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  1. Digit Insurance
  2. Digit Health Insurance
  3. Government Insurance Schemes
  4. Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY)
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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!

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    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

    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

    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.

    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

    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.

    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.

    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.

    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.

    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.

    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.

    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.

    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.

    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.

    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.

    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.

    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.

    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.

    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.

    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.

    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.

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