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Exclusive Wellness Benefits

Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY Scheme)

What is Mahatma Jyotiba Phule Jan Arogya Yojana?

When was MJPJAY Launched?

What are the Features of MJPJAY?

Here is a list of features of the Mahatma Jyotiba Phule Jan Arogya Yojana. Have a look!

Features Description
Financial Coverage This health insurance scheme offers financial coverage up to Rs.1.5 lakhs per year against medical treatments.
Cashless Treatment Policyholders do not need to deposit any sum while undergoing treatment, so it is a cashless process.
Premium Charges The State Government of Maharashtra bears the premium charges required for Mahatma Jyotiba Phule Jan Arogya Yojana.
Coverage Options This scheme allows an individual beneficiary to benefit from it. Alternatively, an entire family can also enjoy insurance benefits with a floater policy.
Pre-existing Ailments The Mahatma Jyotiba Phule Jan Arogya Yojana scheme does not specify any waiting period for pre-existing ailments.
Free Medical Camp Policyholders can also attend 1 medical camp per year free of cost.
Network Hospitals Policyholders have access to a wide network of hospitals to avail themselves of cashless treatment.
Policy Renewal The scheme typically offers easy renewal procedures to ensure continuous coverage.
Claim Process The streamlined claim process for quicker reimbursement or settlement.
Family Coverage Details Specific details on the maximum number of family members covered under the floater policy.

If you want to check the accessibility of such healthcare benefits near you, look up the list of network hospitals. It is available on the official website of the State Health Assurance Society. You can find several private and government-enrolled hospitals on this list. All of these can offer you the benefits of Mahatma Phule Arogya Yojana.

Benefits of Mahatma Jyotiba Phule Jan Arogya Yojana

The primary benefits of MJPJAY are noticeable from the extensive treatment coverage it offers. This includes diagnosis, medication, surgeries, follow-up treatment, and expert consultation.

Following is a detailed list of benefits that policyholders can avail from this scheme:

Benefit 

Description

Financial Coverage

MJPJAY benefits include financial coverage against approximately 975 surgical and therapeutic procedures.

Follow-up Procedures

This scheme covers 30 identified categories, including around 121 types of follow-up procedures.

Treatment at Government Facilities

There are 132 government-reserved procedures under MJPJAY coverage. Policyholders can avail of these treatment benefits only from enlisted government medical colleges and hospitals.

Cashless Treatment

Policyholders can benefit from cashless treatment at empanelled hospitals, reducing the financial burden of medical expenses.

Access to Expert Consultation

Policyholders can receive consultations from specialists and experts, improving the quality of care and treatment outcomes.

In addition to the above-mentioned Mahatma Jyotiba Phule Jan Arogya Yojana benefits are the extended upper ceiling for renal transplant. In this case, beneficiaries can avail a maximum of Rs.2.5 lakhs for operation.

Want to know what other medical procedures you can avail of for free under the MJPJAY scheme?

Keep reading!

Which Treatments Are Covered Under MJPJAY?

1. Surgical Procedures

The following surgical procedures are available with the MJPJAY scheme. Look at the list below to see in details:

S. no. Procedure Description
1 General Encompasses a broad range of surgical interventions, including appendectomies, hernia repairs, and abdominal surgeries.
2 Ophthalmology Focuses on procedures related to the eyes, such as cataract removal, corneal transplants, and retinal surgeries.
3 ENT Includes surgeries for conditions affecting the ear, nose, and throat, such as tonsillectomies, sinus surgeries, and ear drum repairs.
4 Gastroenterology Addresses surgical issues in the digestive tract, including surgeries for ulcers, bowel obstructions, and liver resections.
5 Gynaecology and Obstetrics Involves surgeries related to female reproductive health, including caesarean sections, hysterectomies, and ovarian cyst removals.
6 Orthopaedic Covers surgeries related to the musculoskeletal system, such as joint replacements, fracture repairs, and spine surgeries.
7 Paediatric Focuses on surgical interventions for children, including congenital defect repairs, hernia repairs, and appendectomies in young patients.
8 Cardiac and Cardiothoracic Includes procedures related to the heart and thoracic organs, such as coronary artery bypass grafting, valve replacements, and lung surgeries.
9 Surgical Oncology Deals with the surgical treatment of cancer, including tumour removal, biopsy procedures, and debulking surgeries.
10 Prostheses Involves the fitting and surgical placement of prosthetic devices, such as artificial limbs or dental implants.
11 Neurosurgery Focuses on surgeries involving the brain, spinal cord, and nervous system, including tumour removals, spinal fusions, and aneurysm repairs.
12 Plastic Surgery Covers reconstructive and cosmetic procedures, including skin grafts, reconstructive surgeries after injury, and aesthetic enhancements.

2. Other Procedures

The MJPJAY scheme takes care of these other procedures as well. Check the list below to get a detailed description:

S. No.

Procedure 

Description 

13

Endocrinology

Focuses on the diagnosis and treatment of hormone-related disorders and diseases, including thyroid issues, diabetes management, and adrenal gland disorders.

14

Medical Oncology

Involves the treatment of cancer using medications such as chemotherapy, targeted therapy, and immunotherapy, as well as managing side effects and patient support.

