The Ayushman Bharat Yojana, also known as Pradhan Mantri Jan Arogya Yojana (PM-JAY), is a flagship health insurance scheme launched by the Government of India in 2018. This comprehensive program aims to provide quality healthcare services to millions of Indians, particularly those from economically vulnerable backgrounds. In this detailed guide, we’ll explore the various aspects of the Ayushman Bharat scheme, including how to apply for the Ayushman Bharat card, its benefits, and the recent developments in the Ayushman Bharat Digital Mission.
What is Ayushman Bharat Yojana?
The Ayushman Bharat Yojana is a national health protection scheme that aims to provide free access to healthcare for low-income earners in India. The scheme is designed to offer health coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization. It’s a significant step towards achieving universal health coverage and fulfilling the vision of Health for All.
Key Features of Ayushman Bharat Yojana
- Health Insurance Coverage: The PM-JAY component offers health insurance coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization. This coverage is available to approximately 10 crore families, which translates to around 50 crore individuals.
- Health and Wellness Centers: The initiative aims to set up 1 lakh Health and Wellness Centers across the country to provide comprehensive primary healthcare services.
- Recent Developments: On September 11, 2024, the Indian Cabinet approved a significant expansion of the Ayushman Bharat scheme to include all senior citizens aged 70 and above, regardless of their income. This decision is expected to benefit approximately 4.5 crore families, allowing elderly citizens to access the same ₹5 lakh health coverage under the PM-JAY scheme.
- Accessibility and Benefits: Eligible beneficiaries can receive cashless treatment at over 29,000 empaneled hospitals, both public and private, across India. The initiative has seen the issuance of more than 34 crore Ayushman cards, facilitating access to healthcare services for millions.
- Impact: The Ayushman Bharat Yojana has already approved hospital admissions for over 7.37 crore patients, indicating its substantial impact on improving healthcare access for low-income families.
This scheme represents a crucial step towards universal healthcare in India, ensuring that even the most vulnerable populations receive necessary medical attention without financial strain.
Eligibility for Ayushman Bharat Yojana
Not everyone qualifies for the Ayushman Bharat Yojana. To be eligible, individuals need to meet specific criteria. The Socio-Economic Caste Census (SECC) 2011 is used to identify the beneficiaries.
1. Rural Households
To qualify for the Ayushman Bharat scheme, rural households must meet specific deprivation criteria as –
- Kucha House: Families living in a single room with kucha walls and roofs.
- No Adult Members: Households with no adult members aged between 16 and 59 years.
- No Adult Male Members: Families without any adult male member in the age group of 16-59 years.
- Disabled Members: Households without an able-bodied adult member or having a disabled member.
- Scheduled Castes and Tribes: Families belonging to SC/ST categories.
- Landless Laborers: Households that earn a significant portion of their income from manual labor and do not own land.
2. Urban Households
For urban families, eligibility is determined by occupational categories. Eligible categories include:
- Ragpickers
- Domestic Workers
- Street Vendors
- Other Low-Income Workers
3. Income Criteria
- Families with an annual income of less than INR 1.80 lakh are eligible for coverage.
- Enrollment in state-specific schemes, such as the Mukhyamantri Antyodaya Parivar Utthan Yojana in Haryana, can also qualify families for benefits.
4. Additional Considerations
- There are no restrictions on family size or age; newborns can be included in the coverage.
- The scheme covers all pre-existing health conditions from the first day of enrollment
How to Apply for Ayushman Bharat Card
To apply for the Ayushman Bharat Card, which provides health insurance coverage under the Pradhan Mantri Jan Arogya Yojana (PMJAY), follow these steps:
Application Process
Step 1: Check Eligibility
Before applying, verify your eligibility through the following methods:
- Online Verification: Visit the official PMJAY website and click on the “Am I Eligible” option. Enter your mobile number, select your state, and complete the captcha. The system will indicate your eligibility based on the Socio-Economic Caste Census (SECC) 2011 data.
- Offline Verification: Visit a Common Service Center (CSC) or an empaneled Ayushman Bharat hospital. Staff at these locations can assist you in checking your eligibility using your Aadhaar or ration card.
