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Ayushman Bharat PM

The document discusses Ayushman Bharat PM-JAY, the largest government-funded healthcare program in the world. It provides an annual health coverage of Rs. 500,000 per family for secondary and tertiary care to over 100 million low-income families. Services covered include over 1,300 medical and surgical procedures as well as pre-and post-hospitalization costs. Eligibility is based on deprivation criteria for rural families and occupational categories for urban families. The program aims to reduce out-of-pocket healthcare expenditures and mitigate poverty due to medical costs in India.

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Abhijit Mundale
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0% found this document useful (0 votes)
264 views18 pages

Ayushman Bharat PM

The document discusses Ayushman Bharat PM-JAY, the largest government-funded healthcare program in the world. It provides an annual health coverage of Rs. 500,000 per family for secondary and tertiary care to over 100 million low-income families. Services covered include over 1,300 medical and surgical procedures as well as pre-and post-hospitalization costs. Eligibility is based on deprivation criteria for rural families and occupational categories for urban families. The program aims to reduce out-of-pocket healthcare expenditures and mitigate poverty due to medical costs in India.

Uploaded by

Abhijit Mundale
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Ayushman Bharat PM-JAY is the largest health assurance scheme in the world which

aims at providing a health cover of Rs. 5 lakhs per family per year for secondary and
tertiary care hospitalization to over 10.74 crores poor and vulnerable families
(approximately 50 crore beneficiaries) that form the bottom 40% of the Indian
population.  PM-JAY is fully funded by the Government and cost of implementation is
shared between the Central and State Governments.

Services include approximately 1,393 procedures covering all the costs related to
treatment, including but not limited to drugs, supplies, diagnostic services, physician's
fees, room charges, surgeon charges, OT and ICU charges etc.

 Medical examination, treatment and consultation


 Pre-hospitalization
 Medicine and medical consumables
 Non-intensive and intensive care services
 Diagnostic and laboratory investigations
 Medical implantation services (where necessary)
 Accommodation benefits
 Food services
 Complications arising during treatment
 Post-hospitalization follow-up care up to 15 days

 PM-JAY has been designed in such a way that there is no cap on family size or age of
members.
 India spends only 21 per cent of its total health expenditure from the general
Government revenue and as high as 62 per cent of total health expenditure is out-of-
pocket (Source: National Health Accounts, 2015). Increasing health care needs coupled
with high out-of-pocket expenditure is a leading cause of poverty in India.
Rural Beneficiaries

Out of the total seven deprivation criteria for rural areas, PM-JAY covered all
such families who fall into at least one of the following six deprivation criteria (D1 to D5 and
D7) and automatic inclusion (Destitute/ living on alms, manual scavenger households, and
primitive tribal group, legally released bonded labour) criteria:

 D1- Only one room with kucha walls and kucha roof
 D2- No adult member between ages 16 to 59
 D3- Households with no adult male member between ages 16 to 59
 D4- Disabled member and no able-bodied adult member
 D5- SC/ST households
 D7- Landless households deriving a major part of their income from manual casual
labour

Urban Beneficiaries
For urban areas, the following 11 occupational categories of workers are
eligible for the scheme:

 Ragpicker
 Beggar
 Domestic worker
 Street vendor/ Cobbler/hawker / other service provider working on streets
 Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard/
Coolie and other head-load worker
 Sweeper/ Sanitation worker/ Mali
 Home-based worker/ Artisan/ Handicrafts worker/ Tailor
 Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart puller/
Rickshaw puller
 Shop worker/ Assistant/ Peon in small establishment/ Helper/Delivery assistant /
Attendant/ Waiter
 Electrician/ Mechanic/ Assembler/ Repair worker
 Washer-man/ Chowkidar
Process of hospital empanelment in PM-JAY

The following incentives are being provided under PM-JAY to the hospitals over and above
the package rates

 At the time of empanelment a hospital need not be NABH accredited but if during
the course of association with PM-JAY a hospital attains entry level NABH accreditation,
it is paid 10 per cent higher package rates. Similarly, the hospital attaining a full
accreditation is paid 15 percent higher.
 Hospitals attached to teaching institutions (medical, PG and DNB courses) are
entitled for 10 per cent higher packages.
 Also, to promote the hospitals to reach out to the beneficiaries in underserved areas,
PM-JAY has come up with 10% higher package rates for hospitals which are situated in
aspirational districts.

