The Ayushman Bharat is a government-aided health insurance scheme launched by The Honorable Prime Minister Mr Narendra Modi in the month of August 2018. Later the scheme is renamed as PM Jan Arogya Yojana (PMJAY) which become functional from Tuesday, September 25, on the birth anniversary of Pandit Deendayal Upadhyay. This health insurance is the world’s largest government health insurance scheme under which more than 10 crore families or almost 50 crore Indian citizens are to be covered under this insurance scheme. Let us have a closer look at this government insurance scheme.
The Features and Benefits
- This health insurance will give a defined benefit cover of Rs. 5 lakh per family per year.
- The benefits are portable and the cashless treatment can be availed at any part of the country from any public/private empanelled hospitals
- The eligibility of this scheme will be dependent on the Socio-Economic and Caste Census (SECC) database.
- The benefits of this scheme can be availed from government health care centres or the empanelled hospitals.
- Under this scheme, the treatment will be cashless and paperless.
- There is no cap of the maximum number of family members.
- Priority will be given to the girl child, women and senior citizens.
- The scheme will give coverage to 1,350 medical packages including surgery, medical and daycare treatments, cost of medicines and diagnostics.
- All pre-existing diseases will be covered under this scheme.
Which One Should You Choose: Individual or Family Floater Health Insurance Plan
The Eligibility Criteria to Avail PM Jan Arogya Yojana (PMJAY)
This health insurance scheme is exclusively for the economically backward class people. The PMJAY will benefit only those who belong to deprived rural families and identified occupational category of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) 2011 data. Both rural and urban families are included in this list. The families who own motorized 2/3/4 wheelers/fishing boat(s) or any of the members of the family earns more than Rs.10,000 per month will be automatically excluded from the beneficiary list. Same will be applicable if the family own a refrigerator or a landline telephone.
Ayushman Bharat Scheme Eligibility
For Rural Areas:
- Families living in only one room with kachcha walls and kachcha roof
- Families with no adult members aged between 16 and 59
- Female-headed family with no adult male member in the 16-59 age group
- Families having at least one disabled member and no able-bodied adult member
- SC/ST households
- Landless households deriving a major part of their income from manual casual labour
- Destitute and those surviving on alms
- Manual scavenger families
- Tribal groups
- Legally-released bonded labourers
For Urban Areas:
The following 11 occupational categories are entitled to get the benefits of this scheme
- Domestic worker
- Street vendor/cobbler/hawker/ other service providers working on the streets
- Construction worker/ plumber/ mason/ labour/ painter/ welder/ security guard/ coolie and other head-load workers
- Sweeper/ sanitation worker/ gardener
- Home-based worker/ artisan/ handicrafts worker / tailor
- Transport worker/ driver/ conductor/ helper to drivers and conductors/ cart-puller/ rickshaw puller
- Shop worker/ assistant/ peon in small establishment/ helper/ delivery assistant / attendant/ waiter
- Electrician/ mechanic/ assembler/ repair worker
- Washerman/ chowkidar
More on Ayushman Bharat Scheme
If you fulfill the criteria set by the government or you are engaged in any of the mentioned profession, you will be automatically considered eligible for the scheme. Unlike any other insurance plans, one does not need to enroll yourself to get the benefits of this scheme. One does not require to apply for Ayushman Bharat Yojana Scheme. If you are eligible, you will get the automatic coverage.