Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) and Pradhan Mantri Jan Arogya Yojana

🌿 Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) and Pradhan Mantri Jan Arogya Yojana (PMJAY): A Lifeline for Affordable Healthcare in Maharashtra

🏥 Introduction

Healthcare costs can be overwhelming for many families in India. To bridge this gap, the Government of Maharashtra and the Government of India have launched two major public health insurance schemes — Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) and Pradhan Mantri Jan Arogya Yojana (PMJAY).
These programs provide cashless and quality medical treatment to economically weaker sections of society through empanelled hospitals across the state.

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💡 Objective of the Schemes

Both MJPJAY and PMJAY aim to:

• Provide financial protection against high medical expenses.

• Ensure universal access to secondary and tertiary healthcare services.

• Promote early treatment to reduce morbidity and mortality rates.

• Strengthen the public–private partnership model for health services.

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👪 Eligibility

• MJPJAY primarily covers families residing in Maharashtra whose names appear in the state’s Yellow, Orange, or Antyodaya ration card lists.

• PMJAY (Ayushman Bharat) covers 10.74 crore poor and vulnerable families across India as per SECC (Socio-Economic Caste Census) data.

• Beneficiaries can avail treatment at empanelled government and private hospitals without paying cash.

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💳 Key Features

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💰 Package Costs and Medical Coverage

According to the official package cost list (MJPJAY_PMJAY_Package_Costs.pdf, both schemes include comprehensive coverage across several specialties.
Some notable examples:

🔹 ENT (Ear, Nose & Throat) Surgeries

• Tympanoplasty – ₹15,000

• Stapedectomy with Vein Graft – ₹15,000

• Myringotomy with Grommet (Both Ears) – ₹3,500

• Behind the Ear Analogue Hearing Aid – ₹2,500

• Microlaryngeal Surgery – ₹12,000

🔹 Cardiac and Cardiothoracic Surgery

• Coronary Bypass Surgery (On Pump with IABP) – ₹1,50,000

• Mitral Valve Replacement – ₹1,20,000

• Tricuspid Valve Replacement – ₹1,20,000

• Double Valve Replacement – ₹1,50,000

• Aortic Valve Replacement – ₹1,20,000

🔹 Critical Care

• ARDS with Ventilatory Care (14 days stay) – ₹65,000

• Septic Shock with Ventilatory Assistance – ₹50,000

• COPD with Respiratory Failure (14 days) – ₹70,000

• OP Poisoning requiring Ventilatory Support – ₹30,000

🔹 General Surgery

• Laparoscopic Cholecystectomy – ₹25,000

• Appendectomy – ₹22,000

• Umbilical Hernia Repair with Mesh – ₹25,000

• Splenectomy for Hypersplenism – ₹35,000

• Colostomy Closure – ₹20,000

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🏨 Hospital Empanelment

Hospitals that meet quality and infrastructure standards are empanelled under MJPJAY and PMJAY, ensuring:

• Qualified medical staff

• Emergency facilities

• Cashless transaction systems

• Regular audits by health authorities

Patients can identify empanelled hospitals via:

• MJPJAY official website – https://www.jeevandayee.gov.in

• Ayushman Bharat PMJAY portal – https://pmjay.gov.in

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📲 How to Avail Benefits

1. Visit an Empanelled Hospital
   Present your ration card, Aadhaar, or PMJAY card.

2. Identity Verification
   Hospital staff will verify eligibility through the official portal.

3. Treatment & Cashless Admission
   Once approved, patients receive cashless treatment for approved packages.

4. Post-treatment Discharge
   The scheme covers hospitalization, surgery, medicines, and follow-up care.

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🌈 Impact of the Scheme

Since its implementation, MJPJAY–PMJAY has:

• Benefited millions of low-income families in Maharashtra.

• Reduced out-of-pocket healthcare expenses significantly.

• Enhanced accessibility to specialized treatments like cardiac, ENT, oncology, and orthopedic surgeries.

• Promoted digital transparency and improved healthcare infrastructure in the state.

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🩺 Conclusion

The MJPJAY and PMJAY are more than just health insurance schemes — they are lifelines for the underprivileged, ensuring that no one is denied medical treatment due to financial constraints.
By providing standardized package costs and cashless access, these programs are transforming Maharashtra’s healthcare ecosystem — one patient at a time.