Step 2: Gather Required Documents
Prepare the necessary documents for the application:
- ID Proof: Aadhaar card or another government-issued ID.
- Family Details: Ration card to verify family information.
- Income Proof: Optional, but some states may require an income certificate.
- Proof of Address: Utility bills or other documents confirming your residence.
Step 3: Choose Your Application Method
You can apply online or offline:
- Online Application:
- Go to the PMJAY website.
- Click on the “Register” or “Apply” section.
- Fill in your details, including your Aadhaar number and mobile number.
- Upload scanned copies of all required documents.
- Submit the application.
- Offline Application:
- Visit your nearest CSC or an empaneled hospital.
- The operator will assist you in filling out the application form and submitting it electronically.
Step 4: Track Your Application
After submitting your application, you can track its status online. Visit the PMJAY website, enter your registered mobile number and captcha to check the current status of your application.
Step 5: Download Your Ayushman Bharat Card
Once your application is approved, you will receive your Ayushman Bharat Card. To download it:
- Visit the NHA Setu portal.
- Click on “Download Ayushman Card.”
- Enter your Aadhaar number and verify it using the OTP sent to your mobile.
- Click the download button to save your card.
Ayushman Bharat Scheme for Senior Citizens
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has recently expanded to include health insurance coverage for all senior citizens aged 70 years and above, regardless of their income status. This initiative aims to alleviate the financial burden of healthcare for the elderly, who often face higher medical expenses.
Key Features
- Eligibility: All senior citizens aged 70 and above are eligible for health coverage of up to INR 5 lakh per year. This coverage is provided on a family basis, meaning it can be shared among family members but is specifically designated for the senior citizen.
- Top-Up Coverage: If a senior citizen is part of a family already enrolled in the Ayushman Bharat scheme, they will receive an additional INR 5 lakh top-up coverage, which is exclusive to them and does not affect the existing family coverage.
- No Income Restrictions: The expansion removes previous income criteria, ensuring that all seniors in this age group can access health insurance benefits.
- Health Cards: Eligible senior citizens will receive a new health card that facilitates access to healthcare services under the scheme.
- Compatibility with Other Insurance: Senior citizens who have private health insurance or are part of other public health schemes (like CGHS or ECHS) can still avail themselves of the benefits of AB-PMJAY. However, they must choose between their existing coverage and the new Ayushman Bharat health coverage.
- Funding: The initial cost for this expanded coverage is estimated at INR 3,437 crore, with the central government covering 60% of the expenses and state governments covering 40%. In hilly and northeastern states, the central government will fund 90% of the costs.
Ayushman Bharat Hospital List
To find the hospitals that are part of the Ayushman Bharat scheme, follow these steps:
Step 1: Visit the Official PMJAY Website
- Go to the official PMJAY website.
Step 2: Navigate to the Hospital List
- Click on the “Hospitals” section or look for a link that mentions “Find Hospitals” or “Hospital Empanelment”.
Step 3: Select Your State and District
- From the dropdown menus, select your state and then your district to narrow down the list of hospitals available in your area.
Step 4: Filter by Hospital Type
- You can filter the results based on the type of hospital you are looking for:
- Public Hospitals
- Private-for-Profit Hospitals
- Private Not-for-Profit Hospitals
Step 5: View Hospital Details
- After filtering, you will see a list of hospitals. Click on each hospital name to view more details, including:
- Address
- Contact information
- Types of services offered
- Ratings (if available)
Step 6: Check for Specialties
- If you are looking for specific medical services, you may also be able to filter by medical specialty, such as cardiology, orthopedics, etc.
Conclusion
In a nutshell, the Ayushman Bharat Yojana is a groundbreaking initiative that has redefined healthcare access in India. By offering comprehensive health coverage and embracing digital innovation through the Ayushman Bharat Digital Mission, this program has made quality healthcare accessible to millions. From applying for the Ayushman Bharat Card to availing treatment in empaneled hospitals, the scheme is truly a game-changer.
Summing it up, whether you’re applying for your Ayushman Bharat Card online or downloading it via the Ayushman Bharat App, the process is simple. Furthermore, the scheme ensures that no family member is left behind. Ayushman Bharat Yojana is not just a healthcare initiative; it’s a step toward a healthier and more prosperous India.
