Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY)

What is Mahatma Jyotirao Phule Jan Arogya Yojana?

Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) is Maharashtra's flagship health assurance scheme. It pays for hospital treatment so that a family does not have to sell land, pawn jewellery or borrow at ruinous interest to survive a surgery. The scheme is administered by the State Health Assurance Society under the Public Health Department, Government of Maharashtra.

MJPJAY began life in 2012 as the Rajiv Gandhi Jeevandayee Arogya Yojana, which is why the official portal is still jeevandayee.gov.in, and was renamed Mahatma Jyotirao Phule Jan Arogya Yojana in 2017. Many readers search for it as Mahatma Jyotiba Phule Jan Arogya Yojana; it is the same scheme.

Two changes define the scheme as it stands today. First, from 1 April 2020 MJPJAY was run in convergence with the central Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana, so one hospital network and one set of packages serve both. Second, from 1 July 2024 Maharashtra implemented the expanded integrated scheme: the cover was raised to Rs 5 lakh per family per year and extended to all ration card holding families in the state, turning what was a poverty-targeted scheme into near-universal health coverage.

The entire premium is paid by the Government of Maharashtra. Beneficiary families contribute nothing.

What does MJPJAY cover?

• Rs 5 lakh per family per year, on a floater basis. The limit belongs to the family, not the individual, so one member's cardiac surgery can use the whole amount or three members can share it.
• 1,356 health benefit packages across 34 specialities under the integrated scheme, spanning cardiology and cardiovascular surgery, oncology (surgical, medical and radiation), nephrology including dialysis, neurosurgery, orthopaedics, burns, critical care, paediatric surgery, urology, general surgery and more.
• All pre-existing diseases covered from day one, no waiting period.
• Cashless treatment, covering the bed, surgery, consumables, medicines, diagnostics, food during admission, and one follow-up consultation with medicines for the defined period after discharge.
• Transport allowance to return home is provided under the scheme's norms.

MJPJAY is a hospitalisation scheme. Routine OPD visits, cosmetic procedures and treatments outside the package list are not covered, and some high-end packages are reserved for government hospitals only.

Who is eligible for MJPJAY?

You are eligible if:

• You are a resident of Maharashtra holding a ration card; under the expanded scheme implemented from 1 July 2024, all ration card holding families in the state are covered.
• You hold a yellow, orange, Antyodaya Anna Yojana or Annapurna ration card — the original Category A group, still the core of the scheme.
• You are a farmer family in the 14 agriculturally distressed districts, which formed a separate covered category.
• You belong to one of the special groups the scheme covers, including inmates of government orphanages, ashram shalas, women's ashrams and old age homes, and journalists accredited by the state along with their dependants.
• You are on the SECC-based PM-JAY list, in which case you draw the benefit through the same hospital network.

You cannot claim, or the claim will not be paid, if:

• The family does not hold a ration card and cannot establish residence in Maharashtra, that is the basic eligibility document.
• Treatment is taken at a hospital that is not empanelled. The scheme pays only its network hospitals; a bill from a non-empanelled hospital cannot be reimbursed afterwards.
• The procedure is not in the package list, or is a package reserved for government hospitals and was done privately.
• The treatment did not involve hospitalisation.
• The Rs 5 lakh family limit for that year is already exhausted.
• Pre-authorisation was never raised by the hospital before the procedure, except in a genuine emergency where the hospital must still file it promptly.

How to use MJPJAY at a hospital

1. Identify an empanelled hospital. Use the hospital list on jeevandayee.gov.in, or ask at the district hospital, the rural hospital or your primary health centre. Only network hospitals give cashless treatment.
2. Go straight to the Arogyamitra desk at the hospital with the patient's ration card and Aadhaar. The Arogyamitra is on duty round the clock.
3. Get the eligibility verified and the health card made. The Arogyamitra checks the family record, makes or retrieves the Ayushman / MJPJAY card, and registers the patient.
4. Let the hospital raise pre-authorisation. The treating doctor selects the right package and files the pre-authorisation request with the State Health Assurance Society, which approves it electronically.
5. Take the treatment cashless. Once approved, the hospital cannot ask the family for money for anything within the package; bed, surgery, medicines, diagnostics and food are included.
6. Collect the discharge summary and follow-up instructions. The scheme covers a defined follow-up period after discharge, including consultation, diagnostics and medicines.

In an emergency, go to the nearest empanelled hospital and start treatment first. The Arogyamitra files the pre-authorisation alongside; the family should not be asked to pay a deposit for a covered package.

How to get the Ayushman / MJPJAY health card

1. Visit an empanelled hospital's Arogyamitra desk, a Common Service Centre, an Aaple Sarkar Seva Kendra, or a health card camp organised in your ward or village.
2. Carry your Aadhaar and ration card, and give the biometric or OTP authentication asked for.
3. Collect the card, which is issued free of cost. Anyone charging for the card is charging you for something the state gives for nothing.

The card is not a precondition for treatment. A ration card plus Aadhaar is enough to start, but having it removes a step on the day of admission.

How to check hospitals, packages and case status

• Empanelled hospital list and package list: published on jeevandayee.gov.in, searchable by district and by speciality.
• Case status: ask the Arogyamitra who filed your pre-authorisation, quoting the case or registration number.
• Toll-free helplines: 155388 and 1800-233-2200, for eligibility questions, hospital referrals and complaints.

Common problems and what to do about them

• The hospital asks for a deposit or for money for medicines. For a covered package at an empanelled hospital this is not permitted. Call 155388 or 1800-233-2200 from the hospital itself and ask for the Arogyamitra by name.
• Pre-authorisation rejected. Usually the package chosen does not match the documented diagnosis, or documents were incomplete. The treating doctor can resubmit with the correct package and evidence.
• Name or age mismatch between ration card and Aadhaar. Get the ration card record corrected at the tehsil supply office; mismatches are the commonest reason eligibility verification fails at the desk.
• The nearest hospital is not empanelled. Ask the district hospital or the helpline for the closest network hospital for that speciality. Reimbursement after treatment at a non-network hospital is not available.
• The Rs 5 lakh limit is exhausted. The limit resets for the next policy year; discuss options at a government hospital with the treating unit in the meantime.

Grievance redressal

• Toll-free call centre: 155388 or 1800-233-2200, which handles both information and grievances.
• District Coordinator of the State Health Assurance Society, reachable through the district civil surgeon's office.
• State Health Assurance Society, Public Health Department, through the contact details published on jeevandayee.gov.in.

MJPJAY costs the family nothing. There is no premium, no registration fee and no charge for the health card, and no agent is needed at any stage.