MJPJAY - Mahatma Jyotiba Phule Jan Arogya Yojana

The Mahatma Jyotiba Phule Jan Arogya Yojana, formerly known as Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY), is the flagship health insurance scheme launched by the Government of Maharashtra for the entire state. It was launched on 2nd July, 2012. The primary purpose of this scheme is to provide free quality critical care for low income families.

Note: All information has been sourced from the official website of State Health Assurance Society.

Mahatma Jyotiba Phule Jan Arogya Yojana Details (MJPJAY)

Name of the SchemeMahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY)
Launched in 2nd July, 2012 in Maharashtra
Launched byGovernment of Maharashtra
Date of Announcement2nd July, 2012
Date of Implementation2nd July, 2012
Supervised by State Health Assurance Society, Government of Maharashtra
Targeted TowardsBelow Poverty Line (BPL) and Above Poverty Line (APL) families (excluding White Card Holders as defined by Civil Supplies Department)

Features of Mahatma Jyotiba Phule Jan Arogya Yojana Details (MJPJAY)

The Features Of MJPJAY Are:

  • The premium charges and medical insurance cover is provided by the Government of Maharashtra.
  • The sum insured limit is ₹1.5 lakhs per year.
  • The scheme is available on an individual as well as on a family floater basis.
  • There is no such waiting period for pre-existing diseases.
  • Provides cover for surgeries, follow-up treatment, diagnosis and medications.
  • Beneficiaries have access to one free medical camp per year.
  • The network hospital list is mentioned in the official website of State Health Assurance Society.
  • In addition to government hospitals, there are many private hospitals included in the list of network hospitals.

Benefits of Mahatma Jyotiba Phule Jan Arogya Yojana Details (MJPJAY)

The Benefits Of MJPJAY Are:

  • The scheme covers 971 types of surgeries/procedures/therapies in 30 identified specialized categories.
  • The scheme covers 121 types of follow-up procedures in 30 identified specialized categories.
  • The 132 Government Reserved Procedures are to be performed only in empanelled government hospitals or government medical colleges.
  • The upper ceiling for Renal Transplant is ₹2,50,000 per operation.

    Treatment Coverage

    List of Surgeries Included: Note: All diseases are covered from day 1 including individuals suffering from disease prior to the inception of the policy.
  • GENERAL SURGERY
  • ENT SURGERY
  • OPHTHALMOLOGY SURGERY
  • GYNAECOLOGY AND OBSTETRICS SURGERY
  • ORTHOPEDIC SURGERY AND PROCEDURES
  • SURGICAL GASTROENTEROLOGY
  • CARDIAC AND CARDIOTHORACIC SURGERY
  • PEDIATRIC SURGERY
  • GENITOURINARY SYSTEM
  • NEUROSURGERY
  • SURGICAL ONCOLOGY
  • MEDICAL ONCOLOGY
  • RADIATION ONCOLOGY
  • PLASTIC SURGERY
  • BURNS
  • POLYTRAUMA
  • PROSTHESES
  • CRITICAL CARE
  • GENERAL MEDICINE
  • INFECTIOUS DISEASES
  • PEDIATRICS MEDICAL MANAGEMENT
  • CARDIOLOGY
  • NEPHROLOGY
  • NEUROLOGY
  • PULMONOLOGY
  • DERMATOLOGY
  • RHEUMATOLOGY
  • ENDOCRINOLOGY
  • GASTROENTEROLOGY
  • INTERVENTIONAL RADIOLOGY

Eligibility Criteria of Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY)

Families belonging to any of the 36 districts of Maharashtra and holding Yellow Ration Card, Antyodaya Anna Yojana Card (AAY), Annapurna Card and Orange Ration Card along with Farmers from 14 agriculturally distressed districts of Maharashtra (Amravati, Akola, Aurangabad, Buldhana, Beed, Hingoli, Jalna, Nanded, Latur, Osmanabad, Parbhani, Wardha, Washim and Yavatmal) are eligible under MJPJAY. The identification for farmers from 14 agriculturally distressed districts of Maharashtra will be based on White Ration Card. This would be done along with 7/12 extract bearing the name of the beneficiary / head of the family or certificate from the concerned Talathi / Patwari. This should state that the beneficiary is a farmer or a family member of the farmer with a valid photo ID proof of the beneficiary.

Documents required For Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY)

  • Valid ration card Orange/Yellow/White Ration Card with any KYC photo ID.
  • For children born after the issue of the health card, photograph of child with either parent along with valid Yellow/Orange/White ration card of parent and Birth certificate issued by authorized office.

Claim Procedure of MJPJAY

Once the condition has been successfully diagnosed at the network hospital, the treatment will begin immediately post pre-authorization has been granted. In case the diagnosis has been made in a non-network facility hospital, a referral card will be given to commence treatment in a nearby network hospital. When the cashless treatment has been successfully conducted, the network hospital will send all the relevant details (diagnostic reports, medical bills, and discharge summary) to the insurer. The insurer, in return, will verify all the details and approve the claim settlement.

Post-surgery, follow-up consultations, diagnosis, medicines are free of charge for a period of 10 days.

Customer Helpline Number and Contact Details

The agency responsible for Mahatma Jyotiba Phule Jan Arogya Yojana can be contacted on 155 388 or 1800 233 22 00. The official address of the department is: State Health Assurance Society, ESIS Hospital Compound, Ganpat Jadhav Marg, Worli Naka, Worli Mumbai - 400018, Maharashtra.

Conclusion & Reviews

Conclusion

The Mahatma Jyotiba Phule Jan Arogya Yojana is one of the best initiatives undertaken by the Government of Maharashtra. Not only does it cover the entire state, it also provides medical cover and premium payment for all the registered families.

Review of Mahatma Jyotiba Phule Jan Arogya Yojana - MJPJAY

The ever rising cost of medical treatment can hinder your personal finances. It is ideal to protect yourself and family at all times. The Mahatma Jyotiba Phule Jan Arogya Yojana has been successfully implemented across the state of Maharashtra. The reason for its popularity is that it provides comprehensive medical cover not only during times of hospitalization, but also covers for the expenses post hospitalization for a period of 10 days.

FAQ's On MJPJAY

What is the maximum insurance cover under Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY)?

The maximum insurance cover under Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) is ₹1.5 lakh per family and 2.5 lakhs per operation in case of renal transplant.