The package rate (in case of surgical or defined day-care benefits) includes:

 Registration charges
 Bed charges (General Ward)

 Nursing and Boarding charges

 Surgeons, Anaesthetists, Medical Practitioner, Consultants’ fees, etc.

 Anaesthesia, Blood Transfusion, Oxygen, O.T. Charges, Cost of Surgical Appliances,


etc.
 Medicines and Drugs

 Cost of Prosthetic Devices, implants (unless payable separately)

 Pathology and radiology tests: radiology to include but not be limited to X-ray, MRI,
CT Scan, etc. (as applicable)
 Food to patient

 Pre and Post Hospitalisation expenses: Expenses incurred for consultation, diagnostic
tests and medicines before the admission of the patient in the same hospital, and up to
15 days of the discharge from the hospital for the same ailment/ surgery
 Any other expenses related to the treatment of the patient in the EHCP

How to apply online for Ayushman Bharat Yojana?


 Here is a step by step guide how you can apply for Ayushman Bharat Yojana.
 Step 1: Visit Ayushman Bharat Pradhan Mantri Jan Arogya Yojana official
website, mera.pmjay.gov.in.
 Step 2: Now you have to log on to the government website.
 Step 3: On the home page enter your mobile number.
 Step 4: Just below that you will see the captcha, enter the captcha in the empty box.
 Step 5: After that click on Generate OTP option.
 Step 6: An OTP number will be sent to your mobile, by which you can go to the
website and verify.
People from caste of ST/NT and people from below poverty level got surveyed in 2011 census and
based on this census government made a list of beneficiaries of this scheme. So this list remains with
talathi in every gram-panchayat. So these Aasha workers help the talathi to reach out these people
and they help them to get the smart card (PM-JAY card). For every card aasha workers provide to
these people, they get certain amount of commission. This commission varies from area to area. As
the procedure to get the card is by applying online through the PM-JAY portal, most of the
beneficiaries won’t able to get these benefits. So aasha workers help them to get the cards through
these online portals. For every card they provide to these people they get around 100 rs
commission. Each person gets Rs. 5 lac per annum as the medical insurance so these people can use
this money only in selected hospitals.

