PMJAY Registration – Apply Online for Ayushman Bharat Yojana

  • Author :
  • TATA AIG Team
  • Published on :
  • 05/07/2023

Launched by the Indian government, PMJAY is the world's biggest health insurance scheme, providing free cover of ₹5 lakh per family each year. That's a safety net so you can access quality healthcare without stressing about costs.

But who's eligible, you ask? PMJAY targets those who need it most – farmers, daily wage earners, construction workers, and even families below the poverty line. All in all, over 50 crore Indians can breathe easier knowing they are covered.

PMJAY registration has helped millions of Indians to access quality healthcare services that they would otherwise not have been able to afford. It has also reduced the financial burden on hospitals and helped to improve the overall quality of healthcare in India.

Here, we will get into the intricacies of PMJAY and help you understand everything in detail about the same.

So, let’s dig in!

What is PMJAY – Pradhan Mantri Ayushman Bharat Yojana Scheme?

Ayushman Bharat Yojana (ABY), also known as PMJAY, is a game-changer for healthcare in India. Launched in 2018, it's one of the world's biggest schemes, aiming to cover over 50 crore citizens, especially those with limited means.

Imagine access to quality healthcare without draining your savings. PMJAY makes it possible! It provides the best health insurance plans worth ₹5 lakh per family, covering most medical treatments, medicines, diagnostics and even pre-hospitalisation expenses.

Gone are the days of cash hassles during emergency treatments! With the Ayushman Bharat Yojana e-card, the ones eligible can get cashless treatment at any empanelled hospital across India. They just need to show their PMJAY card, and voila! Treatment becomes the priority, not finance.

But who all can benefit? As stated above, PMJAY empowers millions belonging to families below the poverty line.

This scheme aims to ditch medical anxieties and help the financially weaker section of society to embrace improved health. PMJAY ensures that good health should not be a privilege but a right.

An Overview of PMJAY – At a Glance!

Feature Details
Launched 43344
Aim Provide health insurance to over 50 crore Indian citizens, especially the economically weaker sections
Coverage Up to ₹5 lakh per family per year
What's Covered? Most medical treatments, medicines, diagnostics, pre-hospitalisation expenses
Cashless Treatment? Yes, through Ayushman Bharat Yojana e-card at empanelled hospitals across India
Eligibility Families below the poverty line, SC/ST beneficiaries, farmers, agricultural labourers, unorganised workers, ex-servicemen, transport workers, construction workers, Nari Shakti Kendras
How to Avail Benefits? Ayushman Bharat card or Arogya Mitra app
Funding Central and state governments (60:40 ratio)
Impact Millions now have access to quality healthcare, reduced financial burden on hospitals and improved overall healthcare quality.
Challenges Awareness, infrastructure shortages, fraud
Future Goals Government committed to improving the scheme and making it even more effective
Total Number of Ayushman Card Registration Issued Until Now Over 30.16 crore
Total Number of Hospital Admissions Until Now Over 77.07 crore
Total Number of Registered Families Over 10 crore
Budget ₹8,088 crore
Status Active
Website https://www.pmjay.gov.in/
Helpline Numbers 1800-111-565 or 14555
Address National Health Authority of India, 3rd, 7th and 9th Floor, Tower-L, Jeevan Bharati Building, Connaught Place, New Delhi – 110001

PMJAY – Who is Eligible for PMJAY New Registration?

Launched in 2018, PMJAY aims to bridge the gap between affordability and medical needs, with a special focus on the economically disadvantaged.

The Ayushman Bharat registration scheme categorises eligibility based on the population's residence, rural or urban. Let's delve deeper into the specific criteria for each:

PMJAY Urban

Eligibility Criteria: Under PMJAY Urban, individuals and families residing in urban areas can avail of the Scheme benefits.

Occupational Categories: PM-JAY focuses on specific occupational groups in urban areas considered vulnerable due to informal work or low wages. These include ragpickers, beggars, domestic workers, street vendors, construction workers, sanitation workers, home-based artisans, transport workers, and shop assistants.

Socio-Economic Caste Census (SECC): Eligibility for PMJAY Urban is determined based on the SECC database, which identifies economically vulnerable households in urban areas.

Income Ceiling: While not the primary criterion, families in urban areas with a monthly income below ₹10,000 are also eligible for the scheme.

Other Criteria: The same exclusion criteria, such as being a regular government employee, income taxpayer, or holding a constitutional post, also apply to PMJAY Urban.

PMJAY Rural:

Eligibility Criteria: PMJAY Rural covers individuals and families residing in rural areas of India. Certain groups, regardless of income or deprivation criteria, are automatically included. These include destitute households, manual scavenger families, primitive tribal groups, and legally released bonded labour households.

