What are the Benefits of MJPJAY?

Why Enrol in MJPJAY? Key Health Benefits You Should Know

The Government of Maharashtra launched the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) as its primary healthcare program. This program provides economically disadvantaged families with access to high-quality medical treatment.

Through its wide variety of benefits, the scheme enables access to essential routine and critical medical care. MJPJAY provides reduced financial responsibilities to its beneficiaries who need surgical interventions and post-hospital treatments that lead to enhanced health results.

Read on to explore the key benefits of the scheme and how to enrol to get those benefits.

Benefits of the MJPJAY scheme

The Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) provides various useful benefits for the health needs of economically weaker families in Maharashtra:

1. Comprehensive Financial Protection

Every eligible family covered under MJPJAY is entitled to a maximum amount of annual health insurance coverage worth ₹5 lakhs. This includes a wide range of medical care services, both secondary and tertiary in nature.

2. Cashless Medical Services

One of the major benefits is the option for cashless treatment at empanelled hospitals. This eliminates the stress of initial payments, enabling patients to recover without concern for immediate cost.

3. Wide Range of Treatments

The plan provides insurance for about 971 medical procedures, surgeries, and therapies in 30 various medical specialities, from cardiology and orthopaedics to gynaecology. Follow-up care is also provided via 121 post-operative care packages.

4. Cover for Pre-existing Medical Conditions

Patients are entitled to treatment of pre-existing ailments from the day of admission. This inclusion ensures that chronically ill or previously diagnosed patients are not prevented from receiving treatment.

5. Post-Hospitalization Support

This scheme extends its benefits beyond hospital discharge by providing coverage for consultations and prescribed medications for up to 10 days. This ensures continuity of care and supports the patient’s recovery process.

6. Trusted Government-Linked Facilities

Some medical interventions are performed exclusively in government-empanelled hospitals or associated medical colleges. This guarantees that beneficiaries enjoy quality and credible care within the public health system.

How to Enroll in the MJPJAY Scheme?

After learning the benefits of this scheme, if you want to enrol in it, follow the step-by-step guide mentioned below:

● Step 1: Go to your nearest government hospital, such as a district hospital, women’s hospital, or general hospital and meet with the Arogyamitra, who will help you begin the enrollment process.

● Step 2: If you visit a government healthcare facility, the doctors will carry out a preliminary diagnosis and provide you with a referral card. This card can then be presented at any network hospital for further treatment.

● Step 3: You can also receive a referral card by attending health camps organized by network hospitals.

● Step 4: Submit the referral card along with your yellow or orange ration card. If you do not have one, you may use an Antyodaya or Annapurna card as proof of eligibility.

● Step 5: Once your documents are verified, diagnostic tests and further medical evaluation will be conducted.

● Step 6: If treatment is required, you will be admitted to the network hospital based on the diagnosis.

● Step 7: The MJPJAY authorities will review an e-authorization request for treatment and submit it to the insurance provider.

● Step 8: Medical professionals from both the insurance company and MJPJAY will assess the request. If all conditions are satisfied, approval will be given within 24 hours. In emergency cases, approval will be granted immediately and marked as ‘EM’.

● Step 9: Once authorization is granted, you will receive cashless treatment or hospitalization.

● Step 10: After the treatment is completed, the hospital will send the insurance company the original bills, diagnostic results, the discharge summary, and other relevant documents.

● Step 11: The insurance company will verify all documents, approve the claim, and process payment directly to the hospital.

● Step 12: After discharge, the network hospital will continue to provide free consultations, medicines, and diagnostics for up to 10 days under the scheme.

MJPJAY is a vital support system for countless families across Maharashtra, ensuring that financial constraints do not prevent access to essential healthcare.

With its extensive coverage, inclusive approach, and seamless enrollment process, the scheme promotes timely treatment and improves overall health and well-being among underserved communities.