Oct 31, 2024
Those aged 70 years and above can now benefit from the expansion of the Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) regardless of income, a major shift in the govt policy. Earlier, only poor and vulnerable families and a few specific categories of workers, like ASHA staff, were eligible for the scheme that offers health cover of Rs 5 lakh per family per year for secondary and tertiary-care hospitalisation.
Anyone aged 70 years or above can apply for the Ayushman Bharat Senior Citizen Scheme on the website, www.beneficiary.nha.gov.in, or by using the Ayushman App (available for Android on the Google Play Store). Beneficiaries simply need to verify their identity and eligibility through Aadhaar e- KYC. Aadhaar serves as the primary document for confirming both the beneficiary’s age and state of residence and is the only document required to complete the registration process.
Yes. Family members can register the eligible an beneficiary through beneficiary login option on the mobile app and website. All they must do is to enter their mobile number and put in the OTP that’s generated to initiate the enrolment process. One can also visit the nearest empanelled hospital and get themselves enrolled.
AB PM-JAY is a completely cashless scheme, and govt sources said payments are made to hospitals against the treatment provided to eligible beneficiaries. Empanelled hospitals are mandated to offer cashless treatment to beneficiaries. One can lodge grievances on the AB PM-JAY website or through the national call centre ‘14555’, mail, letter, fax etc. Any complaint regarding denial of treatment by an empaneled hospital is to be seen as an SOS grievance and a ‘turn around time’ of 6 hours has been set for resolving it.
Such beneficiaries will have to re-initiate their Aadhaar based e-KYC via the website or mobile app to be registered as a beneficiary under the senior citizen scheme.
The list of empanelled hospitals for Ayushman Bharat PM-JAY scheme is available on the website www.dashboard.pmjay.gov.in. As of Sept 30, approximately 30,000 hospitals across the country are empanelled to provide benefits under the scheme, which is run overall by the National Health Authority. The list includes 190 leading corporate hospitals like Centre For Sight (Delhi), Medanta-The Medicity (Gurugram), Metro Hospital and Heart Institute (Noida), Fortis Escorts Hospital (Jaipur), Yashoda Super Speciality Hospital & Heart Institute (Ghaziabad), etc.
Public health and hospitals being a state subject under the Indian Constitution, state health agencies (SHAs) are mandated to empanel hospitals under Ayushman Bharat PM-JAY.
Beneficiaries can visit any empanelled hospital, present either their Ayushman card or their PMJAY ID to receive treatment. Before visiting, the beneficiary should confirm that the hospital is empanelled to treat the specific condition for which they require assistance.
Nearly all treatments covered by the scheme cost below Rs 2 lakh and, so, the Rs 5 lakh cover is sufficient to meet beneficiaries’ healthcare needs, govt sources said. Further, under the umbrella scheme of Rashtriya Arogya Nidhi (RAN), financial assistance up to Rs 15 lakh is provided to patients from poor families — who are eligible for PM-JAY — for availing those treatments that are not covered under PM-JAY. Hence, AB PM-JAY along with other central govt schemes can take care of hospitalisation needs of eligible beneficiaries.
No. With these states not implementing the scheme, elderly citizens cannot join or receive the benefits of AB PM-JAY
Source: Times Of India