Socio-Economic Caste Census (SECC): Eligibility is determined based on the SECC database, which identifies economically vulnerable rural households.

Deprivation Criteria: Rural families meeting at least one of the six deprivation criteria (D1 to D5 and D7) are automatically eligible. These criteria range from having only one room with kucha walls and roof to lacking any adult member between 16 and 59 years of age.

Family Definition: The Scheme covers the head of the household, spouse, and dependent children up to 18. In some cases, dependent children up to 23 years studying full-time or married females may also be included.

[Note: The implementation and specific guidelines for PMJAY Urban and PMJAY Rural may vary between states, as the Scheme is administered at the state level. It is advisable to check the guidelines the respective state government provides or visit the official PMJAY website for accurate and up-to-date information regarding eligibility and coverage under each category.]

Who is Not Eligible to Apply for the Pradhan Mantri Ayushman Bharat Yojana Scheme?

Government Employees and Their Families: Those employed by the government, including public sector undertakings (PSUs) and their immediate family members, are not eligible for PM-JAY. This is because they typically have access to separate healthcare benefits through their employers.

Individuals Owning Certain Assets: Individuals or families owning specific assets exceeding defined limits are excluded from the scheme. These assets include:

Two-Wheelers, Three-Wheelers, or Four-Wheelers: Owning any motorised vehicle, regardless of its value, disqualifies individuals from PM-JAY.

Mechanised Farming Equipment: Possession of agricultural machinery like tractors or harvesters indicates a level of financial stability that excludes families from the scheme's purview.

Kisan Card With a Credit Limit Exceeding ₹50,000: This criterion applies to individuals involved in agriculture who possess a Kisan Card, a government-issued credit card for farmers. A high credit limit suggests sufficient financial means for healthcare needs.

Individuals with Landholdings Exceeding 5 Acres: Owning agricultural land exceeding 5 acres indicates financial stability and excludes individuals from PM-JAY eligibility.

Individuals Earning More Than ₹10,000 per Month (Urban Areas Only): While not the primary criterion, individuals in urban areas with a monthly income exceeding ₹10,000 are generally not eligible for PM-JAY. This income level suggests the ability to afford private healthcare.

Ownership of landline phones or refrigerators: Possessing these items indicates a certain level of economic comfort and excludes individuals from the scheme.

Living in Decently Built Houses: Houses with proper walls and roofs constructed from materials like brick or concrete signify secure living conditions and may disqualify individuals from PMJAY benefits.

Things Covered and Not Covered Under the PMJAY Scheme

Things Covered Under the PMJAY Scheme Things Not Covered Under the PMJAY Scheme
Hospitalisation Expenses: PMJAY covers expenses related to hospitalisation, including room charges, nursing charges, and intensive care unit (ICU) charges. Outpatient Care: PMJAY primarily focuses on providing coverage for inpatient hospitalisation expenses. Outpatient care, including routine consultations, medications, and diagnostic tests conducted on an outpatient basis, is not covered under the Scheme.
Surgical Procedures: The Scheme covers the cost of various minor and major surgical procedures, including pre-surgery and post-surgery expenses. Fertility Treatments: PMJAY does not cover fertility treatments, including assisted reproductive technologies like in vitro fertilisation (IVF) and related procedures.
Medical Consultations: PMJAY provides coverage for consultations with doctors and specialists, enabling beneficiaries to seek medical advice for their conditions. Aesthetic and Cosmetic Procedures: Procedures and treatments that are purely aesthetic or cosmetic, such as plastic surgery for non-medical reasons, are not covered under PMJAY.
Diagnostic Tests: The Scheme covers a range of diagnostic tests, including laboratory investigations, imaging studies (like X-rays, ultrasounds, and MRI scans), and other necessary tests for diagnosis and treatment. Organ Transplants: The Scheme does not cover the costs associated with organ transplantation, including the procurement of organs, surgeries, and post-transplant care.
Medications: The cost of essential medicines and drugs required for treatment during hospitalisation is covered by PMJAY. Non-Medical Expenses: Expenses that are not directly related to medical treatment, such as transportation costs, attendant charges, food expenses, and phone bills, are not covered by PMJAY.
Pre & Post-Hospitalisation Expenses and Follow-up Care: The Scheme covers expenses related to medical investigations and consultations conducted before and after hospitalisation. PMJAY extends coverage to post-hospitalisation care and follow-up consultations, ensuring continued support for beneficiaries after discharge. Experimental and Unproven Treatments: PMJAY does not cover experimental or unproven treatments not supported by scientific evidence or approved medical guidelines.
Maternity and Newborn Care: PMJAY provides coverage for antenatal care, delivery expenses, and postnatal care for expectant mothers. It also includes the cost of neonatal intensive care unit (NICU) services for newborns requiring specialised care. Pre-Existing Conditions: The Scheme does not cover pre-existing medical conditions known to the beneficiary before enrolling.
Secondary and Tertiary Care: PMJAY covers secondary and tertiary healthcare services, including specialised treatments and procedures like chemotherapy, dialysis, cardiac surgeries, joint replacements, etc. Injuries Resulting from Hazardous Activities: Expenses incurred to treat injuries resulting from participation in hazardous activities, such as adventure sports or criminal activities, are not covered.

