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Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY Scheme)

Over the years, the Indian Government has devised multiple initiatives to facilitate a better livelihood for the poor. One of them is the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY). It is one of the many schemes aiming to make healthcare easily accessible to the economically backward masses.

Not sure if this scheme can benefit you?

Well, here is a detailed discourse on the “what, how, and for whom” of this government initiative. Read on for a thorough understanding!

Team Digit

What is MJPJAY ?
Features & Benefits of MJPJAY
Treatments under MJPJAY
Eligibility Criteria of MJPJAY
Documents Required
How to Register for MJPJAY?
How to Claim?
How to Find a Hospital List?
Hospitalisation Process
Frequently Asked Questions

What is Mahatma Jyotiba Phule Jan Arogya Yojana?

The Mahatma Jyotiba Phule Jan Arogya Yojana is a healthcare coverage scheme launched by Maharashtra’s State Government. It was initially introduced as the Rajiv Gandhi Jeevandayee Arogya Yojana. The scheme aims to provide affordable and quality medical care to individuals below or marginally above the poverty line.

This healthcare scheme also covers surgical procedures and related consultation and hospitalisation expenses.

When was MJPJAY Launched?

The MJPJAY scheme was first launched in July 2012. It was valid only in 8 districts of Maharashtra. Later, the scheme became functional in all 35 districts from November 2015. Since then, anyone holding a valid document could avail of free healthcare services from network hospitals.

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?

Let us check the list of medical procedures covered under the Mahatma Jyotiba Phule Jan Arogya Yojana.

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

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

The Mahatma Jyotiba Phule Jan Arogya Yojana eligibility requirements demand individuals meet the following parameters to qualify as beneficiaries:

Individual applicants must have an annual income of less than Rs.1 lakh.
Should hold White/Orange/Yellow Ration Card, Annapurna Card, or Antyodaya Anna Yojana Card (AAY).
Registering families must belong to the identified distressed districts of Maharashtra.
Farmers belonging to agriculturally distressed districts of Maharashtra can also sign up for this insurance policy.
Farmers from agriculturally distressed districts are identified using their 7/12 extract, White Ration Card, and the name of the beneficiary or family head, along with a certificate from the relevant Patwari or Talathi.

What are the Documents Required for MJPJAY?

Here is a list of all mandatory documents that you need to submit to qualify for the MJPJAY scheme.

Any of the following KYC photo IDs:

Aadhaar card
PAN card
Passport
Driving license
Voter ID
Senior citizen card
Handicap certificate
Bank passbook with photograph
Marine fishers ID card
Defense ex-service card
College or school ID
Freedom fighter ID card
Any other photo identity proof issued by the Maharashtra State Government or Central Government of India. You can also provide a valid yellow, orange, or white ration card

To register a child born after issuing a health card, his/her authorised birth certificate, photo with either parent, and the parent’s yellow, orange, or white ration card must be issued.

Once you have checked your eligibility and gathered all Mahatma Jyotiba Phule Jan Arogya Yojana documents, proceed with the registration process.

How to Register for Mahatma Jyotiba Phule Jan Arogya Yojana?

In case you do not have a clue as to how to avail of Mahatma Jyotiba Phule Jan Arogya Yojana online registration, here is a step-by-step guide.

Step 1: Go to the official website of MJPJAY.

Step 2: On the home page, click on “New Registration.”
Step 3: Next, the next page will redirect you to the Mahatma Jyotiba Phule Jan Arogya Yojana online application form.
Step 4: Fill in all the mandatory fields with accurate details.
Step 5: Attach scanned copies of the mandatory documents previously mentioned.
Step 6: Click on “Submit.”

Upon completing the above procedure, you will be successfully registered under this insurance scheme. After that, you can raise a claim anytime you need to avail of medical treatment.

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

You can apply for the MJPJAY card in person at a local government health facility by contacting an Aarogyamitra, who is the scheme representative. They will assist you in obtaining the MJPJAY health card.

How to Apply for MJPJAY Card Online?

To apply for an MJPJAY card online, follow these steps:

Step 1: Go to MJPJAY's official website.
Step 2: On the home screen, click on New Registration.
Step 3: Complete the form completely, attach scanned copies of the necessary paperwork, and press the Submit button.
Step 4: After your registration has been approved, you are free to file a claim whenever needed.

How to Raise a Claim for the MJPJAY Health Scheme?

Following is a step-by-step overview of the claim procedure for the Mahatma Jyotiba Phule Jan Arogya Yojana scheme.

Step 1: Visit your nearest network hospital to get your medical condition diagnosed.
Step 2: The hospital authorities will send a digital pre-authorisation request to the insurance company.
Step 3: Upon approval, the treatment procedure will commence. In case of emergencies, this procedure is instant and is not delayed by e-authorisation requirements.
Step 4: If the diagnosis does not take place in a network hospital, then the Arogyamitra will issue a referral card. You need to produce this card at an empanelled hospital to avail of cashless treatment.

After completing the medical procedure, the network hospital will share all essential details like diagnostic reports, treatment summary, and final bill with the insurer. The latter will verify all submitted documents to initiate claim settlement.

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?

