What is Ayushman Bharat (PM-JAY)?

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Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is a flagship initiative taken by the Government of India. Recommended by the National Health Policy 2017, this health insurance scheme was rolled out with the commitment, “leave no one behind” on 23rd September, 2018, in Ranchi, Jharkhand.


It provides free health treatment coverage of up to Rs. 5 lakh per family per year for hospital treatment related to specialised, complex and costly illnesses. The scheme supports more than 12 crore poor and vulnerable families, covering around 55 crore individuals, which represents the bottom 40% of India’s population.


Key Features of Ayushman Bharat PM-JAY


Let’s take a look at the main characteristics of this government-backed scheme:



  • World’s Largest Scheme


AB PM-JAY is the world's largest government-backed health insurance scheme.



  • Financial Security


Coverage of Rs. 5 lakh per year per family in any public and private Indian hospitals.



  • Cashless Benefit


Beneficiaries get cashless access to medical services at the hospital.



  • Pre and Post-hospitalisation Expenses


Beneficiaries get up to 3 days of pre and 15 days post-hospitalisation expenses, which comprise doctor’s fee, screening test expenses and medicines.



  • Comprehensive Coverage


All pre–existing diseases and families, age groups, and genders are covered under this scheme.



  • Portable Benefit


The beneficiary can receive treatment at any empanelled hospital (public or private) in the country.


What are the Benefits Covered Under AB PM-JAY?


This scheme covers the following expenses:



  • Medical check-up



  • Pre-hospotalisation



  • Screening test expenses



  • Medicine cost



  • Intensive and non-intensive care services



  • Implant-related medical treatments



  • Accommodation and food benefits



  • Post-discharge care up to 15 days


What are the Eligibility Criteria for AB PM-JAY?


It is decided depending on the data retrieved from the Socio-Economic Caste Census 2011 (SECC 2011).


For Rural Households:



  1. Families living in a house with only one room made of mud or other materials.

  2. Households that have no adult member(especially male) in the age group from 16 to 59.

  3. Landless families whose major source of income comes from manual casual labour.

  4. Families with at least one disabled member and no physically fit adult who can support the family financially.

  5. Households belong to SC/ST categories.


For Urban Areas:



  1. Domestic workers

  2. Street vendors

  3. Transport workers

  4. Electrician or repair workers

  5. Construction workers

  6. Sanitation workers


Who is Excluded from AB PM-JAY?


Here is the list of exclusions under AB PM-JAY:



  • Individuals who have at least one 2, 3, or 4-wheeler and a properly built house.

  • A person with advanced farming equipment.

  • Individuals who own Kisan cards with a Rs. 50,000 credit limit.

  • Government employees.

  • Individuals whose monthly income is more than Rs. 10,000.

  • Persons who own 5 acres or more of farming land.


How to Apply to Get a PM-JAY E-card?


An eligible candidate needs to follow the steps mentioned below:


Step 1: Submit the PM letter/ RC Number/ RSBY URN/Mobile Number.


Step 2: The operator looks for the person’s details in the BIS system to confirm eligibility.


Step 3: The department performs the identification process if they find the name in the list.


Step 4: Then, they evaluate the family records considering the ration card and the other scanned documents.


Step 5: At this stage, they either approve or recommend rejection.


Step 6: If approved, the beneficiary will receive an e-card.


The potential candidate needs to submit a PAN and Aadhaar card as proof of age, identity and address, contact details, caste and income certificate and current family status proof.