Question: Tell me about the Mahatma Jyotirao Phule Jan Arogya Yojana scheme.

Answer: .Step 8: The Network Hospital shall provide free follow-up consultation, diagnostics, and medicines under the scheme up to 10
days from the date of discharge.Step 9: The Insurer scrutinizes the bills in light of the operational guidelines and mandatory
investigations and pays claims as per the agreed package rates and grade of the Hospital. The Insurance Company shall settle the claims
of the hospitals online within 15 working days of receipt of the complete claim document from the Network Hospital.Note 1: The claim
settlement module along with electronic clearance and the payment gateway will be part of the workflow in the State Health Assurance
Society (SHAS) portal and will be operated by the Insurer.Note 2: The reports will be available for scrutiny on the State Health
Assurance Society (SHAS) login.ï»¿Documents RequiredList of valid photo ID proofs to be accepted along with document of eligible
criteria:1. Aadhaar Card or Aadhaar Registration Slip with a photo of the beneficiary. An Aadhaar Card would be insisted upon as an
identification document and in the absence of an Aadhaar card/number; any document that is accepted for issuance of an Aadhaar card
will also be accepted.2. Pan Card3. Voter ID4. Driving License5. School/College Id6. Passport7. Freedom Fighter ID card8. Health Card
of RGJAY / MJPJAY9. Handicap Certificate10. Nationalized Bank Passbook with Photo11. Senior citizen card issued by the Central
Government or State Government12. Defense ex-servicemen card issued by Sainik Board13. Marine Fishery Identity card (Issued by
Ministry of Agriculture / Fisheries Department Government of Maharashtra).14. Any photo ID proof issued by the Government of
Maharashtra/ Government of IndiaFrequently Asked QuestionsWhat is the full form of MJPJAY?MJPJAY's full form is Mahatma
Jyotiba Phule Jan Arogya Yojana.When was MJPJAY started?MJPJAY was launched in 28 districts of Maharashtra on April 1st,
2020.What is the objective of MJPJAY?MJPJAY aims to provide cashless, quality medical care to the beneficiaries under the scheme
for catastrophic illnesses requiring hospitalization for surgery and treatment under identified specialized services through a network of
health care providers.How much assistance is available under MJPJAY Yojana?MJPJAY Yojana 2024 provides coverage up to â‚¹
1,50,000/- per policy year per family to meet all expenses related to hospitalization of the beneficiary. For renal transplants, this limit has
been increased to â‚¹ 2,50,000/- per family per policy year.Who is eligible for receiving Maintenance Haemodialysis treatment under
MJPJAY?A patient suffering from chronic kidney disease requiring maintenance HD and who has a health card is eligible. If the patient
does not have a health card, he or she should have an orange or yellow ration card or an Antyodaya or Annapurna card along with valid
ID proof.Which services are provided under package of Maintenance Haemodialysis under MJPJAY for the patient?The package
includes pre- and post-treatment diagnostics,consultation, hospital charges, consumables, and medicines. The detailed package is as
follows: >> Investigations Creatinine tests (Monthly) Complete blood count (CBC, Monthly) HIV/Hep.A/Hep.C tests (once every three
months) Serum electrolytes (as per advise) Blood glucose, if required >> Consultion Clinical examination by Nephrologist/Medical
Cordinator. >> Consumable -Dialyser (It will be used upto optimal capacity and replaced if needed free of charge under scheme), -
Tubing (It will be used upto optimal capacity and replaced if needed free of charge under scheme), - Fistula Needle (It will be used upto
optimal capacity and replaced if needed free of charge under scheme). - IV fluids, - Haemodialysis Part A/B and o Heparin. >>
Medicines Inj. Erythropoetin, as per the advice of NephrologistWhat should be frequency of dialysis cycles under MJPJAY for each
approved preauth?The frequency of dialysis should be a minimum of 8 cycles and a maximum of 12 cycles, as recommended by the
nephrologist or medical coordinator based on his or her serum creatinine level.Does patient have to pay any extra money for treatment?
No. The patient should not pay any extra money to the hospital or center for services that are covered under the approved package.Will
Balance Sum Insured used for dialysis patient limit other household members to avail services under MJPJAY?The maximum sum
assured under MJPJAY is â‚¹ 1,50,000/- per family, on a family-floater basis. If the dialysis patient has utilized a particular amount from
the sum assured, other family members can still avail services under MJPJAY till the total amount of â‚¹ 1,50,000/- gets exhausted. This
amount of Sum Insured cannot get extended under any circumstances (except if patient requires a renal transplant, where BSI will be
considered as â‚¹ 2,50,000/-)Can HIV or HCV positive cases avail Maintenance Haemodialysis service under MJPJAY ?Yes. If a patient
is a beneficiary of MJPJAY and is HIV or HCV positive, then he or she can still avail services under MJPJAY. Empanelled hospitals and
stand-alone dialysis centers must have dedicated machines for HIV or HCV-positive patients. Under no circumstances shall these units
be used for other patients.If patient requires blood transfusion, is cost of blood transfusion covered under package?No. Maintenance
Haemodialysis package does not cover the cost of a blood transfusion.In case of a query or to register a complaint what should I do ?In
case of a query, you can contact Arogyamitra or call the toll-free number. Arogyamitra is available round the clock in the hospital or
center and will facilitate and guide you if any problem arises. But if you are not satisfied, then call our toll-free numbers, 155388 or
18002332200, to register a complaint.Sources And ReferencesOfficial WebsiteFAQsOkWas this helpful?News and UpdatesNo new
news and updates availableShareYou need to before applying for
schemesCancelIt seems you have already initiated your application earlier.To
know more please visit CancelApply NowMaharashtraMahatma Jyotirao Phule Jan Arogya YojanaCashless
ServiceDiseasesHealth InsuranceHospitalHospitalDetailsBenefitsEligibilityApplication ProcessDocuments RequiredFrequently Asked
QuestionsMahatma Jyotirao Pule Jan Arogya Yojana is the flagship health insurance scheme of the Government of Maharashtra. The
scheme provides end-to-end cashless services for identified diseases through a network of service providers from the Government and
Private sector. The scheme earlier was known as Rajiv Gandhi Jeevandayee Arogya Yojana which was started on 2nd July 2012 in eight
districts and then was expanded to 28 districts of Maharashtra from 21st November 2013.OBJECTIVE:To provide cashless quality
medical care to beneficiaries under the scheme for catastrophic illnesses requiring hospitalization for surgeries and therapies under
identified specialty services through a network of health care providers.Note: The Integrated Mahatma Jyotirao Phule Jan Arogya Yojana
(MJPJAY) and Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) were launched in the state on 1st April, 2020.
United India Insurance Company Limited (a Public sector Undertaking Company) provides health insurance coverage to beneficiaries
under the insurance mode and the State Health Assurance Society provides coverage in assurance mode. State Health Assurance Society
is paying an insurance premium of â‚¹ 797/- per family per year to the Insurance Company in quarterly installments on behalf of eligible
beneficiary families.OkWas this helpful?ShareNews and UpdatesNo new news and updates availableÂ©2024Powered byDigital India
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24303714Last Updated On : 28/03/2024 | v-2.1.1