No. All eligible beneficiaries can avail free services for secondary and tertiary hospital care for identified packages under PM-JAY at public hospitals and empaneled private hospitals. Beneficiaries will have cashless and paperless access to health services under PM-JAY.
PM-JAY is an entitlement based mission. There is no enrolment process. Families who are identified by the government on the basis of deprivation and occupational criteria using the SECC database both in rural and urban areas are entitled for PM-JAY.
The beneficiaries are identified based on the deprivation categories (D1, D2, D3, D4, D5, and D7) identified under the SECC (Socio-Economic Caste Census) database for rural areas and 11 occupational criteria for urban areas. In addition, RSBY beneficiaries in states where RSBY is active are also included.
In this phase, no additional new families can be added under PM-JAY. However, names of additional family members can be added for those families whose names are already on the SECC list.
A dedicated PM-JAY family identification number will be allotted to eligible families. Additionally, an e-card will also be given to beneficiary at the time of hospitalization.
At the time of admission to the hospital, beneficiaries should carry ration card or any other government recognized photo identity document like Aadhaar etc.
The scheme will have portability of benefits across the country. Beneficiary can avail services all across the implementing States/UTs. You can call helpline number 14555 for details.
The scheme will subsume the functional RSBY schemes – Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
A well-defined three tier complaint and grievance redressal mechanism will be in place. This includes constitution of various committees, use of electronic, mobile platform, an All-India helpline number 14555 internet as well as social media. Robust safeguards to prevent misuse/fraud/abuse by providers and users will also be in place.
Dr. Indu Bhushan serves as the Chief Executive Officer (CEO) of Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB - PMJAY) and the National Health Authority (NHA), Government of India.