Hospital District

1 Uttar Pradesh HOSP9P21000 Aditya Maternity & Nursing Home

2 Uttar Pradesh HOSP9P07412 Ahuja Hospital

3 Uttarakhand HOSP5P02907 Ali Nursing Home

4 Chhattisgarh HOSP22P00596 Ambika Hospital


Hospital District

5 Maharashtra HOSP27P99289 Anand nursing home

6 Jharkhand HOSP20P11789 Anand sewa sadan

7 Jharkhand HOSP20P18643 Anand sewa sadan

8 Jharkhand HOSP20P14902 Anand sewa sadan

9 Uttar Pradesh HOSP9P03632 Ansari Nursing Home

10 Maharashtra HOSP27P12152 Apulki Vairagade Hospital

11 Jharkhand HOSP20P15416 Arogyam hospital and surgical centre

12 Uttarakhand HOSP5P02118 Arogyam Medical College & Hospital

13 Jharkhand HOSP20P07559 Aryan Hospital

14 Maharashtra HOSP27P79245 Ashwini Hospital, Akluj

15 Maharashtra HOSP27P42794 Asian Citicare superspecialty hospital

16 Maharashtra HOSP27P99284 Aster Aadhar hospital

17 Uttarakhand HOSP18P68069 Astha Hospital

18 Jharkhand HOSP20P11363 AZIZI HOSPITAL

19 Uttar Pradesh HOSP9G71446 B D Janta Hospital

20 Maharashtra HOSP27P99301 Basarge Hospital

21 Uttar Pradesh HOSP9P23291 Bhagyashree Hospital

22 Jharkhand HOSP20P16141 BISHRAMAPUR MEDICARE HOSPITAL

23 Uttarakhand HOSP5P01962 Brijesh Hospital


Hospital District

24 Uttar Pradesh HOSP9P06011 Canoosa Hospital

25 Maharashtra HOSP27P99307 CENTRAL AVENUE CRITICAL CARE HOSPITAL

26 Uttar Pradesh HOSP9P73816 Centre For Neuroscience & Trauma Centre

27 Maharashtra HOSP23P82256 CHANDAK HOSPITAL

28 Uttar Pradesh HOSP9P04855 Chandra Hospital

29 Uttar Pradesh HOSP9P00894 Chandra Mother & Eye Care Pvt ltd

30 Maharashtra HOSP27P79277 Chirayu Hospital

31 Maharashtra HOSP27P09580 City Care Hospital

32 Maharashtra HOSP22P93458 CITY HOSPITAL

33 Uttarakhand HOSP5P00781 Complete Medical Institute

34 Tamil Nadu HOSP33P19032 Darshan Surgical Centre, Tiruvallur

35 Tamil Nadu T_1819312074 DEEPAM EYE HOSPITAL PH ROAD, CHENNAI

36 Uttarakhand HOSP5P23031 DEVKI NANDAN HOSPITAL

37 Uttar Pradesh HOSP9P01315 Dhanvantri Superspecilality

38 Jharkhand HOSP20P21919 Dr. C K Minz Hospital

39 Uttar Pradesh HOSP9P05132 Dr. Santosh Shani Hospital

40 Uttar Pradesh HOSP9P04107 Dr. Hansraj Memorial Hospital

41 Maharashtra HOSP27P79154 DR.NAVARE HOSPITAL

42 Maharashtra HOSP27P79199 Dr.Sushila Nayar Hospital, Utawali


Hospital District

43 Uttar Pradesh HOSP9P54720 Drishti Eye Foundation

44 Uttar Pradesh HOSP9P29070 Eye Max Eye Hospital

45 Maharashtra HOSP27P79070 F.J.F.M. Hospital & Community Health Unit

46 Maharashtra HOSP27P92574 G. T. Padole Hospital

47 Maharashtra HOSP27P79175 Gajanan Hospital & Critical care centre

48 Uttar Pradesh HOSP9P08649 Galexy Hospital

49 Maharashtra HOSP27P09211 Ganesh hospital

50 Maharashtra HOSP27P79284 GANGA CARE HOSPITAL

51 Uttarakhand HOSP5P47957 Garibo Ka Hospital

52 Maharashtra   Get well Dialysis Centre

53 Maharashtra HOSP27P79021 GLOBAL 5 HEALTH CARE

54 Maharashtra HOSP27P79258 Godrej Memorial Hospital

55 Tamil Nadu T_1819339890 GUILD OF SERVICE BALAVIHAR,AUTISM, THI

56 Chhattisgarh HS22008031 Gupta Hospital

57 Jharkhand HOSP20P10649 Happy Clinic

