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Understanding Mahatma Jyotirao Phule Jan Arogya Yojana


“Mahatma Jyotirao Phule Jan Arogya Yojana” (MJPJAY) is a medical health insurance scheme carried out by the federal government of Maharashtra, India. The scheme was formally often known as Rajiv Gandhi Jeevandayee Arogya Yojana.

The principle goal of this scheme is to supply monetary help and high quality healthcare to the economically susceptible sections of society in Maharashtra. It goals to cowl the medical bills of eligible households for sure specified therapies and procedures.

Key options of the Mahatma Jyotirao Phule Jan Arogya Yojana embrace:

  1. Protection: The scheme covers varied medical and surgical therapies for beneficiaries at empanelled hospitals.

  2. Eligibility: Eligibility is based totally on socioeconomic standards. Households falling underneath particular earnings classes are eligible for the scheme.

  3. Cashless Transactions: Underneath this scheme, beneficiaries can avail of cashless remedy at community hospitals.

  4. Empanelled Hospitals: A community of presidency and personal hospitals are empanelled to supply providers to beneficiaries.

  5. Identification: Beneficiary households are issued a “Rashtriya Swasthya Bima Yojana” (RSBY) card or an “MJPJAY” card to avail of the advantages.

The target of that is to supply cashless high quality medical care to beneficiaries underneath the scheme for catastrophic diseases requiring hospitalisation for surgical procedures and therapies underneath recognized speciality providers via a community of healthcare suppliers.

Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY) was launched by the Authorities of India on twenty third September 2018. AB-PMJAY was launched in Maharashtra in integration with Mahatma Jyotirao Phule Jan Arogya Yojna and was carried out in combined Insurance coverage and Assurance Mode.

The Built-in Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) and Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) had been launched within the state on 1st April 2020. United India Insurance coverage Firm Restricted (a Public sector Enterprise Firm) is offering medical health insurance protection to beneficiaries underneath the insurance coverage mode and the State Well being Assurance Society supplies protection in assurance mode.

Mahatma Jyotirao Phule Jan Arogya Yojana is totally funded by the Authorities of Maharashtra. Pradhan Mantri Jan Arogya Yojana is collectively funded by the Authorities of India and the Authorities of Maharashtra in a ratio of 60:40.


What’s Coated Underneath the MJPJAY?

MJPJAY beneficiary will get the good thing about 996 Medical and Surgical procedures with 121 follow-up procedures.

  1. Surgical procedures: The scheme covers the price of varied surgical procedures, together with cardiac surgical procedures, neurosurgeries, most cancers surgical procedures, organ transplants, and so on.

  2. Medical Therapies: It consists of protection for medical therapies similar to chemotherapy, radiotherapy, dialysis, and so on.

  3. Maternity Providers: MJPJAY supplies protection for maternity providers, together with regular supply and C-sections.

  4. Neonatal Care: The scheme extends protection for neonatal intensive care and associated therapies.

  5. Pre-Present Ailments: In sure instances, pre-existing illnesses may additionally be lined, topic to scheme tips.

  6. Hospitalisation Bills: The bills associated to hospitalisation, room expenses, and different medical services through the remedy interval are sometimes lined.

  7. Comply with-up Care: The scheme could cowl post-operative follow-up care and coverings.

Sr.No.

Specialised Class

1

Burns

2

Cardiology

3

Cardiovascular and Thoracic surgical procedure

4

Crucial Care

5

Dermatology

6

Endocrinology

7

ENT surgical procedure

8

Basic Medication

9

Basic Surgical procedure

10

Haematology

11

Infectious illnesses

12

Interventional Radiology

13

Medical Gastroenterology

14

Medical Oncology

15

Neonatal and Paediatric Medical Administration

16

Nephrology

17

Neurology

18

Neurosurgery

19

Obstetrics and Gynaecology

20

Ophthalmology

21

Orthopaedics

22

Paediatric Surgical procedure

23

Paediatric Most cancers

24

Plastic Surgical procedure

25

Polytrauma

26

Prosthesis and Orthosis

27

Pulmonology

28

Radiation Oncology

29

Rheumatology

30

Surgical Gastroenterology

31

Surgical Oncology

32

Urology (Genitourinary Surgical procedure)

33

Psychological issues

34

Oral and Maxillofacial Surgical procedure

It’s necessary to emphasize that the protection and advantages can fluctuate, and there may be particular limitations, exclusions, and situations underneath the MJPJAY. The eligible therapies and procedures are typically listed within the official scheme paperwork or on the official web site of the Maharashtra authorities’s well being division.


 Options and Advantages

Listed below are a few of the key options and advantages of the scheme:

  1. Well being Insurance coverage Protection: MJPJAY supplies 1.5 lakh medical health insurance protection yearly for the complete household. The scheme goals to scale back the monetary burden of medical bills for eligible beneficiaries.

