What is PMJAY and ABHA: Solve Your Doubts in 8 Easy Answers

Health insurance is essential today, but it also requires a proper stream of earnings. The government has launched many initiatives to tackle this problem. These schemes aim to provide quality healthcare access to people in need. One such scheme is the Pradhan Mantri Jan Arogya Yojana (PMJAY). It seeks to improve the livelihoods and provide security to those from economically weaker sections.

On the other hand, the ABHA (Aarogya Bharat Health Account) initiative aims to encourage people to create digital health records. This will also help them avail benefits of other schemes like PMJAY easily. Read on to understand what is ABHA cards, PMJAY, and the benefits they offer. 

What is PMJAY?

Prime Minister Narendra Modi launched PMJAY on September 23, 2018. It is one of the largest health-related schemes in the world that aims to make healthcare accessible [1].

Key features of PMJAY include the following.

• Over ten crore families [2] from the vulnerable and poor sections of the society are eligible for this scheme
• It provides an annual cover of up to Rs.5 lakh to each of the eligible families
• It provides for secondary care in all registered private and public hospitals
• Eligible individuals can get cashless benefits for provisions related to healthcare under this scheme
• It covers out-of-pocket expenses incurred during hospitalization 
• It covers pre- and post-hospitalization expenses 

Under this scheme, you are liable to receive compensation for the following expenses:

• Consultation, examination, and treatment for medical issues
• Expenses related to pre- and post-hospitalization (for up to 15 days)
• Diagnostics or lab investigation procedure charges
• Cost of medicines or medical consumables
• Services related to intensive and non-intensive care
• Accommodation expenses due to hospitalization
• Food-related services inside the hospital for patient
• Complications in the treatment (if any)

Who is eligible for PMJAY?

There are two different eligibility criteria regarding the urban and rural populations under PMJAY. 

Here are the eligibility criteria for the families/people in rural areas.

• No male member (age: 16-59 years) present in the family
• No adult (age: 16-59 years) present in the family
• No able-bodied adult present in the family
• Families that fall under scheduled tribes or scheduled castes 
• Families that are landless and earn their major income from manual labor
• Families living in a single room with makeshift walls and roof

The families that become automatically available due to their conditions are

• Underprivileged families that rely on begging as their daily source of income
• Manual scavengers
• Bonded laborers
• Tribal groups (Especially the primitive and vulnerable ones)

Here are the eligibility criteria for the families/people in urban areas.

• Street vendors
• Beggars
• Security guards
• Domestic workers
• Laborers
• Transport workers
• Coolies
• Electricians/ repair workers/ mechanics

Where can you check your PMJAY card eligibility and application?

You can get your PMJAY card eligibility and application checked from:

• Common service centers present in your area
• Any hospital that falls under connection with this scheme
• PMJAY helpline numbers 

You can also check your name in the PMJAY list of beneficiaries from the official website. Click on “Am I Eligible” on the official website and put in the necessary details. After submitting this information, the PMJAY list of beneficiaries will appear, and you can search for your name in it.

How do you get the PMJAY card?

Once you find yourself eligible for PMJAY, get your Aadhaar card or ration card verified at any PMJAY kiosk to avail PMJAY card download facility. Upon successful verification, you will get your unique PMJAY ID and download the e-card.

What is PMJAY ID?

PMAJY ID is the 9-digit number you receive under the initiative. This ID number is mainly used for verification purposes. You can also add a member of your family under PMJAY. How do I find my PMJAY ID? It is there at the bottom of your PMJAY card.

What is an ABHA card?

ABHA card is a ABHA Address (Health ID) card that helps create a safe and efficient digital health record for you and your family. Previously known as ABHA Address (Health ID), it was re-named ABHA to resonate more with the Indians. The ABHA card has the following features:

• All your health records are digitally accessible 
• The sign-up process is easy
• It provides easy access to doctors
• Privacy and security are maintained

What are the uses of the ABHA card? 

The ABHA card is used for

• Identifying people
• Authenticating them
• Listing their health records on multiple sources with consent

How do you get yourself registered for the ABHA card?

The ABHA registration is a simple process. You can register for ABHA on the official website. It involves the following simple steps:

• Visit the Ayushman Bharat Digital Mission website
• On the homepage, click on the option that says “Create your ABHA number.”
• You can generate ABHA ID through your Aadhaar card, driving license, or mobile number
• Fill in your details and create an ABHA account
• Then you can download your ABHA card online from the official website

Government initiatives such as the ABHA or PMJAY help you get healthcare access. There are many private insurance providers offering affordable health insurance policies with which you can cover your major healthcare expenses. Check out the Aarogya Care Health Plans on Bajaj Finserv Health for the best health insurance policies. You can choose from a number of affordable health plan options for you and your family. They also offer benefits like doctor consultations and preventive health check-ups. Sign up today to get comprehensive cover for your health.

You can use the Bajaj Health Card to turn your medical expenditures into simple EMIs if you are not eligible for an ABHA card.