Ayushman Bharat: Benefits, Registration, Eligibility and how to apply

New Delhi, Sep 27: The Modi government has rolled out a mammoth scheme, deemed the largest in the world, to provide free health insurance to India's poor and marginalised families. Named Pradhan Mantri Jan Ayogya Yojana or Ayushman Bharat, the scheme was rolled out last week.

What is it?

Ayushman Bharat is a health insurance scheme under which 10.74 crore poor households across India will be eligible for reimbursement of up to Rs 5 lakh per year towards hospitalisation expenses of their family members. Apart from the expenses on in-patient treatment, the scheme also covers pre- and post-hospitalisation costs to some extent.

Key features of the Modicare:

• There is no restriction on family size, age or gender.
• All members of eligible families as present in SECC database are automatically covered.
• No money needs to be paid by the family for treatment in case of hospitalization
• All pre-existing conditions are covered from day one of the policy. The benefits cover will include pre and post hospitalisation
• You can go to public or empanelled private hospitals across the country and get free treatment
• You need to carry any prescribed ID to receive treatment at the hospital

How to check eligibility

• Go to NHA portal and Log in to mera.pmjay.gov.in
• Enter your mobile number and captcha code.
• A one-time password will be sent to your mobile number.
• After entering the OTP, you will be taken to this screen.
• Select the state: Fill all the fields like name, mobile number, ration card number, or Rashtriya Swasthya Bima Yojna URN number.
• If your name is there in the list, it will show up on the right-hand side of the page.
• Click on 'Family Members' tab to find the beneficiary details

Required documents

• Respective special category certificates
• Age proof documents
• Family structure
• Identification details
• Contact information
• Scanned copy of Aadhar
• Income certificate
• Caste certificate

Registration: No registration required. PMJAY will provide cashless and paperless access to services for the beneficiary at the point of service.

How will beneficiary be identified at the hospital

• Hospital help desk- Identitity verification through Aadhaar and other ID
• Beneficiary identification system using letter with family card
• Give e- card and you can meet the doctor

How to access care under PMJAY

• Patient approaches empanelled hostiptals, 'aarogya mitras' to provide support in beneficiary verification, authentication, query management, grievance redressal.
• Confirm eligibility preferably through Aadhaar
• Pre authorisation request and approval- Hospitals selects packages, checks balance
• Submits supporting evidence required for treatment
• Treatment, discharge and beneficiary feedback