The National Health Authority (NHA) is pursuing a two-pronged strategy to expand the scope and scale of Ayushman Bharat PMJAY. Beneficiary identification and hospital utilization are examples of these. The NHA is relaunching Aapke Dwar Ayushman with zeal.

1. AYUSHMAN
BHARAT YOJNA
VINOD K AGRAWAL & ASSOCIATES, CA

2. INTRODUCTION
 On September 23, 2018, Prime Minister of India Shri Narendra Modi launched the
National Health Protection Scheme, dubbed Ayushman Bharat Yojana.
 The 'Ayushman Bharat Yojana' was launched in response to the National Health
Policy 2017 recommendation, primarily to achieve the vision of Universal Health
Coverage.

3. AMAZING FACT
 Originally known as the 'Ayushman Bharat Yojana,' it has now
been renamed the 'Pradhan Mantri Jan Arogya Yojana.’

4. FEATURES OF THE AYUSHMAN BHARAT YOJNA
 It is the world's largest government-funded health insurance scheme.
 It aims to cover more than 50 million Indian citizens, including over 10 million
underprivileged families.
 It intends to provide a health insurance coverage of INR 5 lakhs per family per
year for tertiary and secondary hospitalization expenses.
 It is a paperless plan.
 It provides cashless hospitalization insurance. Such coverage is available at
both public and network private hospitals.

5. It pays for the following costs, which apply to all
tertiary and secondary care procedures:
 The cost of hospitalization
 The cost of medication
 The cost of three days of pre-hospitalization
 The cost of fifteen days of post-hospitalization expenses.

6. It covers approximately 1400 treatments, some
of which are listed below:
 Knee replacements
 Skull surgery
 Prostate cancer
 Double valve replacement surgery
 Anterior spine fixation

7. ELIGIBILITY
 The person's name appears in the 'Socio Economic Caste Census 2011' data
 They must have an active RSBY (Rashtriya Swasthya Bima Yojana) card.

8. Once the basic eligibility is met, further eligibility is
determined by whether the applicant lives in a rural or
urban area. The same is highlighted below.
Rural area eligibility criteria Urban area eligibility criteria
• The family lives in a single room with
kutcha walls and a kutcha roof.
• Family with no adult/male/earning
member between the ages of 16 and
59.
• Households that do not own land and
rely primarily on manual labor.
• Families of manual scavengers.
• Family with no healthy adult members
and one disabled member.
• Beggar.
• Domestic worker.
• Home based artisan or worker or tailor
or handicraft worker etc.
• Ragpicker.
• Plumber or construction worker or
mason or painter or welder or security
guard or coolie or other head-load
workers.
• Mechanic or electrician or repair
or assembler.
• Rickshaw puller or conductor or cart
puller or transport worker.
• Street vendor or cobbler or hawker.
• Washer man or chowkidar.

9. Persons who are not eligible to receive benefits
under the Ayushman Bharat Yojana include:
 All government employees
 Any individual with a monthly income of more than INR 10,000,
 Anyone who owns a vehicle such as a two-wheeler, three-wheeler, car, etc.
 Any individual who owns a motorized fishing boat.
 A person who owns more than five acres of agricultural land.
 A person who owns agricultural machinery and/or equipment.
 Kisan card holder
 A person who owns a refrigerator and/or a landline phone.
 A person who lives in a properly constructed house.

10. Online procedures for determining eligibility for the
Ayushman Bharat Yojana-
 STEP 1 – Visit https://pmjay.gov.in/
 STEP 2 – Click ‘Am I Eligible’
 STEP 3 – Enter Mobile Number and captcha
 STEP 4 – Click Generate OTP
 STEP 5 – Enter the 6-digit OTP received on the entered mobile number
 STEP 6 – Select State and category (i.e. Search by Name or HHD number or
Ration card number or mobile number) from the drop-down list
 STEP 7 – Provide additional details, based on the category selected at STEP 6
above
 STEP 8 – Click Search

11. Documents required to apply for Ayushman
Bharat Yojana-
 Identification and age proof (Aadhaar card or PAN card)
 Address proof
 Caste certificate
 Income certificate
 Ration book
 Document describing the current status of the family (joint or nuclear) that will
be covered by the scheme

12. THANKYOU
VINOD K AGRAWAL & ASSOCIATES, CA