Healthcare costs in India can often be quite heavy, especially for low- and middle-income families. To address this concern, the Government of Maharashtra has launched the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY). This scheme provides cashless medical treatment to eligible residents across the state and aims to ensure that quality healthcare is accessible to all. Let’s understand the features, eligibility criteria, and benefits of the MJPJAY scheme in detail.
What is the Mahatma Jyotirao Phule Jan Arogya Yojana?
The Mahatma Jyotirao Phule Jan Arogya Yojana is a state-run health insurance scheme. It is initiated by the Public Health and Family Welfare Department of Maharashtra.
- It aims to provide cashless treatment for secondary and tertiary healthcare services to all residents of the state. It originally covered low-income households. However, its scope has broadened to include all families in Maharashtra.
- The Mahatma Jyotirao Phule Jan Arogya Yojana offers financial protection for medical treatments through a network of empanelled public and private hospitals.
- Under MJPJAY, families are eligible for treatment worth up to ₹1.5 lakh per year. Integration with the Ayushman Bharat scheme increases this limit to ₹5 lakh annually. This unified coverage has become fully operational across the state from 1st July 2024.
Eligibility Criteria for Mahatma Jyotirao Phule Jan Arogya Yojana
The Mahatma Jyotiba Phule Jan Arogya Yojana eligibility criteria can be quite specific. The coverage depends on the category the individual falls under.
Category A
This category includes families with Yellow, Antyodaya Anna Yojana (AAY), Annapurna Yojna, or Orange Ration Cards.
Category B
White Ration Card holders, including government/semi-government employees, come under this category.
Families without any ration card but holding a valid domicile certificate of Maharashtra are also Category B policyholders.
Category C
The various profiles for Category C of the Mahatma Jyotiba Phule Jan Arogya Yojana include:
Students in government and recognised Ashram schools.
Orphans, senior citizens, and women living in recognised government institutions.
Journalists and their families (as per government criteria).
Registered construction workers from outside Maharashtra.
Category D
Road traffic accident victims from outside Maharashtra or even India, who suffer accidents within Maharashtra, can access Category D coverage.
Category E
Residents from 865 villages along the Maharashtra–Karnataka border with valid ration cards under AAY, Annapurna Yojna, or Priority House Holder (PHH).
Gaining clarity on the Mahatma Jyotiba Phule Scheme eligibility criteria is crucial, as the category you fall under will determine the coverage you receive.
Benefits of Mahatma Jyotirao Phule Jan Arogya Yojana
The Mahatma Phule Jan Aarogya Yojana provides a wide range of medical and financial benefits for eligible individuals and families.
Financial Coverage
For families that fall under Categories A–E (except D), the coverage is ₹5 lakh per family per year. This amount is provided on a floater basis, meaning the coverage can be used by any family member. For Category D (accident victims who are residents outside of Maharashtra), the coverage is ₹1 lakh per person annually.
Comprehensive Health Packages
The MJPJAY scheme covers more than 1350 medical procedures under 34 specialties for individuals in Categories A, B, C, and E. For Category D, there are 184 specific health benefit packages focusing on road accident treatments.
Follow-up Treatment
In addition to the above, 262 follow-up treatment packages are also available for all categories to ensure continued care.
Cashless Hospitalisation
Patients under the Mahatma Phule Yojana can receive quality treatment without paying hefty costs upfront. Costs like nursing charges, doctor fees, ICU care, surgical care, and blood transfusions are all covered.
Diagnostic & Support Services
The MJPJAY scheme also provides coverage for diagnostic tests, X-rays, in-patient meals, oxygen support, prosthetics, implants, and more.
Transport Support
The MJPJAY Yojana covers travel costs to and from the hospital (second-class rail fare or State Transport bus). In the case of death, the cost of transporting the deceased to their hometown is also covered.
Hassle-free Claim Settlement
The Mahatma Phule Yojana operates on an Assurance Basis. It means the claims are settled directly by the State Health Assurance Society (SHAS) with the hospitals. Patients do not need to worry about extensive claim paperwork.
Application Process
The application for the Mahatma Jyotirao Phule Jan Aarogya Yojana happens offline.
- Visit any empanelled government or private hospital and ask for the MJPJAY application form.
- Fill out the form, attach a passport-sized photo, and submit the required (self-attested) documents.
- Submit the filled form to the hospital authority within the given period.
- Collect the acknowledgement receipt for tracking purposes.
You can also consult the helpdesk at your preferred hospital for guidance.
Taking Financial Protection a Step Ahead
While MJPJAY offers solid healthcare coverage, it is also crucial to have a life insurance policy to improve your financial planning and ensure savings in the long run.
While a health cover can take care of one’s needs during hospitalisation, a life insurance plan is an effective way to ensure financial protection for your loved ones in case you are not there tomorrow. To plan your long-term protection effectively, you can use a life insurance calculator and complement your health plan with a suitable yet affordable life insurance policy.
The Mahatma Jyotiba Phule Jan Arogya Yojana is a positive step towards inclusive and accessible healthcare in Maharashtra. By offering cashless, high-value medical support to all families, the MJPJAY Yojana reduces financial stress and ensures access to quality treatment for all. If you meet the Mahatma Jyotiba Phule Scheme eligibility, do not hesitate to enrol and secure your family’s health and well-being today.
Customers 
Distributor 
Partner with Us 
Employee 
