With the rise in health issues during the coronavirus era, it is crucial to have access to free and quality medical care. Mahatma Jyotiba Phule Jan Arogya Yojana offers free medical care especially specialty services that require hospitalisation for consultations, surgeries, and therapies through an identified network of health care providers. It was initially launched with the moniker Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY).
The MJPJAY shall provide coverage for meeting all expenses for medical care during hospitalisation of the beneficiary with a sum insured amount of Rs.1,50,000 per family per year. The annual coverage of Rs.1,50,000 can be availed by an individual or the entire family through cashless hospitalisation.
The Features of MJPJAY are:
- The premium charges and medical insurance cover is provided by the Government of Maharashtra.
- The sum insured limit is ₹1.5 lakhs per year.
- The scheme is available on an individual as well as on a family floater basis.
- There is no such waiting period for pre-existing diseases.
- Provides cover for surgeries, follow-up treatment, diagnosis, and medications.
- Beneficiaries have access to one free medical camp per year.
- The network hospital list is mentioned on the official website of State Health Assurance Society.
- In addition to government hospitals, there are many private hospitals included in the list of network hospitals.
Eligibility for MJPAY:
Families belonging to any of the 36 districts of Maharashtra and holding Yellow Ration Card, Antyodaya Anna Yojana Card (AAY), Annapurna Card and Orange Ration Card along with Farmers from 14 agriculturally distressed districts of Maharashtra (Amravati, Akola, Aurangabad, Buldhana, Beed, Hingoli, Jalna, Nanded, Latur, Osmanabad, Parbhani, Wardha, Washim and Yavatmal) are eligible under MJPJAY. The identification for farmers from 14 agriculturally distressed districts of Maharashtra will be based on White Ration Card. This would be done along with 7/12 extract bearing the name of the beneficiary/head of the family or certificate from the concerned Talathi / Patwari. This should state that the beneficiary is a farmer or a family member of the farmer with a valid photo ID proof of the beneficiary.
The Benefits of MJPJAY are:
- The scheme covers 971 types of surgeries/procedures/therapies in 30 identified specialized categories.
- The scheme covers 121 types of follow-up procedures in 30 identified specialized categories.
- The 132 Government Reserved Procedures are to be performed only in impaneled government hospitals or government medical colleges.
- The upper ceiling for Renal Transplant is ₹2,50,000 per operation.
Coverage of MJPAY:
- Orthopedic surgery and procedures, general surgery, ENT surgery, gynecology and obstetrics surgery, cardiac and cardiothoracic surgery, ophthalmology surgery, pediatric surgery, radiation surgery, plastic surgery, etc.
- Consultation and medicines post-hospitalisation is covered for up to 10 days from the date of discharge.