58 Jharkhand HOSP20P13508 HEALTH CARE HOSPITAL

59 Uttar Pradesh HOSP9P07647 Heart Lungs And Critical Care Centre

60 Maharashtra HOSP27P79141 HIRACHAND MUNOT MEMORIAL CRITICARE

61 Uttar Pradesh HOSP9P74555 IMS Hospital & Trauma Centre


Hospital District

62 Tamil Nadu HOSP33P19051 Iswarya Fertility Ctr And Womens Hospital

63 Uttar Pradesh HOSP9P04035 J P Hospital

64 Maharashtra HOSP27P99285 Jagdale Mama Hospital,Barshi

65 Jharkhand HOSP20P10732 Jai Maa Jowhariya Hospital

66 Uttar Pradesh HOSP9P07392 Jain Medical Centre & Lazer Eye Hospital

67 Tamil Nadu T_1819311792 JANAKI ENT NURSING HOME

68 Uttarakhand HOSP5P04721 Jansewa Hospital

69 Uttar Pradesh HOSP9P56061 Janta Hospital

70 Uttarakhand HOSP5P86358 Jaspur Metro Hospital

71 Maharashtra HOSP27P99295 Jaya urology hospital

72 Uttarakhand HOSP5P03202 Jeevan Jyoti Hospital

73 Uttar Pradesh HOSP9P02213 K K Jain

74 Tamil Nadu HOSP33P19301 K R Hospital, Dindigul

75 Maharashtra HOSP27P99300 Kai. Shantabai Arali multispecialty hospital

76 Maharashtra HOSP27P79092 Kalyan Cancer Center

77 Tamil Nadu HOSP33P19501 Kamala Hospital

78 Uttar Pradesh HOSP9P04891 Khadra Hospital

79 Uttar Pradesh HOSP9P05144 Khere Surgical & Maternity Centre

80 Uttar Pradesh HOSP9P04934 King Hospital


Hospital District

81 Maharashtra HOSP27P99293 Kolhapur kidney

82 Maharashtra HOSP27P79084 Kolte Hospital

83 Maharashtra HOSP27P99306 Konark hospital

84 Tamil Nadu HOSP33P19495 Kovilpatti Venkateswara Hospitals,Tuticorin

85 Uttarakhand HOSP5P73665 Krishan Hospital

86 Jharkhand HOSP20G68511 Lalita hospital

87 Jharkhand HOSP20P10575 LIFELINE HOSPITAL

88 Jharkhand HOSP20P12539 Long Life Hospital

89 Uttar Pradesh HOSP9P01565 Lucknow Hospital

90 Tamil Nadu Not applied M.V. HOSPITAL FOR DIABETES

91 Jharkhand HOSP20P16692 MAA GULABI SEWA SADAN

92 Jharkhand HOSP20P08098 MAA TARA SEWA CLINIC

93 Tamil Nadu T_1819342590 MAANAVOO SPL SCHOOL AND REHAB CTR,AU

94 Tamil Nadu T_1819310468 MADHU SCAN CENTRE

95 Maharashtra HOSP27P99297 Mahalaxmi Hrudayalay pvt ltd (Shri Sai Cardia

96 Uttar Pradesh HOSP9P01990 Mall Maternity Centre

97 Maharashtra HOSP27P78991 MATRUCHHAYA HOSPITAL

98 Maharashtra HOSP27P99296 Mazi Maay Multispecialty Hospital

99 Uttar Pradesh   Medaxis Hospital


Hospital District

100 Uttar Pradesh HOSP9P08890 Medison Hospital Pvt Ltd

101 Uttar Pradesh HOSP9P01106 Medox hospital

102 Jharkhand HOSP20P58942 Mehar Jeevan Nursing Home & Dental Hospita

103 Uttar Pradesh HOSP9P36429 Mehta mellinium Hospital

104 Maharashtra HOSP27P99304 MGM Hospital Research Centre belapur

105 Maharashtra HOSP27P78960 MHAISALKAR SHINDE HOSPITAL

106 Uttar Pradesh HOSP9P01044 Mimhans Hospital

107 Maharashtra HOSP27P99302 Morya hospital

108 Uttar Pradesh HOSP9P02172 Mother Care Children Hospital

109 Uttarakhand HOSP5P03110 MP Memorial Hopsital

110 Uttar Pradesh HOSP9P04620 ONGC Hospital

111 Tamil Nadu HOSP33P19054 Orthomed Hospital Pvt Limited

112 Maharashtra HOSP27P78955 Ozone Multispeciality Hospital & Critical Care


( Unit Of VNRN Health Services PVT.LTD. )

