About the Scheme – The Government of Maharashtra launched the Mahatma Jyotirao Phule Jan Arogya Yojana (formerly Rajiv Gandhi Jeevandayee Arogya Yojana) on a pilot basis in eight districts from 2 July 2012 and later this scheme was extended to all the districts of Maharashtra from 21 November 2013. This ambitious scheme was initially launched for low-income families and later other beneficiary groups were included in it from time to time.
• Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana was launched by the Government of India from 23 September 2018. The families included in this scheme were based on the socio-economic caste-wise census 2011 and occupational criteria for rural and urban areas respectively. This scheme was implemented jointly with the Mahatma Jyotirao Phule Jan Arogya Yojana from 2018 to 2020. The share of the expenditure incurred for this scheme is 60:40 between the Government of India and the Government of Maharashtra.
• In the combined scheme being implemented as above, the Government has Amendments were made by the government decision dated 26 February 2019. Accordingly, the scheme provided insurance cover of Rs. 1.50 lakh per family per year for 996 treatments under the Mahatma Jyotirao Phule Jan Arogya Yojana. Also, health cover of Rs. 5.00 lakh per family per year for 1209 treatments under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana was applicable. The said scheme was implemented from 1.04.2020 to 30.06.2024.
• Meanwhile, the Maharashtra government decided to implement the Mahatma Jyotirao Phule Jan Arogya Yojana for all families in the state through a government decision dated 28 July 2023 and increased the scope of the current scheme. Accordingly, an integrated scheme with an expanded scope is being implemented from 1 July 2024. This scheme covers the entire population of Maharashtra. This scheme provides cashless quality medical services from admission to hospital till discharge from home for secondary and tertiary diseases requiring hospitalization through approved hospitals. This scheme is being implemented on a fully guaranteed basis.
• Salient features of the combined scheme:
o Health coverage for all citizens of Maharashtra
o Cashless secondary and tertiary treatment in approved hospitals
o Health coverage of Rs. 5 lakh per year can be used by one or all members of the family.
o All diseases covered under the medical service scheme for surgical treatment under 34 special services requiring hospitalization are covered from day one.
o Beneficiaries of Mahatma Jyotirao Phule Jan Arogya Yojana can get treatment in any government/private approved hospitals in the state of Maharashtra.
o Pradhan Mantri Jan Arogya Yojana can be availed in any approved hospital in any state across the country.
o Dedicated call centre for the scheme where beneficiaries can get information about the scheme and complain about the services under the scheme
o The scheme is completely paperless and implemented through a computer system.
o Health friends have been appointed in every approved hospital to provide help and assistance to the beneficiaries.
o In case of emergency, patients can seek treatment by informing through phone or email.
• The details of the expanded scheme are as follows :
o Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (Group-A) Beneficiaries:
Families registered in the Social, Economic and Caste Census, 2011 (SECC)
Antyodaya Anna Yojana (AAY) and Priority Group (PHH) families covered under the National Food Security Act (NFSA)