Mahatma Jyotiba Phule Jan Arogya Yojana - How to Apply , Eligibility & Benefits

Mahatma Jyotiba Phule Jan Arogya Yojana - How to Apply, Eligibility & Benefits: The State Government of Maharashtra has launched the Mahatma Jyotiba Phule Jan Arogya Yojana, a healthcare coverage Scheme. Originally, it was referred to as the Rajiv Gandhi Jeevandayee Arogya Yojana. The programme seeks to provide affordable, high-quality medical care to those living at or just above the poverty line.

Mahatma Jyotiba Phule Jan Arogya Yojana

This health insurance scheme also covers surgical procedures and the associated consultation and hospitalisation costs. The MJPJAY scheme was first introduced in July 2012. It was only applicable in 08 Maharashtra districts. In November 2015, the scheme became operational in all 35 districts. Since then, anyone with a proper ID can get free health care at network hospitals.

 

Eligibility Criteria of MJPJAY

To be eligible for the Mahatma Jyotiba Phule Jan Arogya Yojana, a person must meet the following requirements:

 
1) Individual candidates must have yearly incomes less than Rs.1 lakh.
2) Benefits from the Mahatma Jyotiba Phule Jan Arogya Yojana can also be used by the applicant's family.
3) Any family interested in registering must come from one of Maharashtra's designated economically depressed areas.
4) Farmers in areas of Maharashtra struggling with farming can also sign up for this insurance policy.


Once you have met the eligibility standards outlined above, you must provide specific documents to support your claims.

 

Documents required

Here is a list of all the required documents you must submit to qualify for the MJPJAY scheme. Any of the following photo IDs for KYC: 

1) Aadhaar card
2) PAN card
3) Passport
4) Driving license
5) Voter ID
6) Marine Fisher's ID card
7) Defense ex-service card
8) College or school ID
9) Senior citizen card
10) Bank passbook with photograph
11) Freedom fighter ID card
12) Handicap certificate

Other photographic identification documents issued by the Maharashtra State Government or the Central Government of India. You can also show a yellow, orange, or white ration card that is still good.

To register a child born after the issuance of a health card, an official birth certificate, a photo with either parent, and the yellow, orange, or white ration card of the parent must be issued.

After verifying your eligibility and collecting all Mahatma Jyotiba Phule Jan Arogya Yojana documents, you may proceed with the registration procedure.

 

Benefits & Features of MJPJAY

1) 1.5 lakh Every year, coverage is given to the whole family.
2) Coverage for pre-existing illnesses started on Day 1.
3) Checkups for health problems are free at government hospital camps.
4) Covers the cost of appointments, tests, care, surgeries, and medicines.
5) Coverage is given to each person and each family.
6) Good medical treatment at both private and government centres that are approved.
7) The State Government is responsible for paying the fee.

What is Covered in the MJPJAY

1) 971 medical procedures.
2) Listed therapies
3) Listed surgeries
4) Radiation surgery
5) Ophthalmology surgery
6) Paediatric surgery
7) 121 follow-ups
8) Cardiac surgery
9) Gynaecology
10) Obstetrics surgery
11) ENT surgery
12) General surgery
13) Cardiothoracic surgery
14) Renal transplant up to Rs 2.5 lakh
15) Post-hospitalization expenses up to 10 days
16) Plastic surgery
17) Orthopaedic surgery

How to Enroll Under the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY)?

The enrollment procedure for the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) is outlined below:

1) Applicants can start the registration process by meeting with the Aarogyamitra at the nearest district, general, network, or women's hospital.
2) You will be provided with a health card to be presented to a network institution participating in the recommended. Treatment plan.
3) Then you have to show your orange or yellow ration card or your Annapurna Card if you don't have a ration card.
4) A request for electronic authorization will be sent to the insurance provider, and MJPJAY will assess the request.
5) As soon as the verification is complete, the cashless treatment will begin.
6) The hospital will submit the original invoices and supporting documentation to the insurer for the claim processing. After reviewing the patient's medical records and approving the claim, the hospital will issue payment.

Also, the network hospital gives free doctor visits, medicines, and tests for 10 days after a patient leaves.

 

Steps to Apply for Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) Card

To apply for a Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) card, visit the nearest government health facility, where the MJPJAY scheme's representative, Aarogyamitra, will assist you. The Aarogyamitra will help you get the Mahatma Phule Jan Arogya Yojana (MPJAY) Card.

 

Claim Process for MJPJAY

You can file a claim under Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) by following the steps below: 

1) A diagnosis is performed to determine the condition. 

2) If the diagnosis is made in a network hospital, treatment will commence immediately after obtaining preauthorization from the insurance provider.
3) If the diagnosis is not made in a network hospital, Arogyamitra will provide a referral certificate so that the patient can begin treatment at an empanelled hospital.
4) The insurance provider will provide the network hospital with online e-authorization.
5) After the hospital receives the authorization letter from the insurance company, the treatment will begin.
6) After treatment is concluded, the hospital will provide the insurance company with all pertinent documents, including medical invoices, discharge summaries, and diagnostics.
7) The insurance company will initiate document verification.
8) Once the verification is complete, the insurer will authorise the claim payment.

 

Mahatma Jyotiba Phule Jan Arogya Yojana - How to Apply, Eligibility & Benefits