Integrated Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana & Mahatma Jyotirao Phule Jan Arogya Yojana

About Scheme :

Government of Maharashtra started Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) (erstwhile Rajiv Gandhi Jeevandayee Arogya Yojana) from 2nd July, 2012 in eight districts on pilot basis and then it was expanded in all districts of Maharashtra from 21st November, 2013. This flagship health scheme was initially started for low income families and then added other categories from time to time.

Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) was launched by the Government of India on 23rd September 2018. Earlier the households included were based on the deprivation and occupational criteria of Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas respectively. This scheme was implemented in integration with Mahatma Jyotirao Phule Jan Arogya Yojana during 2018 to 2020. Government of India and Government of Maharashtra have been sharing cost of implementation in the ratio of 60:40.

The Government made amendments in the integrated scheme as per the Government Resolution dated 26th February, 2019 being implemented as above. Accordingly, an insurance cover of Rs.1.50 lakh per family per year was provided for 996 treatments in the Mahatma Jyotirao Phule Jan Arogya Yojana,. Also health coverage of Rs.5.00 lakh per family per year was applicable for 1209 treatments through Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana. The said scheme was implemented from 1.04.2020 to 30.06.2024.

Meanwhile, Government of Maharashtra has taken decision vide GR dated 28th July, 2023 to implement MJPJAY for all families in the state and expanded the scope of current scheme. Accordingly, integrated scheme is being implemented from 1st July, 2024 with expanded scope. The scheme covers all population of Maharashtra. The scheme provides end to end cashless quality medical services for identified secondary and tertiary diseases requiring hospitalization through empaneled hospitals. The scheme is implemented on fully Assurance mode.

Beneficiary:

Universal Health Coverage for all citizens of Maharashtra

Benefits:

Cashless secondary and tertiary healthcare procedures in network hospitals. Provides health coverage of Rs.5 lakhs per year on a family floater basis which means that it can be used by one or all members of the family. Medical services of surgeries/treatments requiring hospitalization under 34 Specialties. All pre–existing diseases are covered from day one. MJPAY Beneficiary can avail cashless treatment in any Govt./Pvt. network hospital in State. Benefits of PMJAY scheme are portable across the country. Dedicated call center for scheme where beneficiary can get information of scheme and raise grievance of services under the scheme. Scheme is fully paperless and run on dedicated portal.