Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, commonly referred to as PM-JAY, is a pioneer healthcare programme initiated by the Honourable Prime Minister. The programme's objective is to provide adequate and free health cover to the vulnerable sections of society – the economically weaker citizens. In this guide, we share a detailed step-by-step guide on how to apply for Ayushman Bharat Yojana. 

Quick Overview on the Salient Features of Ayushman Bharat Yojana 

Even today, nearly 63% of the Indian population pay for hospitalisation and healthcare expenses out of their own pocket. The vast majority of Indian citizens empty their lives' savings, sell their assets, or take on expensive loans to pay for healthcare. The PM-JAY programme aims to provide affordable healthcare to all – especially the vulnerable sections of society.

PM-JAY is an ambitious initiative by the central government. It's one of the world's largest free healthcare schemes. It aims to provide free medical treatment up to Rs. 5 lakhs per year for each eligible individual. The programme aims to bring nearly 50 crore economically weak citizens under the formal healthcare system. It was launched on 23rd September 2018 by the Prime Minister of India.  

  • It provides a maximum sum assured of Rs. 5 lakhs for each individual for health insurance coverage in a year.

  • It covers the costs of medical treatment, diagnostics, medicines, pre and post hospitalisation expenses. 

  • It's a paperless & cashless health insurance scheme available at all government hospitals and select private hospitals. 

  • The scheme's beneficiaries do not have to pay any charges at empanelled hospitals – it's totally cashless.

  • Beneficiaries of the scheme can show their Ayushman Bharat Yojana e-card to get free healthcare services at any empanelled hospital in India. 

Now that you're aware of the scheme's benefits, let's focus on applying for the programme.

How to apply for Ayushman Bharat Yojana?

Note that the Ayushman Bharat Yojana scheme is offered to all eligible beneficiaries; hence there is no separate enrolment process. Eligible beneficiaries are chosen based on the State-Economic-Caste-Census data of 2011. If you wish to avail of this scheme's benefits, the first step is to check your eligibility.  

Step 1: Eligibility Check 

PM-JAY offers coverage to more than 10 crore economically weak families, around 50 crore beneficiaries. The beneficiaries include poor rural families and occupational urban workers and their families as per the latest SECC (State-Economic Caste Census) data. 

Here are a few ways to check your eligibility for Ayushman Bharat Yojana:

  • Visit an EHCP (Empanelled Health Care Provider) hospital near you. Ask the staff at the registration desk to check if you’re eligible. 

  • Visit any PM-JAY kiosk to check your eligibility. Follow the on-screen instructions displayed, provide the required details to check if you’re a beneficiary. 

  • Call the helpline numbers 1800-111-565 or 14555 to check your eligibility. 

  • Use the website “pmjay.gov.in” and select the “Am I eligible” button. 

    • Enter your mobile number, provide the captcha code, and generate OTP.  

    • Choose your state. 

    • Check for your name on the beneficiary list by entering your mobile number, ration card number, or HHD number.

    • Once you provide the required details, you can get the results stating if you’re eligible for PM-JAY or not. 

Step 2: Generating the Patient Card 

As mentioned above, the PM-JAY is a paperless, cashless scheme. To avail of the plan's benefits at any network hospital in India, eligible beneficiaries should provide the PM-JAY e-card during hospital admission. This e-card contains all the information about the patient and is applicable at all empanelled hospitals across India.

Once you have checked your eligibility for the scheme, the next step is to generate the e-card. It can be done either online or offline. Let’s see how you can get your patient card. 

Offline Process

Once you have checked your eligibility, you can visit a nearby PMJAY kiosk. These kiosks are set up at government hospitals, district collector offices, etc. The PMAM (Pradhan Mantri Arogya Mitra) operating the booth will verify your identity and eligibility using the BIS (Beneficiary Identity System). This is when your e-card (PM-JAY Golden Card) will be generated. 

Online Process

To generate the PM-JAY Golden card online, follow the steps below:

  • Visit the official PM-JAY website (mera.pmjay.gov.in). Log in using your registered mobile number. 

  • Generate your HHD code (Household ID number). 

The rest of the process has to be completed offline. Provide the HHD code to the CSC (Common Service Centre). The CSC representatives, known as Ayushman Mitra, will help you with the rest of the process. They will check your details and issue the Ayushman Bharat card. You have to pay Rs. 30 to obtain the card. 

Key Points to Remember while Applying for Ayushman Bharat Yojana

  • All eligible beneficiaries can avail of the benefits of the schemes. There is no separate enrolment process. However, it's highly recommended that you check your eligibility and generate the patient card, so you can furnish it when needed.

  • Once you have verified your eligibility, you need to generate the Ayushman Bharat patient card. 

  • Each member of the beneficiary’s family is provided with a separate patient card. 

  • Make sure to have the card safely. You will have to furnish at the hospital during the time of treatment. 

  • During the enrolment process, you may be required to provide the following documents:

    • Aadhaar card for identity and age proof 

    • Residential proof using ration card 

    • Caste and income certificate 

What is covered under Ayushman Bharat Yojana? 

It provides coverage of a maximum of Rs. 5 lakhs to eligible beneficiaries for the following:

  • Medical examination, diagnostic tests, consultation, medical treatments, implants, intensive care, non-intensive care services, physician fees, and surgeries.

  • Hospital room rent, food services, etc. 

  • Covid-19 treatment 

  • Pre-hospitalisation expenses for up to 3 days

  • Post-hospitalisation expenses for up to 15 days 

  • All pre-existing conditions are treated from day one

  • It provides coverage for around 1390+ medical procedures like angioplasty, prostate cancer, valve replacement, etc. 

What is not covered under Ayushman Bharat Yojana? 

Just like other health insurance plans, the Ayushman Bharat Yojana scheme has specific exclusions. They are: 

  • OPD (Out-Patient) Department Expenses

  • Fertility Treatments

  • Cosmetic Surgeries 

  • Organ Transplant 

  • Drug Rehabilitation 

Bottom Line

The Ayushman Bharat Yojana is an ambitious healthcare scheme that provides free healthcare to the needy. It offers health coverage for all members of eligible families. There are no restrictions based on the size of the family or the age of family members. Once you have received your Ayushman Bharat Patient Card, you can receive quality medical services at any empanelled public and private hospital across the country.  

Start by checking your eligibility and then applying for the Ayushman Bharat Golden Patient Card to avail the scheme's various benefits.