Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) is the flagship health insurance scheme launched by the Government of Maharashtra. Originally introduced as Rajiv Gandhi Jeevandayee Arogya Yojana on July 2, 2012, the scheme began in eight districts and expanded to 28 districts by November 21, 2013. It aims to provide end-to-end cashless medical services for a wide array of diseases through an extensive network of public and private healthcare providers. The initiative seeks to alleviate the financial burden on families needing hospitalization for severe and chronic illnesses.
On April 1, 2020, MJPJAY was integrated with Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to broaden its reach and enhance the quality of care provided. This integration allows beneficiaries to access a wider range of medical services under a unified framework. The scheme is managed by the State Health Assurance Society, which collaborates with United India Insurance Company Limited, a public sector undertaking, to ensure health insurance coverage for eligible families.
The scheme’s implementation is designed to ensure that the most vulnerable populations in Maharashtra receive the medical care they need without the burden of out-of-pocket expenses. By offering cashless treatment, the government aims to ensure that financial constraints do not prevent individuals from accessing necessary medical interventions. This holistic approach not only improves health outcomes but also contributes to the overall well-being of the state’s residents.
MJPJAY Yojana Overview
| Launch Date | 2nd July 2012 |
| Expanded Coverage Date | 21st November 2013 |
| Integrated with AB-PMJAY | 1st April 2020 |
| Implementing Body | State Health Assurance Society |
| Insurance Provider | United India Insurance Company Limited |
| Annual Premium per Family | ₹ 797 |
| Total Medical Procedures Covered | 996 |
| Government Reserved Procedures | 131 |
MJPJAY Yojana Objective
The primary objective of Mahatma Jyotirao Phule Jan Arogya Yojana is to provide cashless quality medical care to beneficiaries suffering from catastrophic illnesses that require hospitalization for surgeries and therapies. The scheme aims to ensure that financial limitations do not hinder access to necessary medical treatments, thereby reducing the burden on families and improving health outcomes across the state.
Benefits
Under MJPJAY, beneficiaries receive cashless medical and surgical treatment for a wide range of procedures across 34 identified specialities. The scheme covers 996 medical and surgical procedures, including 121 follow-up procedures, ensuring comprehensive healthcare coverage. Beneficiaries have access to a network of empanelled public and private hospitals, which provide end-to-end medical services without any out-of-pocket expenses.
Mahatma Jyotirao Phule Jan Arogya Yojana Eligibility
Eligibility for MJPJAY is categorized into three groups:
- Category A: Families with Yellow ration card, Antyodaya Anna Yojana ration card (AAY), Annapurna ration card, or Orange ration card (annual income up to ₹ 1,00,000).
- Category B: White ration card holder farmer families from 14 agriculturally distressed districts, including Aurangabad, Jalna, Beed, Parbhani, Hingoli, Latur, Nanded, Osmanabad, Amravati, Akola, Buldhana, Washim, Yavatmal, and Wardha.
- Category C: Children of government orphanages, students of government ashram schools, female inmates of government mahila ashram, senior citizens of government old age homes, approved journalists and their families, and construction workers with live registration.
Required Documents
Beneficiaries need to present valid photo ID proofs along with eligibility documents, such as:
- Aadhaar Card or Aadhaar Registration Slip
- 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
- Defense Ex-servicemen Card
- Marine Fishery Identity Card
- Any photo ID proof issued by the Government of Maharashtra/India
Mahatma Jyotirao Phule Jan Arogya Yojana Application Process
The application process involves several steps to ensure eligible beneficiaries receive the required medical care:
- Approaching a Network Hospital: Beneficiaries visit an empanelled hospital or attend a health camp.
- Verification and Registration: Arogyamitras verify ration cards and photo IDs, enrolling the patient.
- Preauthorization: The hospital raises a preauthorization request for the procedure.
- Approval Process: Medical specialists review and approve or reject the request.
- Treatment: Cashless treatment is provided within the stipulated time.
- Follow-up: Free follow-up consultation and treatment are provided up to 10 days post-discharge.
- Claim Settlement: The insurer settles the hospital claims within 15 working days.
Mahatma Jyotirao Phule Jan Arogya Yojana stands as a critical initiative in Maharashtra’s healthcare landscape, ensuring that financial barriers do not impede access to essential medical services for the state’s most vulnerable population.