“Mahatma Jyotirao Phule Jan Arogya Yojana” (MJPJAY) is a medical health insurance scheme carried out by the federal government of Maharashtra, India. The scheme was formally also referred to as Rajiv Gandhi Jeevandayee Arogya Yojana.
The principle goal of this scheme is to supply monetary help and high quality healthcare to the economically weak sections of society in Maharashtra. It goals to cowl the medical bills of eligible households for sure specified therapies and procedures.
Key options of the Mahatma Jyotirao Phule Jan Arogya Yojana embrace:
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Protection: The scheme covers numerous medical and surgical therapies for beneficiaries at empanelled hospitals.
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Eligibility: Eligibility is based totally on socioeconomic standards. Households falling below particular revenue classes are eligible for the scheme.
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Cashless Transactions: Underneath this scheme, beneficiaries can avail of cashless therapy at community hospitals.
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Empanelled Hospitals: A community of presidency and personal hospitals are empanelled to supply providers to beneficiaries.
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Identification: Beneficiary households are issued a “Rashtriya Swasthya Bima Yojana” (RSBY) card or an “MJPJAY” card to avail of the advantages.
The target of that is to supply cashless high quality medical care to beneficiaries below the scheme for catastrophic diseases requiring hospitalisation for surgical procedures and therapies below recognized speciality providers by a community of healthcare suppliers.
Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY) was launched by the Authorities of India on twenty third September 2018. AB-PMJAY was launched in Maharashtra in integration with Mahatma Jyotirao Phule Jan Arogya Yojna and was carried out in blended Insurance coverage and Assurance Mode.
The Built-in Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) and Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) have been launched within the state on 1st April 2020. United India Insurance coverage Firm Restricted (a Public sector Endeavor Firm) is offering medical health insurance protection to beneficiaries below the insurance coverage mode and the State Well being Assurance Society offers protection in assurance mode.
Mahatma Jyotirao Phule Jan Arogya Yojana is totally funded by the Authorities of Maharashtra. Pradhan Mantri Jan Arogya Yojana is collectively funded by the Authorities of India and the Authorities of Maharashtra in a ratio of 60:40.
What’s Coated Underneath the MJPJAY?
MJPJAY beneficiary will get the advantage of 996 Medical and Surgical procedures with 121 follow-up procedures.
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Surgical procedures: The scheme covers the price of numerous surgical procedures, together with cardiac surgical procedures, neurosurgeries, most cancers surgical procedures, organ transplants, and so forth.
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Medical Remedies: It consists of protection for medical therapies akin to chemotherapy, radiotherapy, dialysis, and so forth.
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Maternity Companies: MJPJAY offers protection for maternity providers, together with regular supply and C-sections.
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Neonatal Care: The scheme extends protection for neonatal intensive care and associated therapies.
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Pre-Present Ailments: In sure instances, pre-existing illnesses can also be lined, topic to scheme pointers.
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Hospitalisation Bills: The bills associated to hospitalisation, room costs, and different medical amenities through the therapy interval are usually lined.
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Comply with-up Care: The scheme could cowl post-operative follow-up care and coverings.
Sr.No. |
Specialised Class |
1 |
Burns |
2 |
Cardiology |
3 |
Cardiovascular and Thoracic surgical procedure |
4 |
Essential Care |
5 |
Dermatology |
6 |
Endocrinology |
7 |
ENT surgical procedure |
8 |
Common Medication |
9 |
Common Surgical procedure |
10 |
Haematology |
11 |
Infectious illnesses |
12 |
Interventional Radiology |
13 |
Medical Gastroenterology |
14 |
Medical Oncology |
15 |
Neonatal and Paediatric Medical Administration |
16 |
Nephrology |
17 |
Neurology |
18 |
Neurosurgery |
19 |
Obstetrics and Gynaecology |
20 |
Ophthalmology |
21 |
Orthopaedics |
22 |
Paediatric Surgical procedure |
23 |
Paediatric Most cancers |
24 |
Plastic Surgical procedure |
25 |
Polytrauma |
26 |
Prosthesis and Orthosis |
27 |
Pulmonology |
28 |
Radiation Oncology |
29 |
Rheumatology |
30 |
Surgical Gastroenterology |
31 |
Surgical Oncology |
32 |
Urology (Genitourinary Surgical procedure) |
33 |
Psychological issues |
34 |
Oral and Maxillofacial Surgical procedure |
It’s vital to stress that the protection and advantages can fluctuate, and there could be particular limitations, exclusions, and circumstances below the MJPJAY. The eligible therapies and procedures are typically listed within the official scheme paperwork or on the official web site of the Maharashtra authorities’s well being division.
Options and Advantages
Listed here are among the key options and advantages of the scheme:
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Well being Insurance coverage Protection: MJPJAY offers 1.5 lakh medical health insurance protection yearly for your complete household. The scheme goals to cut back the monetary burden of medical bills for eligible beneficiaries.
