Health Insurance 833 views January 15, 2021

Getting proper access to medical treatment can be a tough task for individuals coming from underprivileged and low-income sections of society. Keeping this in mind, the Government of Maharashtra launched Mahatma Jyotiba Phule Jan Arogya Yojana. This health insurance scheme will ensure top-class medical treatment facilities for low-income families, which will include hospitalization expenses, consultation, follow-up procedures, surgeries, therapies, etc. Earlier known as the Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY), this is a flagship health insurance scheme with which individuals can get cashless medical care through government and private hospitals.

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Want to know more about Mahatma Jyotiba Phule Jan Arogya Yojana? Here, we will discuss some important aspects, such as its key features, benefits, required documents, eligibility criteria, etc. Read on to know more!

Why Should Individuals Choose Mahatma Jyotiba Phule Jan Arogya Yojana?

Supervised by the Government of Maharashtra and State Health Assurance Society, Mahatma Jyotiba Phule Jan Arogya Yojana can be the savior of low-income families fighting against any medical emergency. But one would ask, what are those reasons that make this health insurance scheme so popular and beneficial among individuals? Well, we are discussing some of the key features of this plan below. Please check!

  1. One of the best features of this scheme is that the Government of Maharashtra bears the insurance coverage and premium charges for this health insurance plan. With this plan, families from low-income groups who cannot afford a Private Health Insurance scheme can get proper treatment during hospitalization.
  2. Most health insurance plans do not provide coverage for pre-existing diseases from day 1 of the policy. Individuals can get coverage after a certain waiting period. However, Mahatma Jyotiba Phule Jan Arogya Yojana provides coverage for pre-existing diseases from DAY 1 of your policy.
  3. Individuals can choose this scheme on an individual or a family floater basis according to their convenience. In the Family Floater Option, the sum insured will float equally among all the family members in the case of hospitalization while on choosing the Individual Basis, the sum insured will be provided to an individual only.
  4. This scheme from the Government of Maharashtra covers all the expenses related to surgeries, diagnostics, medications, follow-up consultations, and treatment. So, individuals do not need to worry about managing money in case of any medical emergency.
  5. Individuals who are eligible under this scheme will get access to one FREE medical camp per year. These Health check-up camps will be organized at the government-empaneled hospitals.
  6. With Mahatma Jyotiba Phule Jan Arogya Yojana, individuals can also enjoy a cashless treatment at several private hospitals apart from the government-administered hospitals in Maharashtra.

What is the Sum Insured with Mahatma Jyotiba Phule Jan Arogya Yojana?

Individuals often ask about the Sum Insured Amount when choosing a Health Insurance Plan. With the Mahatma Jyotiba Phule Jan Arogya Yojana, individuals can get cover for all expenses related to medical care during the hospitalization with a Sum Insured Amount of INR 1,50,000 per family per year. This amount can be taken either for an individual or an entire family depending on the choice.

What is Covered Under Mahatma Jyotiba Phule Jan Arogya Yojana?

It is important to know what treatments are covered under this scheme from the Government of Maharashtra. We are showing the same below. Please check!

  1. Mahatma Jyotiba Phule Jan Arogya Yojana covers 971 types of surgeries/procedures/therapies in 34 specified special categories. Other than this, individuals can also get coverage against 121 types of follow-up procedures.
  2. The government has specified a total of 131 procedures that will be performed only at empaneled government hospitals or government medical colleges.
  3. Coming to the consultations and medicine expenses after getting discharged from hospitals, the scheme will cover all expenses up to 10 days from the date of discharge.
  4. In case an individual needs to undergo a renal transplant operation, the upper limit for this procedure stands at INR 2,50,000 per family per policy year.
  5. Procedures like general surgery, ENT Surgery, pediatric surgery, surgical oncology, medical oncology, burns, critical care, cardiology, neurology, pulmonology, interventional radiology, etc are covered under this scheme from the Government of Maharashtra.

Eligibility Criteria for Mahatma Jyotiba Phule Jan Arogya Yojana

What are some of the important conditions that an individual needs to fulfill to get Mahatma Jyotiba Phule Jan Arogya Yojana? Well, you can know about them below. Check them out!

  1. All the families who are part of the 14 Identified Agriculturally Distressed Districts of the State of Maharashtra, such as Amravati, Akola, Aurangabad, Beed, Hingoli, Wardha, Parbhani, Washim, etc. will be eligible under this scheme.
  2. Individuals should hold a White/ Orange/ Yellow Ration card/ Antyodaya Yojana Card (AAY)/Annapurna Card.
  3. Farmers from 14 Agriculturally Distressed Districts will be identified based on 7/12 Extract, White Ration Card, Name of Beneficiary or Head of the Family, or Certificate from the concerned Patwari or Talathi.

Documents Required for Mahatma Jyotiba Phule Jan Arogya Yojana

Individuals will need to submit a Valid Photo ID Proof along with the following documents.

  1. Aadhar Card/ Aadhar Registration Slip with Photo of beneficiary Aadhar Card
  2. PAN Card
  3. Voter ID Card
  4. Driving License
  5. School or College ID
  6. Passport
  7. Health Card of RGJAY/ MPJAY
  8. Freedom Fighter ID Card
  9. Handicap Certificate
  10. Nationalized Bank Passbook with Photo
  11. Senior Citizen Card issued by the Central Government or State Government
  12. Any Photo ID issued by the Government of Maharashtra

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