Know everything about the new insurance coverage under Ayushman Bharat
About the new scheme
Union Cabinet headed by the Prime Minister Narendra Modihas given the green signal to a new initiative designed to provide comprehensive health coverage to senior citizens aged 70 years and above. The scheme falls under the flagship programme Ayushman Bharat.
Coverage
The new initiative of the government will help around 4.5 crore families, which include six (6) crore senior citizens. Under this program, every family will get free health insurance coverage of up to Rs 5 lakh.
AB PM-JAY provides financial security to about 55 crore people, equivalent to 12.34 crore families, by providing health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation. Since its inception, it has facilitated 7.37 crore hospitalisations, with 49 per cent of the beneficiaries being women. The cumulative financial benefits received by the public under the scheme have exceeded Rs 1 lakh crore.
The main advantage of this top-up is that it is available exclusively to senior citizens and does not need to be shared with other family members below the age of 70. Also, senior citizens who are already availing other public health insurance schemes, such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), or Ayushman Central Armed Police Forces (CAPF), have the option to either continue with their existing scheme or switch to AB PM-JAY, depending on their preferences and healthcare needs. Elderly people aged 60 years and above who have private health insurance coverage or who are beneficiaries of the Employees’ State Insurance program can still avail the benefits offered by this scheme. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
Eligibility
The new insurance coverage aims to provide health care benefits to all citizens above the age of 70, regardless of their income level.
The government has announced that senior citizens who fulfil the eligibility criteria will get a unique card different from the existing ones under the scheme.
About the main Pradhan Mantri Jan Arogya Yojana
Pradhan Mantri Jan Arogya Yojana (PM-JAY) is an initiative of the Government aimed at ensuring that all citizens, especially the underprivileged, vulnerable sections of the society and now all citizens above 70 years of age, have access to quality hospital services without facing financial hardship.
PM-JAY offers a wide range of healthcare services, including benefits for hospitalisation-related expenses, day care surgeries, follow-up care, and pre- and post-hospitalisation expenses. The scheme also covers services for newborn children.
Steps to apply online for PMJAYcheck eligibility first
- Visit the official website
PMJAY On the website (www.pmjay.gov.in)(http://www.pmjay.gov.in). - Click on the “Am I Eligible” tab from the homepage menu.
- Enter your mobile number and captcha code and then click on “
Generate OTP , - After OTP verification, enter your name, ration card number, household number or your place of residence along with mobile number.
- If your family falls under this
Ayushman Bharat Scheme Your name will appear in the results. - Check your name in the displayed list to confirm eligibility.
Once you have confirmed your eligibility, follow these steps to avail the PMJAY scheme:
1. Access to Services:
- Beneficiaries can avail services at all public hospitals and listed private healthcare facilities.
- Information about empanelled hospitals will be available through government websites, mobile apps, helplines (14555), Asha, ANM and other local touchpoints.
2. Cashless and paperless access:
Beneficiaries get free treatment for secondary and tertiary care under specific packages. Services are cashless and paperless in public hospitals and listed private hospitals.
3. Empanelment of Hospitals:
The hospitals are empanelled by the state government through an online portal.
4. Eligibility:
PM-JAY is eligibility based, with no enrolment required. Eligible families are identified based on deprivation and occupational criteria using the SECC database in both rural and urban areas.
Documents Required for PMJAY Registration
To register for the PMJAY scheme, make sure you have the following documents ready:
- Age and Identity Proof: Aadhar Card or PAN Card.
- Contact details: Mobile number, residential address and email address.
- Caste certificate (if applicable).
- Income Certificate: Annual income should be up to Rs.5 lakh.
- Family Proof: Document proving the current family status (joint or nuclear family)
(Please note: These steps are applicable for those eligible under the scheme before the recent announcement. The portal has not been updated for the new changes at the time of publishing this article)