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Cashless Therapy: Underneath the MJPJAY, beneficiaries can avail of cashless therapy at empanelled hospitals. They don’t have to pay upfront for the lined therapies; the bills are instantly settled between the hospital and the scheme authorities.
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In depth Community of Hospitals: The scheme has a community of presidency and personal hospitals empanelled to supply medical providers to beneficiaries. These hospitals are outfitted to supply high quality healthcare providers.
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Complete Therapy Protection: The MJPJAY covers a variety of medical therapies, together with consultations, diagnostics, therapy, surgical procedures & medicines. It goals to cowl numerous important diseases and procedures.
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No Age Restrict: Not like another medical health insurance schemes, the MJPJAY doesn’t have an higher age restrict for beneficiaries. It covers people of all age teams who meet the eligibility standards.
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Household Protection: The scheme covers your complete household, together with the first beneficiary, partner, and dependent kids. The protection extends to all eligible members of the family below the identical coverage.
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Pre-Present Ailments: In sure instances, the MJPJAY could cowl pre-existing illnesses, topic to scheme pointers. This offers a big profit to people with current well being circumstances.
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Simple Entry to Healthcare: By offering monetary assist and free check-ups, the MJPJAY ensures that eligible beneficiaries have quick access to healthcare amenities when wanted.
Eligibility Standards
The eligibility standards for the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) or the Maharashtra Well being Scheme can fluctuate based mostly on particular classes of beneficiaries. The scheme primarily targets economically weak households in Maharashtra and goals to supply them with entry to high quality healthcare.
Listed here are the overall eligibility standards for MJPJAY:
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Residence: The first requirement is that the beneficiary have to be a resident of the state of Maharashtra. The scheme applies solely to the residents of Maharashtra. Households that fall within the categorized recognized distressed districts of Maharashtra.
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Socioeconomic Standards: The eligibility is decided based mostly on socioeconomic classes. Households falling below particular revenue classes are eligible for the scheme. The revenue standards could fluctuate now and again, and completely different classes could have completely different revenue ceilings.
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Occupation-Primarily based Eligibility: The scheme additionally extends protection to sure occupational classes, akin to farmers, unorganised employees, building employees, and so forth., no matter their revenue.
Households with a yellow, orange and white ration card from the next districts are eligible-
Washim, Yavatmal, Parbhani, Wardha, Osmanabad, Nanded, Latur, Jalna, Beed, Hingoli, Buldhana, Akola, Aurangabad & Amravati.
Classes |
Description of Beneficiaries |
Class A |
All eligible households shall be recognized with legitimate Yellow, Orange, Antyodaya, and Annapurna ration playing cards (no matter the date of concern of the Ration Card or the inclusion of the beneficiary’s title therein) coupled with any Picture ID proof (as finalised by the Society). |
Class B |
Eligibility for farmers from 14 agriculturally distressed districts of Maharashtra shall be determined based mostly on a white ration card with 7/12 extract bearing the title of the beneficiary/head of the household or certificates from the closest Income Officer stating that the beneficiary is a farmer or a member of the family of a farmer with legitimate picture ID proof of the beneficiary. |
Class C |
The eligibility of beneficiaries shall be determined based mostly on any id card/well being card or some other identification mechanism as determined by the State Well being Assurance Society (SHAS). |
How To Apply For Mjpjay
For Mjpjay Registration or to get the Mahatma Jyotirao Phule Jan Arogya Yojana card, the applicant must strategy the close by Common, Ladies/District/Community hospital. Arogyamitra, who’s the consultant of the scheme, shall facilitate getting the well being card.
For Mjpjay On-line Utility these steps have to be followed-
Step 1: Go to the official web site of Mahatma Jyotirao Phule Jan Arogya Yojana at www.jeevandayee.gov.in.
Step 2: On the homepage, click on on the “New Registration” possibility.
Step 3: It is going to be directed to the appliance kind web page. Fill out the shape with all of the related particulars, and scan and add the required certificates.
Step 4: Present the required info, together with the applicant’s title, father/husband’s title, date of start, gender, and different related particulars. Add the required paperwork as instructed.
Step 5: As soon as the shape has been accomplished and the paperwork are uploaded, click on on the “Submit” button to finalise the appliance and full the enrollment course of.
Paperwork Required
Underneath PMJAY, members from households registered below the Social, Financial and Caste Census, 2011 (SECC) are eligible for getting advantages in all empanelled hospitals by displaying computerised e-cards and picture id playing cards. Beneficiaries of PMJAY from any state having an e-card and picture id proof can avail of therapy at any empanelled hospital of some other state.
The candidates have to submit the next paperwork together with the checklist of legitimate Picture Id proof-
1. Aadhaar Card / Aadhaar Registration Slip with a photograph of the beneficiary. Aadhaar Card could be insisted upon as an identification doc and within the absence of an Aadhaar card/quantity; any doc which is accepted for issuance of an Aadhaar card may also be accepted.