113 Uttar Pradesh HOSP9P50925 P N Hospital

114 Tamil Nadu HOSP33P19065 Padma Clinic and Nursing Home

115 Maharashtra HOSP27P78915 PATTANSHETTI HOSPITAL

116 Maharashtra HOSP27P78901 PIOS HOSPITAL

117 Maharashtra HOSP27P99290 Platina Hospital


Hospital District

118 Uttar Pradesh HOSP9P04940 Prabhakar Hospital

119 Uttarakhand HOSP9P67620 Priya Hospital

120 Himachal Pradesh HS02010020 Puran Hospital Paonta Sahib

121 Maharashtra HOSP27P79259 R.G. Stone

122 Maharashtra HOSP27P70262 Radhakrishan Hospital & Research Institute

123 Jharkhand HOSP20P10577 RAJPATISEWA ASHRAM

124 Maharashtra HOSP27P79003 RAUT HOSPITAL, ACCDENT, FRACTURE, MUL

125 Maharashtra HOSP27P79007 RAVIDEEP HEART CARE CENTER

126 Uttar Pradesh HOSP9P14286 Riyaz Orthopadic Hospital

127 Tamil Nadu HOSP33P19061 RMD Specialities Hospital

128 Uttar Pradesh HOSP9P03612 S/ K D Hospital

129 Uttarakhand HOSP5P28592 Sahota Super Speciality Hospital

130 Maharashtra HOSP27P79171 Sahyadri accidental and neurocare center

131 Maharashtra HOSP27P78942 Sahyadri Specialty Hospital

132 Maharashtra HOSP27P79224 Sai Asian Hospital

133 Maharashtra HOSP27P79134 Sai siddhi multispeciality hospital yeola

134 Maharashtra HOSP27P79281 Sai Vilayatrai Sai Jiwatsingh Sai Vishindas Cha

135 Maharashtra HOSP27P99298 SARASWATI EDUCATION SOCIETYS RAIGAD H

136 Maharashtra HOSP27P78994 Saykhedkar Hospital & Research Center Pvt L

137 Maharashtra HOSP27P79090 Sengupta Hospital and Research Institute


Hospital District

138 Uttar Pradesh HOSP9P04433 Shalimar Hospital

139 Uttar Pradesh HOSP9P01383 Sharma Nursing Home

140 Jharkhand HOSP20P18617 SHASHI SWASTHYA SANSTHAN

141 Uttarakhand HOSP5P00849 Shed Hospital

142 Maharashtra HOSP27P79296 SHIVAM NURSING HOME

143 Uttar Pradesh HOSP9P06754 Shivam Nursing Home

144 Uttarakhand HOSP5P07664 Shree Eye Care

145 Uttar Pradesh HOSP9P67252 Shree Hospital

146 Uttar Pradesh HOSP9P07493 Shreshtha Netra Chikitsalaya

147 Uttar Pradesh HOSP9P11401 Shrestha Netra Chikitsalaya

148 Uttar Pradesh HOSP9P07318 Shri Guru Prasad Memorial Hospital

149 Jharkhand HOSP20P15117 SHRI LILAWATI HOSPITAL

150 Uttar Pradesh HOSP9P61728 Shri Mahaveer Netra Nursing Home

151 Maharashtra HOSP27P79184 Shri Markandey Solapur Sahakari Rugnalaya a

152 Uttarakhand HOSP5P88082 Shri Sita Ram Dharmarth Hospital

153 Maharashtra HOSP27P78923 SHRI. YOGIRAJ HOSPITAL, PEDIATRIC CARE U

154 Himachal Pradesh HS02002075 Sood Nursing Home Nagrota Bagwan

155 Maharashtra HOSP9P01446 SPARSH HOSPITAL

156 Jharkhand HOSP20P07975 SPS HOSPITAL


Hospital District

