How to Get Pradhan Mantri Medical Insurance?

How to Apply for Pradhan Mantri Ayushman Bharat Yojana?

The government launched Pradhan Mantri Ayushman Bharat Yojana in September 2018 to provide standard healthcare facilities to the economically weaker section of society. To avail of the benefits of this insurance scheme, one first needs to check the eligibility criteria.

Keep reading to learn about eligibility for this scheme, the steps to apply, and the benefits available upon completing the registration.

Eligibility for Pradhan Mantri Medical Insurance

Usually, rural families and some selected urban families can apply for this health insurance plan. The eligibility criteria for each of them are as follows:

1. Urban Families

The following is the list of eligible people who can apply for Pradhan Mantri Medical Insurance:

● Street vendors, hawkers, cobblers, or other workers on the streets

● Beggars and rag pickers

● Domestic workers

● Coolies

● Construction site workers, masons, plumbers, painters, security guards, and welders

● Transport workers such as conductors, cart pullers, and drivers

● Sweepers, gardeners, and sanitation workers

● Watchmen and washermen

● Artisans, handicraft workers, home-based workers, and tailors

● Electricians, repair workers, mechanics, and assemblers

● Peons, delivery assistants, shop workers, attendants, helpers, and waiters

● All senior citizens over 70, irrespective of their income

2. Rural Families

Almost every rural family are eligible for this scheme, which includes:

● Destitute families which primarily depend on alms

● Families of bonded labour

● Families of manual scavengers

● Primitive and vulnerable tribal groups

● All senior citizens over 70 years of age

The following families are not eligible for this scheme:

● Households lacking adults aged between 16 and 59 years

● Families with females as heads and no male members aged between 16 and 59 years

● Scheduled caste and scheduled tribe families

● Households with no land and manual labour work as their primary income source

● Families living in a single room with kucha walls and a roof

● Households comprising only disabled members and no able-bodied members offering support

Upon fulfilling the eligibility criteria of this scheme, you can proceed with the application for Pradhan Mantri Ayushman Bharat Yojana.

For people who are not eligible for Pradhan Mantri Medical Insurance, Star Health offers medical coverage specially designed for rural families and farmers under the Star Micro Rural and Farmers Care Insurance Policy for anyone aged between 18 and 65.

Steps to Apply for Pradhan Mantri Medical Insurance

The following are steps to apply for the Pradhan Mantri Medical Insurance plan:

• Step 1: Navigate to the official website of Pradhan Mantri Ayushman Bharat Yojana.
• Step 2: Log in to the portal by accurately entering your mobile number and the captcha code.
• Step 3: Input the OTP received on your registered mobile number to access your account.
• Step 4: Choose the state from the given options where you are applying for the scheme.
• Step 5: Select how you want to check your eligibility for the scheme: Name, Mobile number, Ration card number, or RSBY URN number.
• Step 6: Once you are eligible, your name will be displayed on the right side of the page.

You can also check the beneficiary details by clicking the ‘Family Members’ tab. If you want to add another name, click on ‘Add Family Details.’ After that, enter the Ration Card number and tap on the 'Check Document Details' button.

Features and Benefits of Pradhan Mantri Medical Insurance

The features and benefits of the Pradhan Mantri Medical Insurance plan are as follows:

• Provides access to standard healthcare facilities to about 40% of India’s population.
•  Offers comprehensive coverage encompassing 27 specialty areas. These areas include cardiology, oncology, and orthopaedics.
• Covers treatment-associated medicine and post-discharge care expenses.
•  Provides financial support to patients for various essential surgeries and offers associated procedures at reduced rates.
•  Extends coverage to the treatment of critical illnesses such as heart surgery, cancer, organ transplants and other life-threatening conditions.
• Offers coverage of up to Rs. 5 lakhs per family every year.
• People can avail of the insurance benefits at any government hospital or an empanelled private hospital.
• Covers various pre- and post-hospitalization expenses and daycare treatment costs.
• People can get access to primary, secondary, and tertiary healthcare through this scheme.
• Allows for a cashless hospitalization facility and covers all pre-existing health conditions.

Pradhan Mantri Medical Insurance v/s Private Medical Insurance

The table below highlights the differences between Pradhan Mantri Medical Insurance and private medical insurance:

The Pradhan Mantri Ayushman Bharat Yojana has served and continues to serve people from economically backward societies, helping them access standard healthcare facilities.

Furthermore, top insurance companies like Star Health, with 14,000+ network hospitals across India, offer cashless settlement in less than 2 hours and other benefits ensuring access to advanced healthcare facilities.

Also Read:

→ Is Medical Insurance Mandatory for Employees in India

→ Is Medical Insurance Tax Deductible

→ Is Miscarriage Covered Under Medical Insurance in India

→ What Dental Procedures are Covered by Medical Insurance

→ What Does PCP Mean in Medical Insurance