PMJAY Eligibility

on
July 21, 2023

PMJAY, or Pradhan Mantri Jan Arogya Yojana, is a health insurance scheme launched by the Government of India to provide financial protection against high medical costs for economically vulnerable individuals and families. As per the Ayushman Bharat eligibility, PMJAY primarily targets economically vulnerable households. Families with up to 5 members have PMJAY eligibility.

However, there is no restriction on the family size for families that qualify based on the "deprivation" or "automatic" categories of the SECC database, which include categories such as manual scavengers, primitive tribal groups, and legally released bonded labourers. You need to check these details according to the Ayushman Bharat card eligibility.

To be eligible for Ayushman Bharat Yojana, applicants need to meet certain criteria laid out by the government.

How to Check Ayushman Bharat Yojana Eligibility Online on Govt. Portal

Individuals can check their eligibility for PMJAY by visiting the official website of Ayushman Bharat or through offline methods.

Online Method
You can check your Ayushman Bharat eligibility check online by following these steps:

  • Visit the official website of Ayushman Bharat Yojana - https://www.pmjay.gov.in/.
  • Click on the "Am I Eligible" tab on the homepage.
  • Enter your mobile number and captcha code on the next page and click the "Generate OTP" button.
  • Enter the OTP received on your mobile number and click the "Verify OTP" button.
  • On the next page, you must provide basic details such as name, state, age, family members, and income details.
  • After filling in all the details, click the "Submit" button.

If you are eligible for Ayushman Bharat Yojana, the website will display a message indicating the same, along with details of your eligible benefits. If you are not eligible for the scheme, the website will explain why you are not eligible. Thus, you can go for the Ayushman Bharat card eligibility check, and you will get to know all the information. You will understand the complete process if you carefully check Ayushman's card eligibility.

Offline Method

You can also check your PMJAY eligibility offline by visiting the nearest Common Service Centre (CSC). You will need to provide all the necessary documents required for the Ayushman Bharat eligibility check, and the CSC operator will help you check your eligibility.

If you are eligible for the scheme, you can proceed to register and get your Ayushman Bharat card. The registration process is simple and easy; all you need to do is fill in the Ayushman Bharat registration form with relevant information. Once your application is successfully processed, you will receive the Ayushman Bharat card, which can be used to avail of benefits under the scheme.

PMJAY Eligibility Criteria for Rural People (PMJAY Rural)

Before applying, you must know the Ayushman Bharat Yojana eligibility for rural people. The beneficiaries under PMJAY are identified through the SECC database, a comprehensive survey conducted by the government to identify households living in rural areas based on their socioeconomic status. Families that fall under the following categories are eligible:

  • Families live in only one room with kutcha walls and a roof.
  • Families with no adult members between the ages of 16 and 59.
  • Female-headed households with no adult male members between 16 and 59.
  • Families have at least one disabled member and no non-disabled adult member.
  • SC/ST households.
  • Landless households derive a major part of their income from manual casual labour.

Deprivation Criteria: PMJAY also considers deprivation criteria to determine eligibility for rural beneficiaries. These criteria include:

  • Families with no adult member who is literate or has completed 10 years of education.
  • Families with no adult member who is gainfully employed (government or private sector job, self-employment).
  • Families with no adult member who owns a motorised 2/3/4 wheeler or mechanised farming equipment.
  • Families with no member who owns a refrigerator.
  • Families with no member who owns a landline or mobile phone.

Once you know the eligibility for Ayushman card, you can apply under the scheme and enjoy all the benefits.

PMJAY Eligibility Criteria for Urban People (PMJAY Urban)

It is always best to check Ayushman Bharat card eligibility for urban families, and then only you will know whether you are coming in that category. Urban families falling under any of the following categories come under the Ayushman card eligibility criteria:

  • Families living in one-room makeshift houses with no proper walls or roofs.
  • Families are living in dilapidated houses.
  • Families without adult members aged 16 to 59 years.
  • Families headed by a single woman with no adult male member aged 16 to 59 years.
  • Families with disabled members and no non-disabled adult members.
  • Families are living on alms.
  • Manual scavenger families.
  • Primitive tribal groups.
  • Homeless families.

Beneficiaries must provide valid identification documents such as an Aadhaar card or any other government-issued identification document to establish their identity and eligibility. Also, the beneficiaries must be enrolled in the PMJAY program through the designated enrollment process, including filling out the application form and providing the necessary information. You must carefully review the Ayushman Bharat scheme eligibility to know every detail.

Who is not eligible to avail of coverage under the Ayushman Bharat Yojana?

According to the official guidelines of Ayushman Bharat Yojana, the following persons are not eligible to claim insurance under this scheme:

  1. Central and state government employees and their family members who are entitled to medical care under another scheme.
  2. A person whose income exceeds the established eligibility criteria.
  3. Individuals who own automobiles, mechanical fishing boats, farm equipment, and individuals who hold xanx credit cards exceeding certain limits.
  4. Those who have a refrigerator or landline phone.
  5. Individuals owning irrigated land exceeding 2.5 hectares or non-irrigated land exceeding 5 hectares.
  6. Individuals who have family members who pay income tax.
  7. Individuals hospitalized for procedures not covered by the scheme.
  8. Those who have been hospitalized for more than 15 consecutive days.

It is important to note that the eligibility criteria may vary slightly from state to state in India as implementation of the program is done by each state government.

Conclusion

It's important to note that the eligibility criteria for PMJAY may vary slightly from state to state as implementation is done at the state level. Therefore, it's recommended to check with the local authorities or the official PMJAY website for the most up-to-date and accurate information on eligibility for the scheme. PMJAY is a targeted scheme to provide health insurance coverage to economically vulnerable families in urban and rural areas of India.

The eligibility criteria may vary depending on the guidelines issued by the government and implementing agencies at enrollment. It is recommended to check the latest guidelines and requirements from the official PMJAY website or the designated PMJAY enrollment centres for accurate and up-to-date information.

FAQs

Is PMJAY available for all individuals in India?
PMJAY is available to eligible individuals and families who are identified as per the SECC database and meet the specified criteria. It does not cover all individuals in India but is targeted towards providing health insurance coverage to economically deprived and vulnerable families.

Can I avail of PMJAY benefits if I have a pre-existing medical condition?
Yes, PMJAY covers pre-existing medical conditions. Families with one or more members suffering from specified diseases, such as cancer, cardiovascular diseases, kidney diseases, etc., are eligible for PMJAY benefits. However, it's important to note that PMJAY covers only specified diseases and procedures as listed in the scheme and not all medical conditions.

Can I avail of PMJAY benefits if I have health insurance from another source?
PMJAY is a government-funded health insurance scheme designed to provide coverage to individuals and families who do not have access to health insurance from other sources. However, if you have health insurance from another source, you may still be eligible for PMJAY benefits if you meet the criteria, such as socioeconomic deprivation, presence of specified diseases, and recent hospitalization for specified procedures.