The steps below should help you access the hospital list associated with the MJPJAY. To find a list of hospitals under the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY), follow these steps:

Step 1: Visit the Official Website: Go to the official website of the Maharashtra State Government or the specific health department handling the MJPJAY.

Step 2: Search for MJPJAY Information: Look for a section dedicated to the Mahatma Jyotiba Phule Jan Arogya Yojana or a health insurance section.

Step 3: Locate the Hospital List: A link or document should list the empanelled hospitals under the scheme. This might be a downloadable PDF or an online directory.

Step 4: Contact the Local Health Office: If you have trouble finding the information online, visit or contact your local health office or district collector’s office for assistance.

Step 5: Check with Insurance Providers: Sometimes, insurance companies collaborating with the scheme also have lists of network hospitals. Check with them for more details.

Hospitalisation Process for Mahatma Jyotiba Phule Jan Arogya Yojana

To undergo hospitalisation under the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY), confirm your eligibility for the scheme. Then, identify an empanelled hospital by checking the official MJPJAY website or contacting local health offices. Obtain pre-authorisation from the insurance provider or hospital insurance desk for planned admissions by submitting the necessary documents.

Present your MJPJAY card upon arrival at the hospital to begin the admission process. The hospital will manage the claim process with the insurer, and you should ensure all treatments and procedures are covered. Upon discharge, review and settle any bills as per the scheme’s guidelines and collect your discharge summary and related documents.

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

The toll-free helpline number and address of MJPJAY are:

Toll-Free Number: 1800-233-2200 / 155 388

Address: Jeevandayee Bhavan, ESIC Hospital Compound, Near Worli Naka, Behind Poddar Hospital, Ganpat Jadhav Marg, Worli, Mumbai - 400018.

Purchasing the best health insurance in India is now necessary due to the escalating healthcare costs. Now that you are well acquainted with the detailed registration and claim procedure delay no more. Check your eligibility and enrol yourself and your family under the MJPJAY scheme at the earliest to avail yourself of optimum benefits.

FAQs about MJPJAY

All

Is there any alternative document for the ration card when registering under MJPJAY?

Yes, you can submit an Annapurna or Antyodaya card instead of a ration card to complete your MJPJAY registration.

What is the time limit specified for follow-up treatments under Mahatma Jyotiba Phule Jan Arogya Yojana?

Beneficiaries can avail of follow-up treatments, consultations, and diagnostics from this hospital for free for up to 10 days from the date of discharge.

Which health conditions are not covered under the MJPJAY scheme?

Generally, conditions like appendicitis and hernia are excluded from MJPJAY coverage unless it involves an emergency.

Does MJPJAY require me to pay a fee for my treatment?

No, the hospital will not charge the recipient for any of the medical treatments that are covered by the packages.

Where can I locate the Mahatma Jyotiba Phule Jan Arogya Yojana's list of network hospitals?

Visit their official website to view the list of hospitals that are either networked or empanelled under the Mahatma Jyotiba Phule Jan Arogya Yojana plan.

Does MJPJAY pay for emergency room expenses?

Yes, the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) pay for emergency room expenses.

What is the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) contact number?

The toll-free number for Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) is 1800-233-2200/155 388.

How long does it take to get a pre-authorisation for the Mahatma Jyotiba Phule Jan Arogya Yojana?

The pre-authorisation process for the Mahatma Jyotiba Phule Jan Arogya Yojana takes 12 hours to complete.

Does MJPJAY cover treatment for appendicitis?

No, only the cost of treating appendicular perforations is not covered by the Mahatma Jyotiba Phule Jan Arogya Yojana Scheme.

What is the Mahatma Jyotiba Phule Jan Arogya Yojana's income threshold?

The annual income of the individuals submitting applications shall not exceed Rs. 1 lakh. Benefits of Mahatma Jyotiba Phule Jan Arogya Yojana coverage are also available to the primary applicant's family.

When was the Mahatma Jyotiba Phule Jan Arogya Yojana launched?

In July 2012, the program was originally introduced in eight districts of the state of Maharashtra. By November 2015, it had been extended to all 35 districts.

What are the benefits of Mahatma Jyotiba Phule Jan Arogya Yojana?

The MJPJAY offers free medical treatment for economically disadvantaged families, access to many healthcare services, and financial support for hospitalisation and surgeries. This scheme improves health outcomes and reduces the financial burden on low-income families.

How to make the Mahatma Jyotiba Phule card?

You will receive guidance from Aarogyamitra on how to obtain the MJPJAY health card. Certain KYC (Know Your Customer) documentation will be needed for verification in addition to the ration card. PAN cards, voter ID cards, Aadhaar cards, and nationalised bank passbooks with photos are a few examples of these documents.

What should I do to file a complaint or to ask a question?

Call the toll-free number or the Arogyamitra if you have any questions. Arogyamitra is on duty around the clock at the hospital or centre, and she will help and direct you if an issue arises. However, if you're unhappy, you can file a complaint by calling our toll-free numbers, 18002332200 or 155388.

Can patients with HIV or HCV use the MJPJAY maintenance hemodialysis program?

Yes, a patient may still use MJPJAY services even if they are HIV or HCV-positive and are eligible beneficiaries. Specialised equipment for HIV/HCV-positive patients is required in standalone dialysis clinics and hospitals with empanelment.