Mahatma Jyotirao Phule Jan Arogya Yojana
At a Glance
Scheme Category
Health & Wellness,Disease and conditions,Health care providers and access,Medicine and health products,Financial assistance,Medical insurance,Health Insurance
Target Beneficiaries
Individual
Brief Description
The Mahatma Jyotirao Phule Jan Arogya Yojana, launched by the Government of Maharashtra, offers cashless treatment for identified diseases through a network of government and private healthcare providers.
Benefit Type
Cash
Eligibility Criteria
Category A: Families holding Yellow, Antyodaya Anna Yojana (AAY), Annapurna Yojna and Orange Ration Card. Category B • White ration card holder families (including Govt./Semi Gov employees). • A family without having any kind of ration card but having domicile certificate of Maharashtra Category C • Students in Govt. and Govt. recognized Ashram School • Children in Govt. and Govt. recognized Orphanages • Women in Govt. and Govt. recognized Women&39;s Ashram • Sr. citizens in Govt. and Govt. recognized old age homes • Journalists and their dependent family members as per criteria of Directorate General of Information and Public Relations Office. • Construction workers and their families (who are resident of outside of Maharashtra) registered with Maharashtra Building and Other Construction Workers Board. Category D - Road traffic accident victims from outside Maharashtra and outside India who met with an accident on roads in Maharashtra Category E Families holding below mentioned ration cards from 865 villages of Belgaon, Karwar, Kalburgi and Bidar Districts of Maharashtra- Karnataka border 1) Antyodaya Anna Yojana (AAY) 2) Priority House Holder (PHH) 3) Annapurna Yojna
Application Mode
Offline
Application Process
Step 1: The interested applicant should visit the any Govt./Pvt. network hospital in State, and request the hard copy of the prescribed format of the application form from the concerned authority. Step 2: In the application form, fill in all the mandatory fields, paste the passport-sized photograph (signed across, if required), and attach copies of all the mandatory documents (self-attest, if required). Step 3: Submit the duly filled and signed application form along with the documents, within the prescribed period (if any), to the authority. Step 4: Request a receipt or acknowledgement from the concerned authority to whom the application has been submitted. Ensure that the receipt contains essential details such as the date and time of submission, and a unique identification number (if applicable). NOTE: Ensure that the application is submitted within the prescribed period, if any. > Note 1: The claim settlement module along with electronic clearance and the payment gateway will be part of the workflow in the State Health Assurance Society (SHAS) portal and will be operated by the Insurer. > Note 2: The reports will be available for scrutiny on the State Health Assurance Society (SHAS) <nis:link nis:type=webUrl nis:id=slugId nis:text="login." nis:value=https://www.jeevandayee.gov.in/MJPJAY/FrontServlet?requestType=CommonRH&actionVal=RightFrame&page=undefined%3E%3E%3Cb%3EMJPJAY%20Login%3C/b%3E&pageName=MJPJAY_Login&mainMenu=MJPJAY_Login&subMenu=MJPJAY_Login nis:enabled=true/>
Required Documents
- List of valid photo ID proofs to be accepted along with document of eligible criteria:
- Aadhaar Card or Aadhaar Registration Slip with a photo of the beneficiary. An Aadhaar Card would be insisted upon as an identification document and in the absence of an Aadhaar card/number; any document that is accepted for issuance of an Aadhaar card will also be accepted.
- Pan Card
- Voter ID
- Driving License
- School/College Id
- Passport
- Freedom Fighter ID card
- Health Card of RGJAY / MJPJAY
- Handicap Certificate
- Nationalized Bank Passbook with Photo
- Senior citizen card issued by the Central Government or State Government
- Defense ex-servicemen card issued by Sainik Board
- Marine Fishery Identity card (Issued by Ministry of Agriculture / Fisheries Department Government of Maharashtra).
- Any photo ID proof issued by the Government of Maharashtra/ Government of India
FAQs
What is the full form of MJPJAY?
MJPJAY's full form is Mahatma Jyotiba Phule Jan Arogya Yojana.
When was MJPJAY started?
MJPJAY was launched in 28 districts of Maharashtra on April 1st, 2020.
What is the objective of MJPJAY?
MJPJAY aims to provide cashless, quality medical care to the beneficiaries under the scheme for catastrophic illnesses requiring hospitalization for surgery and treatment under identified specialized services through a network of health care providers.
How much assistance is available under MJPJAY Yojana?
MJPJAY Yojana 2024 provides coverage up to ₹ 1,50,000/- per policy year per family to meet all expenses related to hospitalization of the beneficiary. For renal transplants, this limit has been increased to ₹ 2,50,000/- per family per policy year.
Who is eligible for receiving Maintenance Haemodialysis treatment under MJPJAY?
A patient suffering from chronic kidney disease requiring maintenance HD and who has a health card is eligible. If the patient does not have a health card, he or she should have an orange or yellow ration card or an Antyodaya or Annapurna card along with valid ID proof.
Which services are provided under package of Maintenance Haemodialysis under MJPJAY for the patient?
The package includes pre- and post-treatment diagnostics,consultation, hospital charges, consumables, and medicines. The detailed package is as follows: >> Investigations Creatinine tests (Monthly) Complete blood count (CBC, Monthly) HIV/Hep.A/Hep.C tests (once every three months) Serum electrolytes (as per advise) Blood glucose, if required >> Consultion Clinical examination by Nephrologist/Medical Cordinator. >> Consumable -Dialyser (It will be used upto optimal capacity and replaced if needed free of charge under scheme), -Tubing (It will be used upto optimal capacity and replaced if needed free of charge under scheme), - Fistula Needle (It will be used upto optimal capacity and replaced if needed free of charge under scheme). - IV fluids, - Haemodialysis Part A/B and o Heparin. >> Medicines Inj. Erythropoetin, as per the advice of Nephrologist
What should be frequency of dialysis cycles under MJPJAY for each approved preauth?
The frequency of dialysis should be a minimum of 8 cycles and a maximum of 12 cycles, as recommended by the nephrologist or medical coordinator based on his or her serum creatinine level.
Does patient have to pay any extra money for treatment?
No. The patient should not pay any extra money to the hospital or center for services that are covered under the approved package.
Will Balance Sum Insured used for dialysis patient limit other household members to avail services under MJPJAY?
The maximum sum assured under MJPJAY is ₹ 1,50,000/- per family, on a family-floater basis. If the dialysis patient has utilized a particular amount from the sum assured, other family members can still avail services under MJPJAY till the total amount of ₹ 1,50,000/- gets exhausted. This amount of Sum Insured cannot get extended under any circumstances (except if patient requires a renal transplant, where BSI will be considered as ₹ 2,50,000/-)
Can HIV or HCV positive cases avail Maintenance Haemodialysis service under MJPJAY ?
Yes. If a patient is a beneficiary of MJPJAY and is HIV or HCV positive, then he or she can still avail services under MJPJAY. Empanelled hospitals and stand-alone dialysis centers must have dedicated machines for HIV or HCV-positive patients. Under no circumstances shall these units be used for other patients.
If patient requires blood transfusion, is cost of blood transfusion covered under package?
No. Maintenance Haemodialysis package does not cover the cost of a blood transfusion.
In case of a query or to register a complaint what should I do ?
In case of a query, you can contact Arogyamitra or call the toll-free number. Arogyamitra is available round the clock in the hospital or center and will facilitate and guide you if any problem arises. But if you are not satisfied, then call our toll-free numbers, 155388 or 18002332200, to register a complaint.