15

Polytrauma

Refers to the treatment of patients with multiple, severe injuries often resulting from traumatic events like accidents or falls, requiring comprehensive and coordinated care.

16

Critical Care

Encompasses intensive care for patients with life-threatening conditions, involving close monitoring and advanced medical interventions in specialised units.

17

Genitourinary System

Focuses on surgical interventions for the male and female reproductive systems and urinary tract, including procedures for kidney stones, prostate issues, and bladder conditions.

18

Nephrology

Deals with kidney-related conditions, including treatment for chronic kidney disease, dialysis management, and kidney transplant evaluations.

19

Cardiology

Involves the diagnosis and treatment of heart conditions, including coronary artery disease, heart failure, and arrhythmias, through non-invasive and invasive techniques.

20

Neurology

Focuses on disorders of the nervous system, including treatments for stroke, epilepsy, and neurodegenerative diseases such as Parkinson’s and Alzheimer’s.

21

Infectious Disease

Specialises in diagnosing and treating infections caused by bacteria, viruses, fungi, and parasites, including management of complex or resistant infections.

22

Radiation Oncology

Involves the use of radiation therapy to treat cancer by targeting tumour cells with high-energy radiation to destroy or damage them.

23

Burns

Covers the management of burn injuries, including treatment for different burn severities, wound care, skin grafts, and rehabilitation.

24

Gastroenterology

Focuses on digestive system disorders, including treatment for gastrointestinal diseases such as ulcers, liver diseases, and inflammatory bowel disease.

25

Dermatology

Involves the diagnosis and treatment of skin conditions, including acne, eczema, psoriasis, skin cancers, and cosmetic skin procedures.

26

Rheumatology

Deals with autoimmune and inflammatory diseases affecting the joints and connective tissues, such as rheumatoid arthritis, lupus, and gout.

27

Interventional Radiology

Uses imaging techniques to guide minimally invasive procedures, such as angioplasty, biopsy, and drainage of fluid collections, to treat various conditions.

28

Pulmonology

Focuses on respiratory system disorders, including chronic obstructive pulmonary disease (COPD), asthma, and lung infections, as well as critical care for respiratory failure.

3. General Medicine

General medicine is a broad term for common illnesses and medical conditions. This also falls under the MJPJAY Scheme.

Sl. No.

Medicine

Description

29

General Medicine

Encompasses a broad spectrum of non-surgical medical care, focusing on the prevention, diagnosis, and treatment of common and complex diseases across various organ systems. 

This field includes managing chronic conditions, acute illnesses, and overall patient health through comprehensive medical evaluations and treatments.

Generally, most insurance plans come with specific exclusions. However, no such Mahatma Jyotiba Phule Jan Arogya Yojana disease list is available for this scheme, explicitly mentioning procedures not covered under the scheme. Instead, there are specific conditions mentioned under which certain medical treatments are provided.

If you belong to an APL or BPL family, you can get all the above treatments covered under MJPJAY by registering for the scheme. However, you need to consider the eligibility requirements before moving on with the process.

Eligibility Criteria of MJPJAY

What are the Documents Required for MJPJAY?

How to Register for Mahatma Jyotiba Phule Jan Arogya Yojana?

How to Apply for Mahatma Jyotiba Phule Jan Arogya Yojana Card (MJPJAY) Card Offline?

How to Apply for MJPJAY Card Online?

How to Raise a Claim for the MJPJAY Health Scheme?

Medical Packages Under MJPJAY Scheme

The MJPJAY Scheme offers various medical packages for the benefit of the common people. Check the list below to find the main packages under MJPJAY Scheme:

Category Name

Category Code

Number of Packages 

Burns 

S13

10

Cardiac And Cardiothoracic Surgery

S7

139

Cardiology 

M7

31

Critical Care

M3

18

Dermatology 

M11

3

Endocrinology

M13

15

ENT Surgery

S2

68

Gastroenterology 

M14

22

General Medicine

M16

18

General Surgery

S1

155

Genitourinary System

S9

84

Gynaecology And Obstetrics Surgery

S4

51

Haematology

M18

6

Infectious Diseases

M5

4

Interventional Radiology

M15

50

Investigations

M19

19

Medical Oncology

M1

107

Mental Disorders Packages

M17

11

Nephrology

M8

11

Neurology

M9

16

Neurosurgery

S10

90

Ophthalmology Surgery

S3

88

Oral and Maxillofacial Surgery

S20

2

Orthopaedic Surgery and Procedures

S5

110

Paediatric Cancer

S21

3

Paediatric Surgery

S8

60

Pediatrics Medical Management

M6

60

Physiotherapy 

M20

6

Plastic Surgery

S12

24

Polytrauma

S14

24

Prostheses 

S15

22

Pulmonology 

M10

8

Radiation Oncology

M2

15

Rheumatology

M12

6

Surgical Gastro Enterology

S6

65

Surgical Oncology

S11

169

How Do You Find a Hospital List Under MJPJAY?

Hospitalisation Process for Mahatma Jyotiba Phule Jan Arogya Yojana

Mahatma Jyotiba Phule Jan Arogya Yojana Toll-Free Number and Address

FAQs about MJPJAY