Bihar State Madarsa Strengthening Scheme 2026

The Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a flagship health insurance scheme providing ₹5 Lakh annual Read More... cover to low-income and vulnerable families for secondary and tertiary healthcare, making it one of the world's largest health assurance programs. Read less

Details

The Indian government's Ayushman Bharat initiative has a major component called the Pradhan Mantri Jan Arogya Yojana (PM-JAY). This scheme is designed to offer a crucial financial safety net for families in India who struggle to afford healthcare.

What Is PM-JAY?

PM-JAY, launched on September 23, 2018, aims to provide cashless hospitalisation coverage of up to ₹5,00,000 per family annually. It covers essential secondary and tertiary healthcare services, ensuring that no one has to face financial hardship due to medical emergencies. This is part of a larger 'Ayushman Bharat' effort to create a comprehensive healthcare system, from primary prevention to advanced tertiary care.

Who Can Benefit From PM-JAY?

The scheme specifically targets poor and vulnerable families across both rural and urban areas of India. The identification of beneficiaries is based on government-approved deprivation and occupational criteria, ensuring that those most in need receive the benefits.

Why PM-JAY Is Important

PM-JAY is a transformative step towards ensuring universal access to quality healthcare. By offering cashless and paperless treatment, it removes financial barriers that often prevent people from seeking timely medical attention. This scheme supports a continuum of care, from preventive health through Health and Wellness Centres to advanced treatments under PM-JAY itself.

Objective

The Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a flagship health insurance scheme providing ₹5 Lakh annual cover to low-income and vulnerable families for secondary and tertiary healthcare, making it one of the world's largest health assurance programs.

Benefits

Under this scheme, basic facilities and infrastructure will be provided to madrasas recognized by the Bihar State Madarsa Board and other government madarsas to enhance educational quality. The support includes:

Construction of buildings, office rooms, multipurpose halls, hostels, and vocational training halls.
Establishment of computer and science labs, additional classrooms, and libraries.
Provision of essential amenities such as kitchens, mess halls, and toilets.
Renovation of existing structures and installation of borewells, pumps, and tanks for clean drinking water.
Upgrades to electricity systems and installation of solar power plants etc.

Sources and references

Scheme Details (Page No. 11)

Who Can Apply for PM-JAY?

Beneficiary identification for PM-JAY is primarily based on the Socio-Economic Caste Census (SECC) data from 2011. Families are included based on specific deprivation and occupational criteria.

For Rural Areas:

Families are eligible if they fall under at least one of the following SECC 2011 deprivation criteria:

Households living in a house with only one room that has kutcha walls and kutcha roof.
Households with no adult male member between the ages of 16 to 59.
Households with no adult member between the ages of 16 to 59.
Households with a disabled member and no able-bodied adult member.
Households belonging to Scheduled Castes (SC) or Scheduled Tribes (ST).
Landless households deriving a major part of their income from manual casual labour.

Additionally, families who are automatically included based on automatic inclusion criteria are also eligible:

Households without shelter.
Destitute families or those living on alms.
Families working as manual scavengers.
Primitive tribal groups.
Legally released bonded labour.

For Urban Areas:

Eligibility for urban areas is based on 11 defined occupational categories. Families belonging to these professions are eligible:

Ragpicker
Beggar
Domestic worker
Street vendor, Cobbler, Hawker, or other service providers working on the streets
Construction worker, Plumber, Mason, Labourer, Painter, Welder, Security guard, Coolie, and other head-load workers
Sweeper, Sanitation worker, Mali (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 a small establishment, Helper, Delivery assistant, Attendant, Waiter
Electrician, Mechanic, Assembler, Repair worker
Washer-man, Chowkidar (Watchman)

Families holding an active Rashtriya Swasthya Bima Yojana (RSBY) card as of February 28, 2018, are also covered under PM-JAY.

How To Avail Services Under PM-JAY

PM-JAY is an entitlement-based scheme, meaning there is no formal application or enrollment process for beneficiaries. Families identified based on the SECC database and occupational criteria are automatically eligible.

