Youth Empowerment Sphere
(YES Arunachal)
Pradhan Mantri Jan Arogya Yojana (PMJAY)
Official scheme details, eligibility information and application guidance.
About the Scheme
Brief
The Pradhan Mantri Jan Arogya Yojana (PM-JAY), also known as Ayushman Bharat, is the worlds largest government-funded health insurance scheme. Launched on 23 September 2018, it provides a health cover of ₹5 lakh per family per year for secondary and tertiary care hospitalisation.
Objectives
- Accelerate Indias progress toward Sustainable Development Goals (SDGs)
- Mitigate catastrophic healthcare expenses that push nearly 6 crore Indians into poverty annually
- Ensure the bottom 40% of the population has access to cashless hospitalization services at empanelled public and private hospitals
Eligibility Criteria
- Rural Areas: Households meeting at least one of six deprivation criteria, such as:
i. Families with only one room and kutcha walls/roof
ii. Landless households dependent on manual casual labour
iii. Households with no adult members (aged 16–59) or no male adult member
iv. SC/ST households
- Urban Areas: 11 specific occupational categories, including ragpickers, beggars, domestic workers, street vendors, and construction workers
- Senior Citizens (New): As of late 2024, all senior citizens aged 70 and above are eligible for an annual cover of ₹5 lakh, regardless of their socio-economic status
- Automatic Inclusion: Includes families previously covered under the Rashtriya Swasthya Bima Yojana (RSBY)
Benefits
- Cashless & Paperless: Benefits can be availed at the point of service at any empanelled hospital nationwide
- Comprehensive Coverage: Includes medicines, diagnostics, physician fees, room charges, and ICU care for approximately 1,929 procedures
- No Restrictions: There is no cap on family size, age, or gender
- Pre-existing Conditions: All pre-existing illnesses are covered from day one of enrollment
- Pre & Post-Hospitalisation: Covers up to 3 days of pre-hospitalisation and 15 days of post-hospitalisation expenses.
Nodal Department
- Ministry: Ministry of Health and Family Welfare (MoHFW)
- Implementing Agency: National Health Authority (NHA) is responsible for overall implementation and oversight
- State Level: State Health Agencies (SHA) manage implementation at the state level