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Cashless facility under PMJAY

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Dion Global

12 Feb 2019

The details of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) are given below: Government of India has launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) on 23.09.2018. PMJAY is centrally sponsored scheme. It is entirely funded by Government and the funding is shared between Centre and State governments as per prevailing guidelines of Ministry of Finance. PMJAY provides health coverage up to Rs. 5 lakh per family per year for secondary and tertiary hospitalization to around 10.74 crore poor and vulnerable families (approx. 50 crore beneficiaries). PMJAY is an entitlement based scheme. This scheme covers poor and vulnerable families based on deprivation and occupational criteria as per SECC data. PMJAY provides cashless and paperless access to services for the beneficiary at the point of service in any (both public and private) empanelled hospitals across India. In other words, a beneficiary from one State can avail benefits from an empanelled Hospital anywhere in the Country. Under PMAJY, the States are free to choose the modalities for implementation. They can implement the scheme through insurance company or directly through the Trust/ Society or mixed model. There is no restriction on family size, ensuring all members of designated families specifically girl child and senior citizens get coverage. At National level, National Health Authority (NHA) has been set up to implement the scheme. MoU has been signed between National Health Agency (now National Health Authority) and 33 States/UTs to implement PMJAY. About 1393 treatment packages are available for the beneficiaries under PMJAY. The details of package, operational guidelines and key features are available at www. pmjay.gov.in.

Any beneficiary of PMJAY can approach any empanelled hospital in the country under PMJAY to avail the benefits. It is an entitlement based scheme and does not involve enrolment, or issue of plastic cards. On establishment of the beneficiary’s identity, services are rendered to him/her in a cashless manner.