Frequently Asked Questions

Frequently Asked Questions under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

1. What is Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

Ayushman Bharat, a flagship scheme of Government of India, was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to “leave no one behind.”

Ayushman Bharat is an attempt to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. This scheme aims to undertake path breaking interventions to holistically address the healthcare system (covering prevention, promotion and ambulatory care) at the primary, secondary and tertiary level. Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components, which are –

Health and Wellness Centres (HWCs)
Pradhan Mantri Jan Arogya Yojana (PM-JAY)

2. What are the benefits of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

PM-JAY provides cashless cover of up to INR 5,00,000 to each eligible family per annum for listed secondary and tertiary care conditions. The cover under the scheme includes all expenses incurred on the following components of the treatment.

Medical examination, treatment and consultation
Pre-hospitalization
Medicine and medical consumables
Non-intensive and intensive care services
Diagnostic and laboratory investigations
Medical implantation services (where necessary)
Accommodation benefits
Food services
Complications arising during treatment
Post-hospitalization follow-up care up to 15 days

The benefits of INR 5,00,000 are on a family floater basis which means that it can be used by one or all members of the family. The RSBY had a family cap of five members. However, based on learning from those schemes, PMJAY has been designed in such a way that there is no cap on family size or age of members. In addition, pre-existing diseases are covered from the very first day. This means that any eligible person suffering from any medical condition before being covered by PM-JAY will now be able to get treatment for all those medical conditions as well under this scheme right from the day they are enrolled.

3. What is the maximum benefits size in Rupees under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

PM-JAY provides cashless cover of up to INR 5,00,000 to each eligible family per annum for listed secondary and tertiary care conditions.

4. Can I have to pay any amount beyond the wallet size under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

PM-JAY provides cashless cover of up to INR 5,00,000 only to each eligible family per annum for listed secondary and tertiary care conditions. Any amount incurred in respect to medical expenses beyond Rs. 5,00,000 per year per family has to borne by the beneficiary.

5. How many packages are covered under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

There are 874 packages and 1592 procedures under PM-JAY.

6. Who were the beneficiaries of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

At present those persons will be considered as beneficiary of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana who were covered under specific categories of SECC-2011 database of Govt. of India.

7. What are the most common documents for checking the eligibility for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

PM/CM entitlement letter
Ration Card
Aadhaar Card for identification only

8. Is there any Income criteria for eligibility under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana? Can I take any benefits if I am not covered in SECC-2011 database?

No.

9. Can I check on-line for my eligibility under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

https://mera.pmjay.gov.in/search/login

10. What is the process for inclusion of beneficiaries of Haryana Mukhyamantri Antyodaya Parivar Utthan Yojana?

The beneficiaries under Mukhyamantri Antyodaya Parivar Utthan Yojana whose annual family income is less than 1.80 Lakh are eligible for availing benefits under AB-PMJAY.

The eligible beneficiaries do not require to submit any request letter / entitlement letter. They can get their Ayushman Bharat card at Ayushman

Kiosk in all PMJAY empanelled hospitals and from the Common Services Centers (CSC).

11. From where a beneficiary can get Ayushman card?

Beneficiary can get their Ayushman Bharat card at Ayushman Kiosk in all PMJAY empanelled hospitals and from the Common Services Centers (CSC).

12. From where a beneficiary can get benefits of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana?

Beneficiaries can avail the benefits of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana in all Government Hospitals, CHC, PHC and any other empanelled private hospitals.

13. Does the scheme covers OPD services?

14. Can I check the list of hospitals in and around my district online?

Yes, here is the website link: https://hospitals.pmjay.gov.in/Search/

15. Can I take benefits on national portability basis?

Yes

16. Can I raise any grievance against any hospitals/person?

Yes, here is the website link: https://cgrms.pmjay.gov.in/GRMS/loginnew.htm

17. Is there any State/National toll free number?

Toll-Free Call Center Number – 14555/ 1800111565 / 18001802415