Vidyamana Kannada News

Apply Ayushman Bharat

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1. Introduction

Healthcare in India has always been a crucial challenge. With a population of over 1.4 billion, millions of families struggle with out-of-pocket medical expenses. According to studies, nearly 60% of Indians fall into poverty due to health costs. To solve this, the Government of India introduced the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in 2018.

Apply Ayushman Bharat
Apply Ayushman Bharat

This scheme is popularly known as Modicare and is considered the world’s largest government-funded health assurance scheme. It provides cashless health insurance coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization, benefiting more than 50 crore (500 million) people.


2. Objective of the Scheme

The major goals of PMJAY are:

  • To provide financial protection to poor and vulnerable families.
  • To reduce catastrophic health expenditures.
  • To ensure universal health coverage for India’s poor.
  • To improve access to quality healthcare services in both government and private hospitals.
  • To promote equity in healthcare access (removing inequality between rich and poor).

3. Eligibility

PMJAY targets the poorest and most vulnerable families. Eligibility is decided on the basis of Socio-Economic Caste Census (SECC) 2011 data and is linked with ration cards under the National Food Security Act.

Rural Beneficiaries

  • Families living in one-room kucha houses.
  • Families with no adult members (16–59 years).
  • Families headed by women with no adult male.
  • SC/ST households.
  • Landless households depending on manual labor.

Urban Beneficiaries

  • Families working as street vendors, rickshaw pullers, ragpickers, domestic workers, construction workers, sanitation workers, etc.
  • Families with low-income ration cards.

Special Expansion (2024–25 update)

  • From 2025, all senior citizens above 70 years are included, irrespective of ration card type.
  • Senior citizens in PMJAY families also get an extra ₹5 lakh top-up health cover only for themselves.

4. Benefits of PMJAY

  1. Health Coverage
    • ₹5 lakh per family per year.
    • Covers hospitalization (secondary & tertiary care).
  2. Cashless & Paperless
    • No upfront payment required.
    • Beneficiaries can walk into empanelled hospitals.
  3. Portability
    • Benefits can be availed in any empanelled hospital across India.
  4. Wide Treatment Coverage
    • Covers over 1,500 medical packages (surgeries, treatment, medicines, diagnostics).
    • Includes cardiology, oncology, orthopedics, nephrology, maternity, burns, etc.
  5. Pre-existing Conditions
    • All pre-existing diseases covered from day one.
  6. No Cap on Family Size
    • Entire family is covered.
    • No restriction on age, gender, or number of members.

5. How PMJAY Works

  • Funded jointly by the Central and State Governments.
  • The National Health Authority (NHA) manages it at the central level.
  • State Health Agencies (SHA) manage it at the state level.
  • Hospitals are empanelled (both government and private) after meeting quality standards.
  • Beneficiaries are identified using ration cards & Aadhaar verification.

6. Services Covered

PMJAY covers:

  • Day-care treatments.
  • Hospitalization expenses.
  • Pre and post-hospitalization (3 days before and 15 days after).
  • Diagnostics, lab tests, consultation, medicines.
  • ICU services.
  • Complications during treatment.

7. Services Not Covered

PMJAY does not cover:

  • OPD consultations without hospitalization.
  • Cosmetic surgery.
  • Fertility treatments (IVF).
  • Drug rehabilitation.
  • Individual diagnostics outside hospitalization.

8. Application Process

Step 1: Check Eligibility

  • Visit mera.pmjay.gov.in.
  • Enter your ration card number / mobile number.
  • Check if your family is eligible.

Step 2: Apply / Register

  • If eligible, apply through:
    • Common Service Centers (CSCs).
    • Empanelled hospitals.
    • Ayushman Mitra centers.

Step 3: Documents Required

  • Ration card.
  • Aadhaar card.
  • Voter ID.
  • Mobile number.
  • Passport-size photos.

Step 4: Golden Card

  • Once verified, you’ll get an Ayushman Bharat Golden Card.
  • This card is used to access cashless treatment.

9. Hospitals Covered

  • Government hospitals.
  • Private hospitals (after empanelment).
  • Over 28,000 hospitals empanelled across India.
  • Each hospital has an Ayushman Mitra help desk.

10. Success & Impact

  • More than 5 crore hospital admissions have been supported.
  • Over 50 crore beneficiaries identified.
  • Billions saved in out-of-pocket expenses.
  • Boosted public-private partnerships in healthcare.

11. Challenges

  • Awareness among rural poor is still low.
  • Some private hospitals hesitate to join due to low package rates.
  • Fraudulent claims and misuse need strict monitoring.
  • Digital literacy is a barrier for online application.

12. Future Plans

  • Integration with Ayushman Bharat Digital Mission (ABDM).
  • Linking with E-Sanjeevani telemedicine for rural health.
  • Expansion to all ration card holders in the long term.
  • Improved hospital empanelment and stricter fraud control.

13. Comparison with Other Schemes

SchemeCoverageAmountTarget Group
PMJAY (Central)All India₹5 lakh per familyRation card holders & poor families
MJPJAY (Maharashtra)Maharashtra₹5 lakh per familyRation card families in state
Biju Swasthya Kalyan Yojana (Odisha)Odisha₹5 lakh (₹10 lakh for women)Ration card holders
Subhadra Yojana (Odisha)Odisha₹50,000 cash supportMarried women

14. Why PMJAY is the Best Scheme

  • Largest coverage in the world.
  • Helps ration card families the most.
  • Provides huge financial protection from health shocks.
  • Boosts trust in government healthcare.
  • Reduces poverty caused by medical costs.
  • Covers all pre-existing diseases.
  • Women, children, elderly all equally covered.
  • Senior citizens above 70 get extra protection.

15. Conclusion

The Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana is undoubtedly one of the best central government schemes for poor and vulnerable families, especially women with ration cards. Instead of a one-time grant, it provides a continuous health insurance safety net worth ₹5 lakh every year, which saves lives and prevents financial ruin.

It represents a new era of social security in India, ensuring that healthcare is not a privilege but a right for every citizen.

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