Identification: Beneficiaries are identified through the SECC database (for rural and urban poor) and specified occupational categories (for urban informal sector workers).
Verification: Upon reaching a public hospital or an empanelled private hospital, beneficiaries can get verified at the Ayushman Bharat Kiosk.
Authorization: An Ayushman Mitra at the hospital helps in verifying the beneficiary's eligibility using their details.
Treatment: Once verified and authorized, the beneficiary can receive cashless and paperless treatment for the identified secondary and tertiary care packages.

For more information, you can visit the official website or contact the helpline.

Official Website: https://pmjay.gov.in/

Helpline Number: 14555

Documents Needed for Verification

While there's no application form to fill, beneficiaries need to carry certain documents for verification at the hospital to confirm their eligibility and avail cashless treatment:

Aadhaar Card (preferred for verification)
PAN Card
Proof of Identity
Proof of Address
Contact details (Mobile number)
Caste Certificate (if applicable)
Income Certificate (if required for specific verification)
Document proving the family's current status (e.g., joint or nuclear family structure, as applicable)

Aadhaar card is not mandatory, but it significantly speeds up the verification process.

FAQ’s

What is the claim submission timeline for hospitals?

Empanelled health facilities are required to submit claims within 24 hours of a patient's discharge, including the patient's discharge summary and other necessary clinical reports.

How are beneficiaries identified for PM-JAY?

Beneficiaries are identified using the Socio-Economic Caste Census (SECC) 2011 data. For rural areas, specific deprivation criteria are used, and for urban areas, 11 occupational categories determine eligibility. Families with an active RSBY card as of February 28, 2018, are also included.

Can newborn babies receive treatment under this scheme?

Yes, newborn children are eligible for treatment under PM-JAY. They can also be added to the beneficiary family's record by providing the necessary documentation.

What is the maximum time for claim approval and payment?

Once all claim documents are submitted, the claim must be approved within 15 days by the State Health Agency (SHA) for final processing. The SHA will then process payments within 15 days of internal authentication.

Are there any costs involved for beneficiaries to get covered?

No, eligible beneficiaries can access all covered secondary and tertiary healthcare services for free at public and empanelled private hospitals. The process is cashless and paperless.

Who is an Ayushman Mitra and what do they do?

An Ayushman Mitra is a trained frontline healthcare professional stationed at empanelled hospitals. They act as the first point of contact for beneficiaries, assisting with identity verification, document processing, and claim submission, working alongside the medical team.

Can I get treatment if my name isn't on the official list?

Currently, no new families can be added to PM-JAY in this phase. However, if your family is already on the SECC list, you can add names of additional family members to your existing record.

What are the different levels of grievance redressal?

PM-JAY has a three-tier grievance redressal system: the District Grievance Redressal Committee (DGRC) at the district level, the State Grievance Redressal Committee (SGRC) chaired by the CEO of the State Health Agency, and the National Grievance Redressal Committee (NGRC) chaired by the Deputy CEO of the National Health Agency, which serves as the final appellate authority.

Is an Aadhaar Card mandatory to use the scheme's benefits?

No, an Aadhaar Card is not mandatory for availing services under PM-JAY. However, having it can expedite the verification process.

What is Pradhan Mantri Jan Arogya Yojana (PM-JAY)?

PM-JAY is a government initiative by Prime Minister Modi aimed at providing health coverage to the poor and vulnerable sections of society. Its goal is to ensure that everyone, especially those with limited means, has access to quality hospital services without facing financial hardship.

Are pre-existing medical conditions covered by the scheme?

Yes, all pre-existing illnesses and medical conditions are covered under PM-JAY from the very first day the beneficiary is covered by the scheme.

Where can I get treatment under PM-JAY?

You can receive treatment at any public hospital or private hospital that has been empanelled under the PM-JAY scheme. Information about empanelled hospitals is available on the official website and through the helpline.

How does the claim submission process work?

After a patient is discharged, the hospital initiates the claim by submitting a request online, along with the patient's discharge summary and relevant medical reports. This claim needs to be submitted promptly for processing.

What types of health services are included in PM-JAY?

The scheme covers a wide array of health services, including hospitalization expenses, daycare surgeries, follow-up care, pre and post-hospitalization benefits, and care for newborn children. A comprehensive list of covered services can be found on the official PM-JAY website.

Are RSBY cardholders included in this scheme?

Yes, any family that held an active Rashtriya Swasthya Bima Yojana (RSBY) card as of February 28, 2018, is covered under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.