Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) is a key health insurance initiative by the State Government Of Maharashtra. It is designed to provide health care services to poor people at no cost. Since health is a fundamental concern, this govt scheme also provides financial assistance for several forms of medical and surgical care. Beneficiaries can access these services in both government and private hospitals across Maharashtra, ensuring quality care without worrying about fees.

Scheme Name	Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY)
Launched By	Government of Maharashtra
Launch Date	July 2, 2012
Coverage	Up to ₹1,50,000 per family per year; ₹2,50,000 for renal transplants
Services	Cashless treatment in empanelled hospitals
Eligibility	Families with Yellow, Orange, AAY, and Annapurna ration cards
Official Website	www.jeevandayee.gov.in

What Is Mahatma Jyotirao Phule Jan Arogya Yojana?

Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) is a health insurance scheme for the economically weaker section in the state of Maharashtra. It provides cashless medical services for hospitalised patients. The aim is to ensure that individuals can access proper health care without worrying about the expenses.

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Feature

The Mahatma Jyotirao Phule Jan Arogya Yojana offers several key features that ensure comprehensive healthcare for beneficiaries:

• Cashless Treatment: All the treatments are provided free of charge.

• High Coverage: The schemes cover up to ₹ 1,50,000 per family year, with ₹2,50,000 for kidney transplants.

• Empaneled Hospitals: Beneficiaries can access services at both government and private hospitals across the state.

• Wide Range of Procedures: MJPJAY covers 996 healthcare procedures in 34 specialties.

• Free Follow-Up: Patients receive free medications and consultations for up to 10 days after surgery.

Objective

MJPJAY aims to protect below-poverty-line families from financial hardship caused by medical expenses. It covers more than 996 medical and surgical procedures making healthcare more affordable. This government scheme reduces the financial burden and improves the health of people in Maharashtra.

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Benefits

The benefits of the Mahatma Jyotirao Phule Jan Arogya Yojana make healthcare accessible and affordable for beneficiaries:

• Comprehensive Healthcare Coverage: The insurance scheme ensures quality healthcare by covering a range of medical and surgical treatments.

• Family Floater Benefit: The total coverage amount can be used by one or more family members.

• No Out-of-Pocket Expenses: Patients do not have to pay any charges for treatment at the hospital.

• Access to Specialised Care: The scheme covers specialised treatments in fields like cardiology, oncology, and neurology.

List Of Disease Coverage Under The Govt Scheme

MJPJAY covers a wide range of diseases and medical treatments, the list of which is mentioned below. Let us have a look at the disease list:

• Burns

• Cardiology & Cardiothoracic surgery

• Critical Care

• Endocrinology

• ENT surgery

• General Surgery

• Haematology

• Neurology & Neurosurgery

• Medical Oncology

• Nephrology

• Obstetrics & Gynecology

• Orthopedics

• Pediatric Surgery & Cancer

• Urology (Genitourinary Surgery)

• Mental Disorders

• Surgical Oncology

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List Of The Empaneled Hospitals

MJPJAY provides treatment in both government and private hospitals across Maharashtra. Some of the empanelled hospitals included are mentioned below, let us have a look.

District	Hospital Name	Type
Akola	Government Medical College and Hospital	Government
Pune	Ruby Hall Clinic	Private
Nagpur	Orange City Hospital	Private
Mumbai	Sion Hospital	Government
Aurangabad	MGM Hospital	Private

Eligibility Criteria

For the MJPJAY an individual must meet all of the specific eligibility criteria set for them. Let us have a look at them and check what requirements need to be met.

• The family must have a Yellow, Orange, Antyodaya, or Annapurna ration card.

• Farmers from distressed districts are eligible with a 7/12 extract or supporting documents from the nearest revenue officer.

• Orphaned children in government orphanages, senior citizens in old-age homes, and registered construction workers are also eligible.

Application Process

Enrolling under the Mahatma Jyotirao Phule Jan Arogya Yojana is a simple process, and the following steps should be followed:

Step 1: Visit the nearest empanelled network hospital or attend health camps organised by the scheme.

Step 2: Meet with the Aarogyamitra representative at the hospital, who will assist with the application process.

Step 3: Provide the required identification documents and a valid ration card.

Step 4: The hospital will then generate a health referral card for further treatment.

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How To Claim Insurance?

The claim procedure for the Mahatma Jyotirao Phule Jan Arogya Yojana is straightforward and involves the following steps, let us have a look.

Step 1: The Aarogyamitra will check your eligibility and register you for the necessary treatment.

Step 2: An e-pre authorisation request will be made to the insurer for his or her approval.

Step 3: Following approval, one can proceed with the recommended surgery or any other medical treatment without any prepayment.

Step 4: The hospital shall after treatment of the patient, file all the necessary papers to the insurer for settlement of the claims.

Documents Required

The list of documents that are required for the MJPJAY are mentioned below. Make sure you have all the documents ready before proceeding towards the application process.

• Aadhaar Card

• Valid Ration Card (Yellow/Orange/AAY/Annapurna)

• PAN Card/Voter ID/Driving License/Passport

• School/College Identity Card (if applicable)

• Handicap Certificate (if applicable)

• Nationalised Bank Fhash book with photo.

File A Complaint Under MJPJAY

If you encounter any issues with MJPJAY, you can file a complaint by following the below-mentioned steps to resolve your complaint or queries.

Step 1: Visit the official MJPJAY website or contact the nearest Aarogyamitra at an empanelled hospital.

Step 2: Fill out the complaint form with your details, the nature of the complaint, and hospital information.

Step 3: You can also reach the MJPJAY helpline at 1800-123-456 or email support@mjpjay.gov.in for assistance.

Conclusion

The Mahatma Jyotirao Phule Jan Arogya Yojana aims to provide free healthcare services to disadvantaged families in Maharashtra. The state government scheme covers a wide range of treatments, ensuring that beneficiaries don’t have to worry about medical expenses. With a large network of empanelled hospitals and a simple application process, MJPJAY has become a lifeline for many families in the state.

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Government Sources

Official website: https://www.jeevandayee.gov.in/

List of Hospitals: https://hospitals.pmjay.gov.in/Search/empnlWorkFlow.htm?actionFlag=ViewRegisteredHosptlsNew