The Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) is a healthcare scheme for all families in the state of Maharashtra, with an extended scope of coverage per various added categories. This scheme was initially introduced for all beneficiaries who are below the poverty line (BPL). It was earlier known as Rajiv Gandhi Jeevandayee Arogya Yojana.
The Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) is one of the flagship programmes for citizens to access healthcare and other facilities. This is done through the health insurance scheme-affiliated hospitals which provide this healthcare service under the scheme.
The objective of this scheme is to provide healthcare facilities and services to those who are in need. Accordingly, an insurance cover of Rs.5 lakh per family per year is provided for 996 treatments in the Mahatma Jyotirao Phule Jan Arogya Yojana.
This scheme was launched by the state of Maharashtra on 2nd July 2012, in eight districts on a pilot basis and it was expanded in all districts of Maharashtra from 21st November 2013. Meanwhile, the Government of Maharashtra has decided via GR dated 28th July 2023 to implement MJPJAY for all families in the state and expand the scope of the current scheme.
The beneficiaries category under the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) is explained as per the table below (MJPJAY Categories):
| Category | Description / Eligible Groups |
|---|---|
| Category A |
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| Category B |
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| Category C |
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| Category D |
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| Category E | Families from 865 border villages (Belgaon, Karwar, Kalburgi, Bidar) with:
|
If you are covered in the above beneficiary category you will need the below documents to verify your eligibility for the same:
| Scheme & Category | Required Documents |
|---|---|
| MJPJAY (Category A) |
|
| MJPJAY (Category A) |
|
| MJPJAY (Category B) |
If no White Ration Card:
For Govt./Semi-Govt. Employees:
|
| MJPJAY (Category C) |
|
| MJPJAY (Category D) |
|
| MJPJAY (Category E) |
Below are the benefits of the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY):
Below is the list of top diseases and Treatments covered under the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY):
Below is the list of treatments which are not covered under the Mahatma Jyotiba Phule Jan Arogya Yojana: Cataract surgery for adults.
The Mahatma Jyotiba Jan Arogya Yojana (MJPAY), is designed so that health care is accessible to everyone in the state. One of the interesting features of this scheme is that one can avail of treatment in an emergency by reaching out via phone or e-mail. Below is the list of features of the MPJPAY scheme:
Below are the documents required to apply for Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY):
You can follow the below steps to register for the above scheme:
Locate and visit your nearest empanelled government or private hospital under MJPJAY.
At the hospital, contact the Aarogyamitra (healthcare facilitator) stationed there. They will assist you in initiating the application process.
Present the necessary documents, including a valid ration card (Yellow, Orange, Antyodaya Anna Yojana (AAY), or Annapurna) and a valid photo ID proof.
The hospital's medical coordinator will assess your medical condition to determine eligibility under the scheme.
If eligible, the hospital will submit an e-authorization request to the insurance company for approval.
Upon approval, you will receive cashless treatment for the covered procedures.
After discharge, you may avail of follow-up consultations and diagnostic services as per the scheme's provisions.
After successful completion of registration by Aarogyamitra you will receive a card and you can check the status of the same via official website login.
Here’s a step-by-step how hospitalisation and the claim process work under the MJPJAY scheme.
Visit an empanelled hospital under MJPJAY. A healthcare facilitator, known as an Aarogyamitra, will assist in verifying your eligibility.
The hospital submits a pre-authorization request to the insurance provider detailing the required treatment.
Upon receiving approval from the insurer, the hospital can proceed with the treatment.
After treatment, the hospital compiles and submits all relevant documents, including medical reports, bills, diagnostic reports, and the discharge summary, to the insurer for claim processing.
After the treatment, you need to submit all procedures and medical documents for a claim which is a cashless process for the beneficiary.
This process allows immediate treatment in emergencies under MJPJAY through a quick ETI-based hospitalisation system.
The Medical Coordinator Officer (MCO) from the Network Hospital collects patient, hospital, and surgery details and submits them to generate a Telephonic Intimation ID.
The TPA’s Preauthorization Executive verifies the ETI details and updates remarks in the system.
Once verified, the hospital can begin treatment immediately under MJPJAY.
After ETI verification, Aarogyamitra registers the patient in the system for MJPJAY benefits.
If there's a technical/system failure, the hospital can email patient and doctor details to the TPA and speak with the Preauth Executive to get a provisional ETI number.
Once the system is back online, the hospital must generate the ETI in the software for the same patient.
The final preauthorization must be submitted within 5 business days using the ETI ID. If not, the ETI is automatically cancelled.
Below is the address and contact details:
Address:
Mahatma Jyotiba Phule Jan Arogya Yojana
State Health Assurance Society
ESIS Hospital Compound,
Ganpat Jadhav Marg,
Worli Naka,
Worli
Mumbai-400018
Maharashtra
Toll-Free Number: 155 388, 1800 233 2200
Due to technical issues, if Call Center Helpline numbers are not working, for emergency kindly contact: 9702135277/7208076239
The Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) is a healthcare scheme by the government of Maharashtra to provide cost cover of around rupees 5 lakhs per family for accident/disease treatment.
Visit jeevandayee.gov.in and enter your details to check the MJPJAY approval status online.
There are 5 categories under which people fall under the scheme and those citizens eligible under the MJPJAY scheme.
Yes, individuals from any district in Maharashtra can apply for MJPJAY.
Until and unless there are costs which are incidental to hospitalisation and are excluded under the scheme or if the treatment exceeds the scheme limit, you have to pay the additional or incidental charges.
No, MJPJAY does not cover ambulance charges.
If you follow the Emergency Telephonic intimation, you can get it pre-authorised within a day. Normally it can take a few days to get a pre-authorisation for the Mahatma Jyotiba Phule Jan Arogya Yojana.
Yes, you get a cashless treatment under the MJPJAY.
You can visit MJPJAY's official website and find the list of authorized hospitals under the hospital section.
The family's annual income should be less than or equal to ₹1,00,000.
The MJPJAY benefits families by providing a cover of 5 lakh per family.
The scheme operates on a family floater basis, providing a total annual health coverage of ₹5 lakh per family.
You can download the MJPJAY card by visiting jeevandayee.gov.in and logging in with your registered credentials.
No, there are no costs involved in getting the MJPJAY card- enrollment and the card is completely free.
