?

No, eligible beneficiaries can access secondary and tertiary hospital care for specified treatments under PM-JAY at public hospitals and approved private hospitals without any financial burden. This program ensures cashless and paperless access to healthcare services.

Will beneficiaries receive any identification cards?

Eligible families will be assigned a dedicated PM-JAY family identification number. Additionally, beneficiaries will receive an electronic card (e-card) when they are admitted to the hospital.

How does the process for submitting a claim work?

After a patient is discharged from the healthcare facility, the claim submission process begins by initiating a request on the online portal. This request includes the patient's discharge information, along with other essential medical notes and test reports. 
 

It is necessary for healthcare providers to submit claims within 24 hours of a patient's discharge date.

Disclaimers

  • Insurance cover is available under the product.

  • The products are underwritten by Tata AIA Life Insurance Company Ltd.

  • The plans are not guaranteed issuance plans, and they will be subject to the Company’s underwriting and acceptance.

  • For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

  • This blog is for information and illustrative purposes only and does not purport to any financial or investment services and does not offer or form part of any offer or recommendation. The information is not and should not be regarded as investment advice or as a recommendation regarding any particular security or course of action.

  • Please know the associated risks and the applicable charges from your Insurance agent or the Intermediary or policy document issued by the insurance company.

  • Every effort is made to ensure that all information contained in this blog is accurate at the date of publication. However, the Tata AIA Life shall not have any liability for any damages of any kind (including but not limited to errors and omissions) whatsoever relating to this material.