The Maharashtra government introduced the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) to provide free access to good medical care to all ration cardholders in the state. The fundamental purpose of this healthcare program is to provide disadvantaged and vulnerable people with free medical care.

What is the MJPJAY (Mahatma Jyotiba Phule Jan Arogya Yojana)?

The Maharashtra state government launched the MJPJAY with the goal of providing free and high-quality medical care to low-income households. Through an established network of health care professionals, the system provides free medical treatment, particularly for specialty services that need hospitalization for consultations, procedures, and therapies. Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) was the name given to it when it was first introduced.

With a sum insured amount of Rs.1,50,000 per family every year, the MJPJAY would cover all medical expenses incurred by the beneficiary while he or she is hospitalized. Through cashless hospitalization, an individual or a family can obtain an annual coverage of Rs.1,50,000.

What does the Mahatma Jyotiba Phule Jan Arogya Yojana cover?

The Mahatma Jyotiba Phule Jan Arogya Yojana covers around 971 therapies, surgeries, and procedures, as well as 121 follow-up packages in 30 specialized categories. These are some of them:

  • General surgery
  • ENT surgery,
  • Obstetrics surgery,
  • Cardiac and cardiothoracic surgery,
  • Ophthalmology surgery,
  • Pediatric surgery
  • Radiation surgery, plastic surgery, and so on.
  • The government has set aside 132 procedures for empanelled government hospitals or government medical institutes to perform.
  • The maximum cost of a kidney transplant is Rs.2,50,000.
  • Post-hospitalization consultations and medications are covered for up to 10 days from the date of discharge.

What Isn’t Included in the scheme?

Except for the planned 131 procedures such as vaginal or abdominal hysterectomy, hernia, cholecystectomy, appendectomy, discectomy, and others, all acceptable medical care will be provided under the scheme. These procedures will be performed only at government empaneled hospitals or government medical colleges.

The Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) has the following features and benefits:

The following are the key characteristics of the MJPJAY:

  • The Maharashtra State Government is responsible for health insurance coverage and premiums.
  • Per family, the sum covered is Rs.1,50,000 per year.
  • The plan can be used by a single person or as a family floater.
  • Surgical procedures, tests, drugs, and follow-up consultations and treatment are all covered.
  • From the start, all pre-existing conditions are covered.
  • Several private hospitals are mentioned in addition to government-run institutions.
  • Health camps held in government-run hospitals are available.

Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) Benefits:

People from BPL and APL families can benefit from the MJPJAY program in a variety of ways.

The following are some of the scheme’s advantages:

  • It contains 971 different surgeries, therapies, and procedures in 30 different categories.
  • It comprises 121 different types of follow-up procedures divided into 30 different groups.
  • Only government-approved hospitals and medical schools will be able to perform the 132 government-reserved operations.
  • The upper limit for a renal transplant is Rs.2,50,000.

The following is a list of diseases and treatments covered by MJPJAY:

The system covers all pre-existing diseases from the start; the following is a list of diseases and treatments covered by the MJPJAY:

  • Surgery in general
  • Ophthalmology Surgery
  • ENT Surgery
  • Obstetrics and Gynecology Surgery
  • Gastroenterology Surgical
  • Procedures and Surgery in Orthopedics

Mahatma Jyotiba Jan Arogya Yojana (MJPJAY) Eligibility:

The Mahatma Jyotiba Jan Arogya Yojana (MJPJAY) has the following qualifying criteria:

  • Families who live in the state of Maharashtra’s identified distressed districts.
  • Should possess a White, Orange, or Yellow Ration Card, as well as an Antyodaya Anna Yojana Card (AAY) or an Annapurna Card.
  • Farmers from Amaravati, Aurangabad, Akola, Buldhana, Hingoli, Beed, Jalna, Latur, Nanded, Osmanabad, Wardha, Parbhani, Yavatmal, and Washim are among those affected.
  • The 7/12 extract, their White Ration Card, and the name of the recipient or the head of the family, or a certificate from the concerned Patwari or Talathi, are used to identify farmers from these agriculturally impoverished regions.