Does PMJAY Scheme Cover COVID-19?

Since the outbreak of the COVID-19 pandemic, the Government of India has included COVID-19 testing and treatment under the PMJAY scheme. Beneficiaries can avail of cashless treatment for COVID-19 at empanelled public and private hospitals across India.

The scheme covers the expenses related to hospitalisation, including room charges, ICU charges, consultation fees, diagnostics, medicines, and more. It provides financial protection to eligible individuals and families, ensuring access to quality healthcare during these challenging times.

Features of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

Coverage for a Wide Range of Medical Services: PMJAY covers a comprehensive set of medical services, including hospitalisation expenses, surgeries, consultations, diagnostic tests, pre- and post-hospitalisation care, and more.

Empanelled Hospitals: Beneficiaries can access healthcare services at both government hospitals and empanelled private hospitals, ensuring a wide network of healthcare providers for treatment.

Portability: PMJAY offers portability, allowing beneficiaries to avail treatment in any empanelled hospital across India, irrespective of their residence.

Beneficiary Identification: Eligible beneficiaries receive an Ayushman Bharat card, a health insurance e-card that helps in easy identification and verification at healthcare facilities.

Beneficiary Empowerment: PMJAY promotes beneficiary empowerment by providing access to information through the Ayushman Bharat website and helpline, allowing beneficiaries to make informed healthcare decisions.

Technology-Driven Implementation: The scheme leverages technology for efficient implementation, including IT systems for beneficiary identification, e-card generation, and seamless claims processing.

Fraud Control and Monitoring: PMJAY incorporates robust fraud control and monitoring mechanisms to ensure the scheme's resources are utilised appropriately and maintain transparency in the implementation process.

Also Read: Benefits of PMJAY Scheme

PMJAY Apply Online: Detailed Steps to Apply for the Scheme

If you were wondering how to go about the Ayushman Bharat, register online process. You can follow these steps:

Visit the Official Website: Go to the official PMJAY website.

Find the "Am I Eligible?" Section: To proceed, click on the "Am I Eligible?" section on the website's homepage.

Enter the Required Information: Provide the necessary details as prompted on the eligibility check page. This may include your mobile number, ration card number, SECC database-related information, or any other details required for eligibility verification. Fill in the information accurately.

Verify Your Mobile Number: After entering the required information, you will receive an OTP (One-Time Password) on your provided mobile number. Enter the OTP to verify your mobile number.

Check Eligibility: Once the mobile number is verified, the website will verify your eligibility based on the information provided and the SECC data. It will indicate whether you are eligible for the PMJAY scheme or not.

Apply Online: If you are eligible, you can proceed with the online application process. Follow the instructions provided on the website to complete the application form. Accurately enter the required personal details, family information, and other necessary information.

Upload Documents: You will be prompted to upload scanned or digital copies of the required documents. These may include identification proof, address proof, income certificate, and other supporting documents. Ensure that the documents are clear and legible.

Review and Submit: Review all the entered information and uploaded documents before applying. Make sure everything is accurate and complete. Submit the application form.

Track Application Status: After submitting the application, you will receive an application reference number or an acknowledgement. Note it down, or keep it for future reference. You can use this reference number to track the status of your application online.

Documents Required to Apply for the PMJAY Scheme

Now that you know how to apply for PMJAY, you should also know about the necessary documents you would need to apply for PMJAY.

Here is the detailed list of documents:

Identification Proof: Any government-issued identification document can be submitted. This can include an Aadhaar card, Voter ID card, PAN card, Passport, or Driving License.

Address Proof: Proof of address is required to verify your residential address. You can submit documents such as an Aadhaar card, Voter ID card, Passport, Driving License, or any other government-issued address proof document.

Income Certificate: An income certificate or proof of income is usually required to establish your economic status and eligibility for the scheme. This can include salary slips, income tax returns, BPL (Below Poverty Line) certificate, or any other document that verifies your income.

Caste Certificate (if applicable): In certain cases, a caste certificate may be required to establish your eligibility under specific categories or reservation criteria. This document certifies your caste or community.

Family Details: You may need to provide details of your family members, including their names, ages, and any relevant identification documents for each family member.

SECC Details: Socio-Economic Caste Census (SECC) data is used to determine eligibility for PMJAY. You may be required to provide information related to your SECC data, such as your ration card number or any other details mentioned in the SECC database.

