Mukhyamantri Jan Arogya Yojana (Uttar Pradesh)

What is Mukhyamantri Jan Arogya Yojana?

Mukhyamantri Jan Arogya Yojana is the Uttar Pradesh state government's own health assurance scheme, run by the Medical Health and Family Welfare Department through the State Agency for Comprehensive Health and Integrated Services (SACHIS). The scheme is also referred to as Mukhyamantri Jan Arogya Abhiyan, and it provides Rs 5 lakh of cashless hospital treatment per family per year, exactly the same cover as the central Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

The reason the state scheme exists is a gap in the central list. AB-PMJAY selects beneficiaries from the deprivation criteria of the Socio-Economic and Caste Census of 2011. That census left out large numbers of genuinely poor Uttar Pradesh households: families that had moved, families whose deprivation category was recorded differently, and families that fell into hardship after 2011. Uttar Pradesh created Mukhyamantri Jan Arogya Yojana to cover those households from its own budget, so that a family's protection does not depend on how a fifteen-year-old census recorded them.

According to SACHIS, the combined Ayushman programme in Uttar Pradesh now covers around 9.57 crore beneficiaries, has issued about 5.85 crore cards, and works through 6,468 empanelled hospitals. Over 96 lakh claims have been submitted and the agency reports a claim settlement rate of about 93.5 per cent.

The practical point for a reader is this: the card, the hospitals, the package rates and the treatment are identical to AB-PMJAY. A hospital does not treat a state-scheme cardholder differently. Only the source of the money differs, and that is an accounting matter between SACHIS and the National Health Authority.

Who is eligible for Mukhyamantri Jan Arogya Yojana?

You can be covered if:

• Your family is a resident of Uttar Pradesh and is not already on the central AB-PMJAY beneficiary list. The state scheme is precisely for the excluded.
• Your household holds an Antyodaya Anna Yojana ration card. Antyodaya families are a directly notified category for state-funded cover in Uttar Pradesh.
• Your household falls into one of the other categories notified by the state government from time to time, the state has periodically extended cover to specific occupational and vulnerable groups.
• Every member you want covered has an Aadhaar number and appears on the family's ration card.

There is no age limit, no waiting period and no exclusion for pre-existing conditions. A person diagnosed with a serious illness before the card was issued is covered from the day the card is generated.

You are not eligible if:

• Your family is already covered under AB-PMJAY — in that case you are not excluded from treatment at all, you simply draw the same Rs 5 lakh from the central scheme instead, using the same card.
• Your household does not appear on any eligible list maintained by SACHIS and does not fall in a notified category. Cover under this scheme is list-based; it is not open to any household that chooses to enrol.
• You are not a resident of Uttar Pradesh.
• The person seeking cover cannot complete Aadhaar e-KYC, since card generation depends on it.

The single most reliable way to settle the question is the "Am I Eligible" check on the beneficiary portal or the Ayushman app, which searches by mobile number, ration card number or Aadhaar and tells you which scheme your family sits under.

What does the Rs 5 lakh cover, and what does it not?

Mukhyamantri Jan Arogya Yojana pays for hospitalisation, at rates fixed in the national health package master approved by the National Health Authority. Within an admission the package rate is all-inclusive, and covers:

• Bed charges in a general ward, along with nursing and doctor's fees.
• Medicines, consumables and implants used during the admission.
• Diagnostics, laboratory tests, imaging and pathology linked to the treatment.
• Surgery, ICU care, anaesthesia and the operation theatre.
• Three days of pre-hospitalisation expenses and fifteen days of post-hospitalisation expenses, including follow-up medicines.
• Food for the patient during the admission.

The cover is a family floater: the Rs 5 lakh belongs to the household, not to each person, and any one member can use the entire amount in a single admission.

Not covered are routine outpatient consultations, medicines bought without an admission, cosmetic procedures, and treatment at hospitals that are not empanelled, except in a genuine emergency, where the rules for stabilisation and transfer apply. Fertility treatment, drug rehabilitation and a handful of other exclusions also apply as listed in the national package master.

How to apply for the Ayushman card in Uttar Pradesh

Getting the card is free. There is no application fee and no charge at a Common Service Centre for Ayushman card generation.

1. Check your eligibility first. Open the beneficiary portal linked from sachis.in, or install the official Ayushman app, and use the "Am I Eligible" search with your mobile number, Aadhaar number or ration card number.
2. Select the family member whose card you want from the household list the search returns. Each member needs a separate card, though the Rs 5 lakh limit is shared.
3. Complete Aadhaar e-KYC. On the app you can use face authentication, which works even if your mobile number is not linked to Aadhaar. If your mobile is Aadhaar-linked, OTP verification is quicker. A live photograph and basic details are captured at this step.
4. Submit and wait for approval. Most e-KYC requests are auto-approved within minutes; a few go to the District Implementation Unit for manual approval, which takes a day or two.
5. Download the card from the app or the portal once the status shows approved, and keep a printed copy at home along with the ration card.

If you cannot do it yourself

1. Visit the nearest Common Service Centre (Jan Seva Kendra) with the Aadhaar cards and ration card of everyone in the family. The Village Level Entrepreneur completes biometric e-KYC on the spot.
2. Or go to the Ayushman Mitra desk at any empanelled government or private hospital. Every empanelled hospital is required to have one, and the desk can generate a card even at the moment of admission if the family is on the list.
3. Or attend an Ayushman camp held at the Panchayat Bhavan or the block headquarters. These camps are announced by the district administration and are the easiest route in villages.