How to enroll for the Mahatma Jyotiba Jan Arogya Yojana (MJPJAY)?

The following is the procedure for enrolling in the Maharashtra MJPJAY scheme:

  • Step 1: Individuals or families should go to a nearby Network/District/Women/General hospital and meet Arogyamitra to start the scheme application.
  • Step 2: If you go to a Government Health Facility, you will be given a referral card, which you can show to the Network Hospital together with the preliminary diagnosis made by the doctors at the Government Health Facility.
  • Step 3: You may also acquire the referral card by attending one of the Network Hospital’s Health Camps.
  • Step 4: The reference card, as well as your Yellow or Orange Card, must be shown. Instead of a ration card, you can show your Antyodaya or Annapurna Card.
  • Step 5: Once you’ve provided the above information, the diagnostic and follow-up will begin.
  • Step 6: You will be admitted to the Network Hospital based on the diagnosis.
  • Step 7: The insurance company will get an E-authorization request, which will be examined by the MJPJAY as well.
  • Step 8: The insurance company’s medical specialists and MJPJAY will assess the authorization request and authorize it if all conditions are met. This authorization will be completed within 24 hours, and in the event of an emergency, it will be completed quickly if the authorization is indicated as “EM.”
  • Step 9: Once your authorization has been approved, you will be able to get cashless treatment or hospitalization.
  • Step 10: The hospital will give the insurance company all of the original bills, diagnostic reports, discharge summary, and other applicable evidence in order to settle the claim.
  • Step 11: After reviewing the paperwork, the insurance company will approve the claim and provide the funds to the hospital.
  • Step 12: For up to 10 days after release, the network hospital will provide free consultations, medicines, and tests under the scheme.

To apply for the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY), the following documents are required:

You must present any of the following KYC documents in addition to your ration card (Orange/Yellow/White) for identification purposes:

  • Pan Card
  • Driving License
  • Aadhar Card
  • Voter ID
  • Handicap Certificate
  • Pan Card
  • Driving License
  • Aadhar Car
  • Voter ID
  • Handicap Certificate
  • Nationalized Bank Passbook with Photograph
  • School/College ID
  • In metropolitan regions, stamps and signatures of government local bodies/Tahsildars on the applicant’s photograph
  • In rural areas, the stamp and signature of the Tahsildar on the applicant’s photograph.
  • Passports
  • Freedom Fighter ID card
  • Senior citizen card issued by central and state government Of India
  • Any picture ID evidence issued by the Maharashtra/Indian governments.
  • Defense ex-service card issued by the Sainik board.
  • Identification card for Marine Fishers.

If the name and photo of a newborn kid are not accessible on the card or on a valid Yellow or Orange Ration card, submit the child’s photograph with either of the parents, as well as the White/Orange/Yellow ration card and the child’s birth certificate.

How to Apply for Mahatma Jyotiba Jan Arogya Yojana Card Online?

You must go to a nearby General, Women’s/District/Network hospital to apply for or receive the Mahatma Jyotiba Jan Arogya Yojana card. Arogyamitra, who is the scheme’s agent, will assist you in obtaining a health card.

Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) Claim Procedures:

The MJPJAY scheme’s claim procedure is as follows:

  • Step 1: To determine the condition, a diagnostic is made.
  • Step 2: Treatment will begin as soon as the pre-authorization from the insurance provider is acquired if the diagnosis is made in a network hospital.
  • Step 3: If the diagnosis is not performed in a network hospital, the Arogyamitra will issue a referral card allowing the patient to begin treatment at the impaneled hospital.
  • Step 4: The online mode will be used by the network hospital to get e-authorization from the insurance provider.
  • Step 5: The impanelled hospital will begin treatment after acquiring authorization from the insurance company.
  • Step 6: Once the therapy and operation are completed, the hospital will provide all essential paperwork to the insurance company, including medical bills, diagnostics, and discharge summaries.
  • Step 7: The insurance company verifies all pertinent paperwork and approves the claim settlement.
  • Step 8: For up to 10 days after release, the network hospital will provide consultations, diagnostics, and medications.

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