Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) — State level scheme launched by Government of Maharashtra under Public Health and Family Welfare Department—It has cashless medical services for secondary and tertiary treatments from empaneled hospitals under it.
Launched initially for marginal families the scheme now includes all families in the state with a cap of ₹1.5 lakh under MJPJAY and ₹5 lakh annually under Ayushman Bharat. From 1st July 2024, it ensures comprehensive, cashless healthcare for the entire population of Maharashtra.
Benefits
- Health Coverage:
- For Categories A to E (Excluding D): ₹5 lakhs per family per year on a floater basis under both schemes.
- For Category D: ₹1 lakh per person per year.
- Medical Benefits:
- 1356 health benefits packages under 34 specialties for Categories A to E.
- 184 health benefits packages for road accident patients in Category D.
- 262 health benefits packages for both schemes (for Categories A to E).
- 119 packages reserved for government hospitals for Categories A to E.
Hospitalization Costs
The health packages under MJPJAY include:
- Bed charges, nursing, and boarding charges.
- Fees for medical practitioners, surgeons, and consultants.
- Charges for oxygen, ICU facilities, surgical appliances, drugs, consumables, etc.
Transportation Costs
- Transport to and from the hospital.
- Transport of the deceased’s body to their village if applicable.
Scheme on Assurance Mode
- The scheme operates on an Assurance Basis, where claims from empaneled hospitals are directly paid by the State Health Assurance Societies.
Eligibility
- Category A: Families holding Yellow, AAY, Annapurna, and Orange Ration Cards.
- Category B: White Ration card holders (including government employees) or those with a domicile certificate of Maharashtra.
- Category C: Includes students in government schools, children in orphanages, women in recognized women’s ashrams, senior citizens in old age homes, journalists, construction workers, etc.
- Category D: Road accident victims outside Maharashtra who were treated in Maharashtra.
- Category E: Families with AAY, PHH, Annapurna Ration Cards from specific villages on the Maharashtra-Karnataka border.
Exclusions
- Government servants, pensioners, or their families are not eligible for this scheme.
- Families already covered under Ayushman Bharat (SECC 2011, RSBY) cannot avail the benefits of MJPJAY.
Application Process
Offline
- Visit any empaneled government or private hospital in Maharashtra to obtain an application form.
- Fill out the form and attach the required documents (photo ID proof, ration card, etc.).
- Submit the completed form to the concerned hospital authority.
- Request a receipt or acknowledgment of submission, ensuring you have a unique identification number.
Documents Required
- Photo ID Proof (Aadhaar, PAN, Voter ID, etc.)
- Ration Card (Yellow, AAY, etc.)
- Medical Documents (if applicable)
- MJPJAY Health Card (if previously enrolled)
Frequently Asked Questions
1. What is the full form of MJPJAY?
MJPJAY stands for Mahatma Jyotirao Phule Jan Arogya Yojana.
2. When was MJPJAY started?
The scheme was launched to provide cashless treatment to low-income families and extend coverage to all families in Maharashtra.
3. What is the objective of MJPJAY?
To provide cashless medical services for secondary and tertiary treatments, especially for those who were not covered under other schemes.
4. How much assistance is available under MJPJAY Yojana?
Eligible beneficiaries can receive up to ₹5,00,000 per family per year under MJPJAY and ₹1.5 lakh under Ayushman Bharat.
5. Who is eligible for receiving maintenance haemodialysis treatment under MJPJAY?
Patients who require maintenance haemodialysis under the approved preauth package can receive assistance.
6. What services are provided under the maintenance haemodialysis package?
The package includes dialysis cycles, blood transfusions, and other related medical services.
7. Does the patient have to pay any extra money for treatment?
The scheme is cashless, meaning the patient does not need to pay anything upfront for treatment.
8. Can HIV or HCV positive cases avail maintenance haemodialysis service?
Yes, HIV or HCV positive cases can avail this service under MJPJAY.
9. Is the cost of blood transfusion covered?
Yes, the cost of blood transfusions is covered under the health packages.
10. What should I do if I have a query or want to register a complaint?
You can reach out to the MJPJAY helpline or contact the scheme’s official website for assistance.