Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a national public health insurance scheme of the Government of India that aims to provide free medical treatment and hospitalization for certain illnesses and procedures.
It is the second component under Ayushman Bharat, which was launched on September 23, 2018, in Ranchi, Jharkhand by the Hon’ble Prime Minister of India, Shri Narendra Modi.
PM-JAY is the largest health assurance scheme in the world, which aims to provide a health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to over 12 crores of poor and vulnerable families.
The benefits of Pradhan Mantri Jan Arogya Yojana (PM-JAY) include:
Health Coverage: PM-JAY provides a health insurance plan of Rs. 5 lakh annually per family for secondary and tertiary care hospitalization, benefiting over 12 crore vulnerable families.
Comprehensive Coverage: The scheme covers all hospitalization expenses, including diagnostic services, drugs, room charges, physician's fees, surgeon charges, supplies, ICU and OT charges.
Pre-Existing Conditions: All pre-existing conditions are covered from day one under PM-JAY.
Cashless Transactions: Beneficiaries can avail of cashless hospitalization services at empanelled hospitals.
Accommodation and Post-Hospitalization Costs: PM-JAY covers accommodation during hospitalization and pre and post-hospitalization costs
No Family Size Restriction: There is no cap on family size or age of members eligible for the scheme.
Coverage for Informal Sanitation Workers and Transgender Persons: The scheme has been extended to include informal sanitation workers and transgender persons, providing them with health insurance coverage of Rs. 5 lakh per family per year.
PM-JAY covers annual household medical expenses up to a ceiling of Rs. 5,00,000 (US$6130) without any limit on the number of household members incurring expenses. The benefit package includes 1393 treatments in 24 specialties with no exclusion of pre-existing conditions.
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.
As many as 21.9 crore beneficiaries have been verified under the Ayushman Bharat Pradhan Mantri – Jan Arogya Yojana (AB PM-JAY) Scheme including 3 crore beneficiaries verified using State IT systems as of 4th January 2023.
Approximately 4.3 crore hospital admissions, amounting to Rs. 50,409 crores, have also been authorized under the scheme through a network of over 26,055 hospitals, highlights the Economic Survey 2022-23.
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