Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) – Key Information for Beneficiaries

Overview: MJPJAY is a health scheme launched by the Government of Maharashtra to provide universal health coverage to all residents. It offers cashless treatment for secondary and tertiary healthcare needs through network hospitals across Maharashtra.

Eligibility Criteria & Required Documents

1. Category A (Low-Income Families):

   • Eligible: Families holding Yellow, AAY (Antyodaya Anna Yojana), Annapurna, or Orange Ration Cards.
   • Documents: Ration Card and valid ID proof.

2. Category B (Other Families):

   • Eligible: White ration cardholders or families without a ration card but with a valid Maharashtra domicile certificate.
   • Documents: White Ration Card/Domicile Certificate, Self-Declaration, and valid ID proof.

3. Category C (Special Groups):

   • Eligible: Students, women, senior citizens in government institutions, journalists, construction workers, etc.
   • Documents: Ayushman card or ID card from respective organizations.

4. Category D (Road Accident Victims):

   • Eligible: Victims of road accidents in Maharashtra, including those from outside Maharashtra.
   • Documents: Geotagged photo, police report, and ID proof.

5. Category E (Maharashtra-Karnataka Border):

   • Eligible: Families holding AAY, Annapurna, or PHH ration cards from border districts.
   • Documents: Ration card issued by Karnataka Government, self-declaration, and valid ID proof.

Benefits of the Scheme

• Health Coverage:

  • Rs. 5 lakh per family per year for Categories A, B, C, and E (on a floater basis).
  • Rs. 1 lakh per person per year for road accident victims in Category D.

• Medical Treatments:

  • Covers 1356 health packages under 34 specialties for Categories A, B, C, and E.
  • 184 packages for road accident patients under Category D.

• Follow-up Treatment: 262 packages for post-treatment care across all categories.

• Government Hospital Treatments: 119 health packages reserved for government hospitals.

• Comprehensive Coverage: Includes charges for hospitalization, surgeries, diagnostic tests, medicines, and even transportation (including body transportation in case of death).

Key Features

• Cashless Treatment: Patients can avail treatment in both government and private network hospitals.
• Universal Coverage: All residents of Maharashtra are now covered under the expanded scheme.
• Paperless Process: The scheme operates digitally, with a dedicated portal and helpline for support.
• Portability: Benefits are portable across the country under PMJAY.

For more information or to raise any grievances, you can contact the dedicated call center or approach the Arogyamitra at network hospitals.