157 Tamil Nadu T_1819312875 ST.JOSEPH HOSPITAL, PORUR

158 Tamil Nadu T_1819348899 STEPPING STONES REHAB CENTRE, AUTISM

159 Tamil Nadu T_1819310685 SUGAM CLINIC

160 Maharashtra HOSP27P99283 Sushrisha hospital

161 Maharashtra HOSP27P79268 Suyash Hospital Managed By Suyash Clinic

162 Maharashtra HOSP27P99291 Synergy Hospital And Research Centre

163 Uttar Pradesh HOSP9P04929 Tanisha Medical Centre

164 Maharashtra HOSP27P78920 TAWDE HOSPITAL

165 Maharashtra HOSP27P79096 THE SALVATION ARMY EVANGELINE BOOTH

166 Tamil Nadu HOSP33P18914 Tosh Hospital

167 Tamil Nadu HOSP33P19429 V V R HOSPITAL

168 Tamil Nadu T_1819314403 Vasan Eye Care Hospital Hosur

169 Tamil Nadu HOSP33P18916 Vasan Eye Care Saidapet

170 Uttarakhand HOSP5P00700 Vinod Ortho Clinic

171 Uttarakhand HOSP5P06413 Vohara Mother and Child Hospital, Dehradun

172 Andhra Pradesh   S/V Hospital

173 Jharkhand   PVTG Ramgarh

174 Maharashtra   Balaji Hospital

175 Maharashtra   Bhagawati Hospital Borivali


Hospital District

176 Maharashtra   Chopda medicare & research centre pvt ltd.

177 Maharashtra   Indira Gandhi Memorial Hospital

178 Maharashtra   M/ T/ Agarwal Hospital, Mulund (W)

179 Maharashtra   Maxcare Hospital

180 Maharashtra   Panacea Hospital

181 Maharashtra   Patil Orthopedic Hospital

182 Maharashtra   PES Hospital

183 Maharashtra   Radiance Hospital

184 Maharashtra   S/ L/ Raheja Hospital, Mahim

185 Maharashtra   S/V/D/ Sawarkar Hospital Mulund (E)

186 Maharashtra   Sahyadri, Karve road

187 Maharashtra   Sevenhills Healthcare Pvt Ltd

188 Maharashtra   Shree Markanday Hospital

189 Maharashtra   Shree Yogiraj hospital, Pediatric Care Unit &


Critical Care Centre, Chikhali

190 Maharashtra   SRCC Childrens Hospital - Managed by Naraya

191 Maharashtra   SUB DIST HOSPITAL SHIRPUR DHULE

192 Maharashtra   SUB Distict Hospital Mukhed

193 Maharashtra   Tawade Hospital


Hospital District

194 Maharashtra   Zenith critical Care Hospital

195 Uttarakhand   Astha Hospital, Kahsiput, USN

196 Tamil Nadu T_1819337347 Posh-Pondy Ortho Speciality Hospital, Cuddal

197 Tamil Nadu T_181938472 Bharat Scans, Tirunelveli DC.

198 Tamil Nadu   Lucia tstl mdle scl Mntly Rtrd,Autism

199 Tamil Nadu T_1819312257 ABHIRAMI HOSPITAL, Cuddalore

200 Tamil Nadu T_1819310199 Sundaram Arulraj Hospital

201 Uttarakhand   Priya Hospital

202 Jharkhand HOSP20P14902 Surya Clinic

203 Himachal Pradesh HS02011035 Civil Hospital KOTGARH

204 Himachal Pradesh HOSP02011045 Ayurvedic Hospital Rohru

205 Himachal Pradesh HS02011034 Civil Hospital JUNGA

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