Steps to Download the PMJAY Card Online

Once you know that you are eligible for the PMJAY application, you must also be aware of how to download the PMJAY card online as a document proof.

Beneficiaries are issued this card to transact through the scheme while availing of cashless, portable or paperless treatment at any of the empanelled hospitals under the setup PMJAY scheme.

This is how you can download the card online:

  • Go to the official PMJAY website.

  • Look for the "Download" or "Print Your Card" section on the website's homepage. Click on that section to proceed.

  • Select the identification mode you would like to use to download your card. You will typically have two options: an Aadhaar Number or a Mobile Number.

  • Based on the mode of identification you selected, enter the corresponding information. If you choose your Aadhaar Number, enter your Aadhaar Number and the Captcha code. If you choose Mobile Number, enter your registered Mobile Number and the Captcha code.

  • After entering the required information, you will receive an OTP on the mobile number linked to your Aadhaar or your provided mobile number. Enter the OTP to verify your identity.

  • Once your identity is verified, you can download or print your Ayushman Bharat Yojana card. Click on the appropriate option provided on the screen to download the card as a PDF file.

  • Save the downloaded PDF file to your computer or mobile device. You can print the card using a printer if you prefer a physical copy.

What is the Process of Hospitalisation Under the PMJAY Scheme?

Now that you know how to apply Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, you need to know about the hospitalisation process under the scheme. If you or a family member needs hospitalisation, you are not required to pay anything under the PMJAY scheme as long as you are admitted to one of the authorised public or private hospitals.

Due to a 60:40 cost-sharing structure between the centre and the state, the entire hospitalisation and treatment process is cashless.

You will receive the Ayushman health card as a beneficiary, allowing you to access cashless medical care and hospitalisation. You can take advantage of the scheme's benefits at any accredited public or private hospital if you have a golden card.

To find the empanelled hospital list, visit the official PMJAY website and click the “Find Hospital” section.

How To Check The Name in the PMJAY Beneficiary List in 2024

To see if your name is on the PMJAY list for 2024, you can use these methods:

Common Service Centre (CSC): Go to the nearest CSC or any listed hospital to check if you qualify for the healthcare scheme.

Helpline Numbers: Call 14555 or 1800-111-565 to find out if you are eligible for PMJAY.

Online: Visit the official website https://beneficiary.nha.gov.in/ to see if you qualify for the scheme.

What Are the Medical Packages Included in the PMJAY Scheme?

The PMJAY Scheme covers a vast array of medical packages, encompassing over 1929 procedures across numerous specialities.

These packages provide comprehensive coverage for secondary and tertiary care hospitalisation, including:

Cardiology: Coronary artery bypass grafting, angioplasty with stent, valve replacement.

Neurosurgery: Brain tumour surgery, spinal cord surgery, cranial vault repair.

Oncology: Chemotherapy, radiotherapy, surgery for various cancers.

Paediatrics: Congenital heart surgery, bone marrow transplant, paediatric cancer treatment.

Orthopaedics: Joint replacement, spinal fusion, fracture repair.

[Note: You can not get money back for both medical and surgical costs at the same time. If you have more than one surgery, the most expensive one is paid in full. The second gets 50%, and the third gets 25%. Also, the PMJAY scheme doesn't consider pre-existing illnesses because it's part of the massive healthcare scheme created by the Indian government.]

How to Check the Name of Hospitals Under the PMJAY Scheme?

Step 1: Go to the official PMJAY website's Hospitals section.

Step 2: Pick your state and district.

Step 3: Choose the type of hospital (public/private-for-profit/private and not-for-profit).

Step 4: Select the medical speciality you need.

Step 5: Enter the "Captcha Code" and click search.

Now, you will see a list of Ayushman Bharat Yojana hospitals with addresses, websites, and contact info. You can also check the 'Suspended Hospital List' on the same link.

Also Read: Ayushman Bharat Health Card (ABHA) Card

Conclusion

The PMJAY (Ayushman Bharat Yojana) initiative stands as a significant stride in ensuring affordable and accessible healthcare for millions of vulnerable individuals and families in India.

Its provision of cashless treatment and coverage for diverse medical procedures has effectively eased the financial strain of healthcare expenses for many.

However, acknowledging that the PMJAY scheme has specific limitations, including an eligibility threshold, is crucial. For those ineligible for PMJAY, obtaining health insurance coverage from alternative sources is advisable.

A robust insurance plan addresses this gap and offers unparalleled health insurance tax benefits. Consider a Tata AIG medical insurance plan, which complements the PMJAY scheme by providing extended coverage, personalised benefits, and access to a broader network of hospitals.

Disclaimer / TnC

Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.

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