Pradhan Mantri Jan Arogya Yojana (PM-JAY)

For those belonging to SECC, the Prime Minister of India, Narendra Modi along with the Chief Minister of Manipur, Shri Nongthombam Biren Singh launched the Pradhan Mantri Jan Arogya Yojana (PM-JAY) healthcare service. Through the Pradhan Mantri Jan Arogya Yojana (PM-JAY), a total of 2.77 lakh SECC families have received healthcare cover of Rs.5 lakh per family. Launched on 23 September 2018, the scheme covers a wide range of diseases and treatments and even offers coverage for patients that suffer from pre-existing diseases. The benefit is not limited to a certain number of family members for those eligible and those listed under the scheme can receive treatment even outside Manipur. Those eligible have the benefit of receiving treatment at all listed public and private hospitals.

Eligibility of the Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Listed below are the eligibility criteria of the Pradhan Mantri Jan Arogya Yojana (PM-JAY):

  • All members that belong to the SECC are eligible to receive healthcare coverage.
  • The Pradhan Mantri Jan Arogya Yojana (PM-JAY) does not come with an age limit, or the number of members in a family that can be covered.

Coverage of the Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Listed below are the benefits and the coverage of the Pradhan Mantri Jan Arogya Yojana (PM-JAY) healthcare scheme:

  • All families residing in the state of Manipur and categorised under SECC will receive an annual sum assured of Rs.5 lakh for hospitalisation and medical expenses.
  • The Pradhan Mantri Jan Arogya Yojana (PM-JAY) covers tertiary care and secondary hospitalisation expenses.
  • The Pradhan Mantri Jan Arogya Yojana (PM-JAY) offers coverage for more than 2,500 healthcare packages.
  • The coverage of the Pradhan Mantri Jan Arogya Yojana (PM-JAY) healthcare scheme includes the cost of medicines, both medical and daycare treatments, diagnostic expenses, hospitalisation, and pre-hospitalisation and post-hospitalisation expenses.
  • The Pradhan Mantri Jan Arogya Yojana (PM-JAY) also offers coverage for pre-existing diseases.
  • The Pradhan Mantri Jan Arogya Yojana (PM-JAY) covers the cost of cancer treatments, neonatal surgery, paediatric fees, congenital disorders, daycare procedures, maternal expenses, etc.

What is not covered under the Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Listed below are the exclusions of the Pradhan Mantri Jan Arogya Yojana (PM-JAY):

  • Any sort of cosmetic treatments.
  • Outpatient hospital care.
  • Treatment for drug rehabilitation.
  • Coverage for organ transplants.
  • Coverage for fertility treatments.

Documents required for the Pradhan Mantri Jan Arogya Yojana (PM-JAY) healthcare scheme

In order to receive coverage under the Pradhan Mantri Jan Arogya Yojana (PM-JAY), one will have to submit the following documents at the hospital:

  • Ration card.
  • Aadhaar card.
  • Driving License.
  • Voter ID card.
  • PAN card.

Steps to receive the benefit of the Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Listed below are the steps needed to be followed to receive benefits under the Pradhan Mantri Jan Arogya Yojana (PM-JAY):

  • In order to be insured, the individual has to first verify his/her eligibility with the Aarogya Mitra. The individual has to submit his identification proof such as an Aadhaar card, Ration Card, or any other Government ID card to the Aarogya Mitra.
  • Based on the details in one’s ID card, the Aarogya Mitra will verify the application to be benefited under the scheme.
  • Following the verification, the beneficiary will be saved under the ‘Golden Record PM-JAY verified beneficiary’, and the beneficiary will receive an e-card for no cost.
  • For treatment and coverage of expenses, the beneficiary will have to contact the Aarogya Mitra at the Ayushman Bharat counter at any of the empanelled hospitals.
  • The beneficiary has to then submit his e-card and follow up with the process of registering the patient.
  • If the treatment is covered under the scheme, then a cashless settlement will be made.

List of hospitals under the Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Members from the SECC families can visit any of the below-listed hospitals to receive coverage for treatments and hospitalisation:

District Hospital
Imphal West Sky Hospital & Research Centre
Imphal West Raj Medicity
Imphal West Shija Hospitals
Thoubal-Kakching District Jivan Hospital
Chandel District Chandel District Hospital
Imphal East JNIMS Hospital
Churachandpur District Churachandpur District Hospital
Ukhrul District Ukhrul District Hospital
Imphal West District RIMS Hospital
Bishnupur District Bishnupur District Hospital
Thoubal District Thoubal District Hospital
Imphal West District Tamenglong District Hospital
Senapati District Senapati District Hospital

All the beneficiaries that have been verified by the Aarogya Mitra will have the benefit of being covered for various treatments and health packages up to a sum of Rs.5 lakh. The beneficiary will have the benefit of the cashless facility to cover for medical and hospitalisation expenses.

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