2. Pan Card
3. Voter Id
4. Driving License
5. College/Faculty Id
6. Passport
7. Freedom Fighter ID Card
8. Well being Card of RGJAY / MJPJAY
9. Handicap Certificates
10. Nationalised Financial institution Passbook with Picture
11. Senior citizen card issued by Central Authorities or State Authorities
12. Protection ex-servicemen card issued by Sainik Board
13. Marine Fishery Id card (Issued by Ministry of Agriculture / Fisheries Division Authorities of Maharashtra).
14. Any picture ID proof issued by the Authorities of Maharashtra/ Authorities of India
Declare Procedures
The declare procedures for the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) or the Maharashtra Well being Scheme typically contain the next steps:
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Hospitalisation: If the applicant or a member of the family lined below MJPJAY requires hospitalisation for a lined therapy or process, they need to go to an empanelled hospital authorised below the MJPJAY scheme.
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Verification of Eligibility: On the hospital, the affected person’s eligibility for MJPJAY shall be verified utilizing the MJPJAY card or distinctive identification quantity issued throughout enrollment. The hospital may also confirm that the therapy or process is roofed below the scheme.
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Pre-Authorisation: For sure high-cost therapies or procedures, the hospital could have to get hold of pre-authorisation from the MJPJAY authorities earlier than continuing with the therapy. The hospital will submit the required medical paperwork and therapy particulars to hunt pre-authorisation.
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Submit-Therapy Formalities: After the completion of the therapy, the hospital will put together and submit the required declare paperwork and payments to the MJPJAY authorities for declare reimbursement.
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Declare Processing: The MJPJAY authorities will evaluate the submitted declare paperwork and confirm the therapy particulars. They’ll assess the declare’s validity and test whether or not it complies with the scheme’s pointers.
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Declare Settlement: Upon approval, the eligible quantity shall be reimbursed to the empanelled hospital for the lined therapy or process. The reimbursement shall be made by the MJPJAY authorities.
Hospital Record
The Mjpjay Hospital Record is split by district and might be discovered on the official web site.
The empanelled Hospitals below the Scheme embrace each Authorities and Personal hospitals. Authorities Hospitals embrace Hospitals from Public Well being Division, Medical Training and analysis division, Hospitals from Municipal Firms and Municipality. The utmost variety of Authorities and Personal Hospitals shall be 1000.
Authorities and Personal Hospitals, each multi-speciality and single-speciality, might be empanelled as per the requirement and instructions of the Coordination Empanelment and Disciplinary Committee chaired by the Chief Govt Officer of the State Well being Assurance Society. For multi-speciality Personal hospitals, there are standards of a minimal of 30 beds with ICU (with sure relaxations), whereas for single-speciality hospitals 10 beds and different standards shall be relevant.
MJPJAY Toll-Free Quantity and Deal with
Mjpjay Contact Quantity and deal with are beneath –
The ESIC Hospital, Third Ground
Ganpat Jadhav Marg, Close to Worli Naka
Worli, Mumbai 400018
Toll-Free: 18002332200
Conclusion
In conclusion, the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) is a big healthcare initiative carried out by the federal government of Maharashtra, India. The scheme goals to supply monetary help and high quality healthcare to economically weak households throughout the state. By providing cashless therapy for numerous medical procedures and coverings, MJPJAY helps alleviate the burden of medical bills on beneficiaries, particularly throughout important diseases and emergencies.
The MJPJAY’s key options, akin to an in depth community of empanelled hospitals, protection for a variety of therapies, no higher age restrict for beneficiaries, and household protection, make it a complete and inclusive healthcare scheme. The enrollment course of permits eligible people to avail themselves of the advantages by assembly particular socioeconomic standards and submitting crucial paperwork.
Furthermore, MJPJAY’s declare procedures streamline the reimbursement course of, making certain that beneficiaries obtain the monetary assist required for his or her medical therapies promptly.
Ketto Crowdfunding
Ketto is a crowdfunding platform that goals to deliver donors collectively by a typical portal which is straightforward to entry. The aim is to gather funds for these in want of medical help. Ketto acts as a medium that assists in elevating cash for healthcare throughout India.
To take action one ought to start by creating an account on their web site. As soon as logged in, click on on “Begin a Fundraiser” and supply particulars concerning the medical emergency, together with the affected person’s title, situation, required therapy, and different related info. Set a practical fundraising aim that covers the bills, and add compelling photos and movies associated to the scenario. Share the marketing campaign by social media, e-mail, and private networks to succeed in a wider viewers. Usually replace the marketing campaign web page with progress experiences and milestones. Maintain supporters knowledgeable concerning the affected person’s progress and specific gratitude for his or her contributions.