Who is Eligible for Ayushman Bharat Scheme? Features, Registration Process and More

To provide quality healthcare services to the poor and rural households, the Government of India introduced an ambitious government-sponsored health scheme- the Pradhan Mantri Ayushman Bharat Yojana. Prime Minister, Narendra Modi rolled out the Pradhan Mantri Ayushman Bharat Yojana (now called the Pradhan Mantri Jan Arogya Yojana (PMJAY) on September 2018 to cover over 50 crore Indian citizens and 10 crore underprivileged families without any limitations pertaining to family size and age.

 This scheme will help these households avail the best healthcare service with insurance coverage up to s. 5 lakh for each family yearly for tertiary and secondary hospitalization.

Basic Features of PMJAY

PMJAY is regarded as the world’s largest National Health Protection Scheme with an objective to make secondary and tertiary healthcare entirely cashless. It is designed to support the economically disadvantaged individuals avail easy access to a host of healthcare services. Here are the major key features of this scheme:

  • PMJAY comes with a maximum sum assured of Rs. 500,000 per family, per annum.
  • Under this scheme, beneficiaries get an e-card which they can use to avail healthcare services at any empanelled hospital, anywhere in the country.
  • Beneficiaries can go into their nearest or preferred hospitals to take necessary health service and for this, they just need to show the PMJAY e-card.
  • The scheme also recompenses the transportation cost incurred by the beneficiary during the pre and post-hospitalization period.
  • Along with the medical treatment expenses, PMJAY covers the day-care expenses incurred by the beneficiary.
  • The payment for medical expenses is made as per the package rate pre-determined by the government.
  • Furthermore, at approx. 1,400 procedures and the costs related to them, for instance, OT expenses are covered under this plan.

Who is Eligible for Ayushman Bharat Scheme?

In order to avail the benefits of Ayushman Bharat Scheme, check for your name in the Socio-Economic Caste Census-2011 data. It will make sure if your family is eligible to be covered under this scheme or not. And only if your name is listed in SECC database and active RSBY card holders are entitled to avail PMJAY benefits.

Ayushman Bharat Eligibility Criteria for Rural

To protect people from the rural area from becoming victims of debt traps to the essential health care facilities, the Indian government has defined the Ayushman Bharat Scheme eligibility criteria, it is as under:

  • Individuals and families belonging to SC/ST caste
  • A household with no adult/male/earning member within the age group of 16-59 years
  • Families that are living in one room with Kuccha walls and roof
  • A household without a healthy adult member and one disabled member
  • The poor and needy surviving on alms
  • Landless households earning a major part of their family income from manual labour
  • Manual scavenger families

Ayushman Bharat Eligibility Criteria for Urban

Just like in rural areas, poor people living in an urban area also depend on loans to seek essential medical treatments. As such, the Ayushman Bharat Scheme is designed for people belonging to support people belonging to the below-mentioned groups wherein the sources of income are little to none. They are as under

  • Domestic worker
  • Watchmen and security guards
  • Rag Pickers
  • Beggar
  • Electricians, mechanics and repair workers
  • Gardeners, sweepers and sanitation workers
  • Masons, plumbers, potters, painters, welders and construction workers
  • Drivers, conductors, rickshaw and car pullers and similar transport workers
  • Tailors and handicraft workers
  • Hawkers, cobblers and other street-side service providers
  • Peons in small establishments, assistants, shopkeepers, delivery boys and waiters

How to Register for PMJAY Scheme Online?

It is a simple process to register for PMJAY scheme. It is applicable to all beneficiaries identified under the SECC 2011 list and those are a part of the RSBY scheme. Follow the below steps to register for PMJAY online:

Visit the official PMJAY website at https://www.pmjay.gov.in/ and click on the AM I Eligible tab

Submit your mobile number, CAPTCHA code, and click on Generate OTP button

Now, select the state you are residing in the search by name, HDD number, mobile number, or ration card number

The search will help verify if you are eligible for coverage under PMJAY

If your family is covered under Ayushman Bharat Yojana, then your name will be displayed in the results

Additional Point

According to IRDAI’s regulation, all the health insurance providers are covering COVID-19 hospitalization expenses. And the government-backed Ayushman Bharat scheme also offers coverage against the global pandemic COVID-19. One can avail medical test facilities at any of the panel hospitals without any money being charged as per the NHA’s announcement.

Hopefully, you found this post helpful and avail PMJAY easily.

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