  2. Cashless Remedy: Underneath the MJPJAY, beneficiaries can avail of cashless remedy at empanelled hospitals. They don’t have to pay upfront for the lined therapies; the bills are immediately settled between the hospital and the scheme authorities.

  3. In depth Community of Hospitals: The scheme has a community of presidency and personal hospitals empanelled to supply medical providers to beneficiaries. These hospitals are geared up to supply high quality healthcare providers.

  4. Complete Remedy Protection: The MJPJAY covers a variety of medical therapies, together with consultations, diagnostics, remedy, surgical procedures & drugs. It goals to cowl varied vital diseases and procedures.

  5. No Age Restrict: Not like another medical health insurance schemes, the MJPJAY doesn’t have an higher age restrict for beneficiaries. It covers people of all age teams who meet the eligibility standards.

  6. Household Protection: The scheme covers the complete household, together with the first beneficiary, partner, and dependent youngsters. The protection extends to all eligible relations underneath the identical coverage.

  7. Pre-Present Ailments: In sure instances, the MJPJAY could cowl pre-existing illnesses, topic to scheme tips. This supplies a major profit to people with current well being situations.

  8. Straightforward Entry to Healthcare: By offering monetary help and free check-ups, the MJPJAY ensures that eligible beneficiaries have quick access to healthcare services when wanted.


Eligibility Standards

The eligibility standards for the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) or the Maharashtra Well being Scheme can fluctuate primarily based on particular classes of beneficiaries. The scheme primarily targets economically susceptible households in Maharashtra and goals to supply them with entry to high quality healthcare.

Listed below are the final eligibility standards for MJPJAY:

  1. Residence: The first requirement is that the beneficiary have to be a resident of the state of Maharashtra. The scheme applies solely to the residents of Maharashtra. Households that fall within the categorized recognized distressed districts of Maharashtra.

  2. Socioeconomic Standards: The eligibility is set primarily based on socioeconomic classes. Households falling underneath particular earnings classes are eligible for the scheme. The earnings standards could fluctuate once in a while, and completely different classes could have completely different earnings ceilings.

  3. Occupation-Based mostly Eligibility: The scheme additionally extends protection to sure occupational classes, similar to farmers, unorganised staff, building staff, and so on., no matter their earnings.

Households with a yellow, orange and white ration card from the next districts are eligible-

Washim, Yavatmal, Parbhani, Wardha, Osmanabad, Nanded, Latur, Jalna, Beed, Hingoli, Buldhana, Akola, Aurangabad & Amravati.

Classes

Description of Beneficiaries

Class A

All eligible households shall be recognized with legitimate Yellow, Orange, Antyodaya, and Annapurna ration playing cards (no matter the date of subject of the Ration Card or the inclusion of the beneficiary’s identify therein) coupled with any Picture ID proof (as finalised by the Society).

Class B

Eligibility for farmers from 14 agriculturally distressed districts of Maharashtra can be determined primarily based on a white ration card with 7/12 extract bearing the identify of the beneficiary/head of the household or certificates from the closest Income Officer stating that the beneficiary is a farmer or a member of the family of a farmer with legitimate photograph ID proof of the beneficiary.

Class C

The eligibility of beneficiaries shall be determined primarily based on any id card/well being card or another identification mechanism as determined by the State Well being Assurance Society (SHAS).


How To Apply For Mjpjay

For Mjpjay Registration or to get the Mahatma Jyotirao Phule Jan Arogya Yojana card, the applicant must method the close by Basic, Ladies/District/Community hospital. Arogyamitra, who’s the consultant of the scheme, shall facilitate getting the well being card.

For Mjpjay On-line Software these steps have to be followed-

Step 1: Go to the official web site of Mahatma Jyotirao Phule Jan Arogya Yojana at www.jeevandayee.gov.in.

Step 2: On the homepage, click on on the “New Registration” possibility.

Step 3: It will likely be directed to the appliance type web page. Fill out the shape with all of the related particulars, and scan and add the required certificates.

Step 4: Present the required data, together with the applicant’s identify, father/husband’s identify, date of beginning, gender, and different related particulars. Add the required paperwork as instructed.

Step 5: As soon as the shape has been accomplished and the paperwork are uploaded, click on on the “Submit” button to finalise the appliance and full the enrollment course of.


Paperwork Required

Underneath PMJAY, members from households registered underneath the Social, Financial and Caste Census, 2011 (SECC) are eligible for getting advantages in all empanelled hospitals by displaying computerised e-cards and photograph id playing cards. Beneficiaries of PMJAY from any state having an e-card and photograph id proof can avail of remedy at any empanelled hospital of another state.