How to use the card at a hospital

1. Choose a hospital from the empanelled list, searchable on the Ayushman app and the beneficiary portal by district and by speciality.
2. Report to the Ayushman Mitra desk, not the billing counter, and present the Ayushman card along with Aadhaar.
3. The hospital raises a pre-authorisation request to SACHIS for the proposed procedure. Approval for most planned procedures comes within hours; emergency admissions proceed immediately and the authorisation follows.
4. Get treated cashless. You should sign nothing that commits you to payment, and you should not be asked to buy medicines from outside during the admission.
5. At discharge, take the discharge summary and the claim reference. These are what you need if a dispute arises later.

Common problems and what to do about them

• "Your name is not on the list." Run the Am I Eligible search yourself before accepting this. If your ration card is Antyodaya and your name still does not appear, take the ration card and Aadhaar to the District Implementation Unit at the Chief Medical Officer's office.
• e-KYC failing on face authentication. Try again in good light with no spectacles, or switch to biometric e-KYC at a CSC.
• Name mismatch between Aadhaar and ration card. Correct the Aadhaar record first at an Aadhaar centre, since the ration card database is updated against it.
• Hospital demanding money. Call 1800 1800 4444 from the hospital itself. This is the single most effective step, because the District Implementation Unit can intervene while the patient is still admitted.
• Card issued but limit shows as exhausted. Ask the Ayushman Mitra to print the transaction history; a wrongly booked claim against your family can be reversed.

Helpline and grievance redressal

• SACHIS toll-free helpline: 1800 1800 4444
• National Ayushman Bharat helpline: 14555
• Grievance portal: the Centralised Grievance Redressal Management System linked from sachis.in, where a written complaint gets a tracking number
• District level: the District Implementation Unit at the office of the Chief Medical Officer in each district
• State level: Uttar Pradesh's general grievance route at jansunwai.up.nic.in

No fee is payable at any stage, not for the card, not for e-KYC, and not for treatment covered by a package. Anyone charging for an Ayushman card is committing a fraud, and SACHIS can be told about it on the same toll-free number.

How to check your application status

There is no separate "application" that sits pending for weeks under Mukhyamantri Jan Arogya Yojana. What a family actually tracks is the status of their Aadhaar e-KYC request and the resulting Ayushman card. Four ways to check, in order of ease:

1. Ayushman app, "Am I Eligible" search. Enter the mobile number, Aadhaar number or ration card number used at the time of e-KYC. The result shows whether the household is on the beneficiary list, whether a card already exists for each member, and whether a pending e-KYC request is still awaiting approval or has been auto-approved.
2. Beneficiary portal linked from sachis.in. The same "Am I Eligible" search works from a browser if a smartphone with the app is not handy, useful when checking from a cyber cafe or a relative's computer.
3. Ask at the point of submission. If the e-KYC was done at a Common Service Centre, the Village Level Entrepreneur can look up the same status on their own login and tell the family directly, since they hold the request reference.
4. Ayushman Mitra desk at any empanelled hospital. The desk staff can pull up card status even for a household that registered elsewhere, because the search runs on Aadhaar or ration card number, not on where the request originated.

Most e-KYC requests clear automatically within minutes. A request that moves to the District Implementation Unit for manual review, typically because of a name mismatch or an unclear photograph, takes a day or two longer. If the status has not changed after three to four days, calling the SACHIS toll-free helpline 1800 1800 4444 with the Aadhaar or ration card number is the fastest way to find out what is holding it up, since the helpline can see the same case file the District Implementation Unit is working from.

Common reasons for rejection

Mukhyamantri Jan Arogya Yojana rarely "rejects" a family outright. Instead an e-KYC request stalls or a name search comes back empty, and the underlying causes are almost always one of these:

• The household simply is not on any eligible list. Cover under this scheme is list-based: a family must appear as an Antyodaya Anna Yojana ration cardholder or in another state-notified category. There is no open enrolment, so a name that never made it onto a notified list will not clear no matter how many times e-KYC is attempted. The fix is to first confirm on the "Am I Eligible" search which list, if any, the household is expected to be on, then take the ration card and Aadhaar to the District Implementation Unit at the Chief Medical Officer's office to ask why the name is missing from a list it should be on.
• Aadhaar and ration card details do not match. A spelling difference in the name, a different date of birth, or a member listed on the ration card who was never added to the Aadhaar-linked family record commonly stalls e-KYC at the manual-review stage. Since the ration card database is reconciled against Aadhaar, the correction has to happen at an Aadhaar centre first, after which the ration card record catches up.
• Face authentication fails repeatedly. Poor lighting, spectacles, or a low-quality phone camera are the usual causes, not an actual eligibility problem. Switching to biometric e-KYC (fingerprint or iris) at a Common Service Centre, where the equipment is more reliable, resolves this far more often than retrying the app.
• The family is already flagged under AB-PMJAY. If a household is found to already carry a central-scheme entry, the state-scheme request will not proceed separately, because the same Rs 5 lakh cover and the same card are meant to serve both. This is not a genuine rejection of the family, only of a duplicate registration attempt, and the existing AB-PMJAY card should be used instead.
• A minor or newly added family member has no independent Aadhaar record yet. Since card generation depends on Aadhaar e-KYC for each individual, a child or a recently married member without their own Aadhaar enrolment cannot get a card until that Aadhaar registration is completed first at an Aadhaar centre.
• Incomplete or torn ration card submitted at a CSC. Operators sometimes cannot proceed if the ration card copy is unreadable or missing a page listing all members. Carrying the original ration card, not just a photocopy, avoids this at the counter.

In every one of these situations the underlying record, not the scheme itself, is the blocker, so the practical fix is almost always to correct the Aadhaar or ration card record first and then repeat the "Am I Eligible" search rather than treat the outcome as final.