Frequently Asked Questions
What is the full form of PM-JAY?
Pradhan Mantri Jan Arogya Yojana(PM-JAY) is a pioneering initiative of Prime Minister Modi to ensure that poor and vulnerable population is provided health cover. This initiative is part of the Government’s vision to ensure that its citizens – especially the poor and vulnerable groups have universal access to good quality hospital services without anyone having to face financial hardship as a consequence of using health services.
Will the beneficiaries have to pay anything to get covered under this scheme?
No. All eligible beneficiaries can avail free services for secondary and tertiary hospital care for identified packages under PM-JAY at public hospitals and empaneled private hospitals. Beneficiaries will have cashless and paperless access to health services under PM-JAY.
Shall a card be given to the beneficiary?
A dedicated PM-JAY family identification number will be allotted to eligible families. Additionally, an e-card will also be given to beneficiary at the time of hospitalization.
Who is entitled under PM-JAY to avail benefits?
PM-JAY covers more than 10 crore poor and vulnerable families across the country, identified as deprived rural families and occupational categories of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data. A list of eligible families has been shared with the respective state government as well as ANMs/BMO/BDOs of relevant area. Only families whose name is on the list are entitled for the benefits of PM-JAY. Additionally, any family that has an active RSBY card as of 28 February 2018 is covered. There is no capping on family size and age of members, which will ensure that all family members specifically girl child and senior citizens will get coverage.
What documents are required as a beneficiary if he/she needs to be hospitalized?
At the time of admission to the hospital, beneficiaries should carry ration card or any other government recognized photo identity document like Aadhaar etc.
Where can recipients have access to PM-JAY services?
Services under the scheme can be availed at all public hospitals and empaneled private health care facilities. Empanelment of the hospitals under PM-JAY will be conducted through an online portal by the state government. Information about empaneled hospitals will be made available at through different means such as government website, mobile app. Beneficiaries can also call the helpline number at 14555. Regular updates will also be provided through ASHAs, ANM and other specific touch points This information will be activated shortly.
What is the registration process and is there any time period to register?
PM-JAY is an entitlement based mission. There is no enrolment process. Families who are identified by the government on the basis of deprivation and occupational criteria using the SECC database both in rural and urban areas are entitled to PM-JAY.
What can be done if I fall ill and out of my district or state?
The scheme will have portability of benefits across the country. Beneficiary can avail services all across the implementing States/UTs. You can call helpline number 14555 for details.
How are the beneficiaries identified?
The beneficiaries are identified based on the deprivation categories (D1, D2, D3, D4, D5, and D7) identified under the SECC (Socio-Economic Caste Census) database for rural areas and 11 occupational criteria for urban areas. In addition, RSBY beneficiaries in states where RSBY is active are also included.
How is PM-JAY affecting previous schemes like RSBY, Senior Citizen Health insurance or any other schemes within the state?
The scheme will subsume the functional RSBY schemes – Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
Would the benefits under PM-JAY help those families whose name aren’t on the list?
In this phase, no additional new families can be added under PM-JAY. However, names of additional family members can be added for those families whose names are already on the SECC list.
A well-defined three-tier complaint and grievance redressal mechanism will be in place. This includes constitution of various committees, use of electronic, mobile platform, an All-India helpline number 14555 internet as well as social media. Robust safeguards to prevent misuse/fraud/abuse by providers and users will also be in place.