The candidates have to submit the next paperwork together with the record of legitimate Picture Id proof-

1. Aadhaar Card / Aadhaar Registration Slip with a photograph of the beneficiary. Aadhaar Card could be insisted upon as an identification doc and within the absence of an Aadhaar card/quantity; any doc which is accepted for issuance of an Aadhaar card may also be accepted.
2. Pan Card
3. Voter Id
4. Driving License
5. College/School Id
6. Passport
7. Freedom Fighter ID Card
8. Well being Card of RGJAY /
MJPJAY
9. Handicap Certificates
10. Nationalised Financial institution Passbook with Picture
11. Senior citizen card issued by Central Authorities or State Authorities
12. Protection ex-servicemen card issued by Sainik Board
13. Marine Fishery Identification card (Issued by Ministry of Agriculture / Fisheries Division Authorities of Maharashtra).
14. Any photograph ID proof issued by the Authorities of Maharashtra/ Authorities of India


Declare Procedures

The declare procedures for the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) or the Maharashtra Well being Scheme typically contain the next steps:

  1. Hospitalisation: If the applicant or a member of the family lined underneath MJPJAY requires hospitalisation for a lined remedy or process, they need to go to an empanelled hospital authorised underneath the MJPJAY scheme.

  2. Verification of Eligibility: On the hospital, the affected person’s eligibility for MJPJAY can be verified utilizing the MJPJAY card or distinctive identification quantity issued throughout enrollment. The hospital may also confirm that the remedy or process is roofed underneath the scheme.

  3. Pre-Authorisation: For sure high-cost therapies or procedures, the hospital could have to get hold of pre-authorisation from the MJPJAY authorities earlier than continuing with the remedy. The hospital will submit the required medical paperwork and remedy particulars to hunt pre-authorisation.

  4. Submit-Remedy Formalities: After the completion of the remedy, the hospital will put together and submit the required declare paperwork and payments to the MJPJAY authorities for declare reimbursement.

  5. Declare Processing: The MJPJAY authorities will evaluate the submitted declare paperwork and confirm the remedy particulars. They’ll assess the declare’s validity and test whether or not it complies with the scheme’s tips.

  6. Declare Settlement: Upon approval, the eligible quantity can be reimbursed to the empanelled hospital for the lined remedy or process. The reimbursement can be made by the MJPJAY authorities.


Hospital Listing

The Mjpjay Hospital Listing is split by district and will be discovered on the official web site.

The empanelled Hospitals underneath the Scheme embrace each Authorities and Personal hospitals. Authorities Hospitals embrace Hospitals from Public Well being Division, Medical Schooling and analysis division, Hospitals from Municipal Companies and Municipality. The utmost variety of Authorities and Personal Hospitals can be 1000.
Authorities and Personal Hospitals, each multi-speciality and single-speciality, will be empanelled as per the requirement and instructions of the Coordination Empanelment and Disciplinary Committee chaired by the Chief Government Officer of the State Well being Assurance Society. For multi-speciality Personal hospitals, there are standards of a minimal of 30 beds with ICU (with sure relaxations), whereas for single-speciality hospitals 10 beds and different standards shall be relevant.


MJPJAY Toll-Free Quantity and Handle

Mjpjay Contact Quantity and deal with are beneath –

The ESIC Hospital, Third Ground
Ganpat Jadhav Marg, Close to Worli Naka
Worli, Mumbai 400018
Toll-Free: 18002332200


Conclusion

In conclusion, the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) is a major healthcare initiative carried out by the federal government of Maharashtra, India. The scheme goals to supply monetary help and high quality healthcare to economically susceptible households throughout the state. By providing cashless remedy for varied medical procedures and coverings, MJPJAY helps alleviate the burden of medical bills on beneficiaries, particularly throughout vital diseases and emergencies.

The MJPJAY’s key options, similar to an intensive community of empanelled hospitals, protection for a variety of therapies, no higher age restrict for beneficiaries, and household protection, make it a complete and inclusive healthcare scheme. The enrollment course of permits eligible people to avail themselves of the advantages by assembly particular socioeconomic standards and submitting needed paperwork.

Furthermore, MJPJAY’s declare procedures streamline the reimbursement course of, making certain that beneficiaries obtain the monetary help required for his or her medical therapies promptly.


Ketto Crowdfunding

Ketto is a crowdfunding platform that goals to convey donors collectively via a standard portal which is straightforward to entry. The objective is to gather funds for these in want of medical help. Ketto acts as a medium that assists in elevating cash for healthcare throughout India.

To take action one ought to start by creating an account on their web site. As soon as logged in, click on on “Begin a Fundraiser” and supply particulars concerning the medical emergency, together with the affected person’s identify, situation, required remedy, and different related data. Set a sensible fundraising objective that covers the bills, and add compelling pictures and movies associated to the state of affairs. Share the marketing campaign via social media, electronic mail, and private networks to succeed in a wider viewers. Usually replace the marketing campaign web page with progress stories and milestones. Hold supporters knowledgeable concerning the affected person’s progress and categorical gratitude for his or her contributions.

 

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