Civil Hospital Amdavad

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Pradhan Mantri Jan Arogya Yojana/Ayushman Bharat | Civil Hospital, Amdavad
Pradhan Mantri Jan Arogya Yojana/Ayushman Bharat | Civil Hospital, Amdavad
Civil Hospital, Ahmedabad

Pradhan Mantri Jan Arogya Yojana/Ayushman Bharat

AB-PMJAY

Ayushman Bharat, a flagship scheme of Government of India, was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to "leave no one behind."

Ayushman Bharat is an attempt to move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. This schemes aims to undertake path breaking interventions to holistically address the healthcare system (covering prevention, promotion and ambulatory care) at the primary, secondary and tertiary level.

Dapartment Name AB-PMJAY-MA-INSURNCE CELL

Head of Department Name DR. RAKESH K. JOSHI (MEDICAL SUPERINTENDENT)
Headof Unit Name (All Units Name) DR. RAJESH PATEL (MEDICAL OFFICER)

Department Organogram M. S. – R.M.O. – M.O – M.Cs – D.E.O.s
Department Office Address ROOM NO. 16, TRAUMA GROUND FLOOR, CIVIL HOSPITAL, AHMEDBAD

Department Office Contact Number 079-22681493
OPD Location (1) OFFICE NO. “0” OPD BUILDING, CIVIL HOSPITAL, AHMEDABAD
(2) 1200 BED, OPD BUILDING, MEDICITY CIVIL HOSPITAL, AHMEDABAD
OPD Contact Number (1) ROOM NO. 16 & BED OPD : MONDAY TO FRIDAY (09:00 A.M. TO 05:00 P.M.) SATURDAY (09:00 A.M. TO 1:00 P.M.)
OPD Schedule (1) PMJAY DESK AT TRAUMA GROUND FLOOR : ROUND O’CLOCK (24*7)
Services Offered CASHLESS TRETMNT BENEFIT TO AB-PMJAY-MA CARD HOLDER BENEFICIARY
Other Details MED-CLAIM/DEATH CLAIM FORM, CERTIFICATION OF TKR/GYNEC., ESIS BILLING
Department Activity / Clinical Services Available ENROLLMENT, REGISTRATION, FILE PROCESSING, CLAIM FILES

ABBREVIATION :-

  • M. S. :- MEDICAL SUPERINTENDENT
  • R.M.O. :- RESIDENT MEDICAL OFFICER
  • M.O. :- MEDICAL OFFICER
  • M.Cs :- MEDICAL CO-ORDINATORS
  • D.E. Os :- DATA ENTRY OPERATORS

“P.M.J.A.Y. - Benefits under “MA” scheme

  • Annual per family Rs. Village cover up to 5 (five) lakhs.
  • There is no limit on the number and age of family members.
  • Health oriented cashless treatment.
  • All diseases are covered from day one.
  • Excellent cashless treatment for a total of up to 2700 scheduled procedures.
  • Includes hospital registration, consultation, laboratory report for diagnosis, surgery, post-surgery follow-up services, medicines, admission charges, patient food, follow-up, travel expenses etc.
  • Under the scheme, the beneficiaries will be given Rs. 300/- assistance.

Beneficiaries of the scheme

Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana :- A total of 43.84 lakh households from rural and urban divisions registered under Socio-Economic and Caste Based Survey 2011.

“MOTHER” PLAN:- Households living under the wild line. (Scores from 0 to 20)

“Maa Vatsalya” scheme:-

  • Annual Rs. 4.00 lakhs or middle class families with income below
  • All Asha sisters from rural as well as urban areas.
  • Accredited journalists.
  • Fixed salary employees appointed by direct recruitment to posts in all cadres of Class-III and Class-IV of the State Government.
  • U-WIN Card Holders.
  • Annual Rs. 6 lakhs or less from families of senior citizens.
  • Non-Government Chairman and Non-Government Vice-Chairmen of different public enterprises of the State Government.
  • Socially deprived groups (old people in old age homes, children in orphanages, widows and derelicts in widows' homes, monks and saints living a sattvic life, mentally ill and helpless people)
  • Group of Victims (Gujarat Victim Compensation Scheme-2019 Victims - Victims of incidents like rape victims, acid victims, sexual violence crimes)
  • Families of Corona Warriors (Policemen, Cleaners and Health Workers)
  • Children orphaned during the Covid-19 pandemic period

Card under the scheme

SPECIALTIES COVERED UNDER SCHEME

SR.NO. SPECIALITY CODE SPECIALITY NAME TOTAL PROCEDURES FOR GUJARAT STATE
1 BM BURNS MANAGEMENT 20
2 ER EMERGENCY ROOM PACKAGES 6
3 ID INFECTIOUS DISEASES 1
4 IN Interventional Neuroradiology 33
5 JR JOINT REPLACEMENT 6
6 MC CARDIOLOGY 46
7 MG GENERAL MEDICINE 151
8 MM MENTAL DISORDER 10
9 MN NEO-NATAL CARE 10
10 MO MEDICAL ONCOLOGY 305
11 MP PEDIATRIC MEDICAL MANAGEMENT 157
12 MR RADIATION ONCOLOGY 59
13 OT ORGAN & TISSUE TRANSPLANT 105
14 SB ORTHOPAEDICS 169
15 SC SURGICAL ONCOLOGY 290
16 SE OPTHALMOLOGY 54
17 SG GENERAL SURGERY 202
18 SL ENT 90
19 SM ORAL & MAXILLOFACIAL SURGERY 15
20 SN NEUROSURGERY 159
21 SO OBSTETRICS & GYNAECOLOGY 104
22 SP PLASTIC & RECONSTRUCTIVE 31
23 SS PAEDIATRIC SURGERY 250
24 ST POLYTRAUMA 43
25 SU UROLOGY 203
26 SV CTVS 181
27 US UNSPECIFIED SURGICAL PACKAGES 1
TOTAL 2701

Not Covered Under Scheme

  • Out-patient Department (OPD) Expenses
  • Drug Deaddiction Treatment
  • Cosmetic Surgeries
  • Beriatric and Asthetics
  • Fertility Tretaments
  • Individual Diagnostics

PROCESS FOR CASHLESS TREATMENT UNDER SCHEME AT HOSPITAL

Key Features of PM-JAY

  • PM-JAY is the world’s largest health insurance/ assurance scheme fully financed by the government.
  • It provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empanelled hospitals in India.
  • Over 10.74 crore poor and vulnerable entitled families (approximately 50 crore beneficiaries) are eligible for these benefits.
  • PM-JAY provides cashless access to health care services for the beneficiary at the point of service, that is, the hospital.
  • PM-JAY envisions to help mitigate catastrophic expenditure on medical treatment which pushes nearly 6 crore Indians into poverty each year.
  • It covers up to 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines.
  • There is no restriction on the family size, age or gender.
  • All pre–existing conditions are covered from day one.
  • Benefits of the scheme are portable across the country i.e. a beneficiary can visit any empanelled public or private hospital in India to avail cashless treatment.
  • Services include approximately 1,393 procedures covering all the costs related to treatment, including but not limited to drugs, supplies, diagnostic services, physician's fees, room charges, surgeon charges, OT and ICU charges etc.
  • Public hospitals are reimbursed for the healthcare services at par with the private hospitals.

Benefit Cover Under PM-JAY

Benefit cover under various Government-funded health insurance schemes in India have always been structured on an upper ceiling limit ranging from an annual cover of INR30,000 to INR3,00,000 per family across various States which created a fragmented system. PM-JAY provides cashless cover of up to INR5,00,000 to each eligible family per annum for listed secondary and tertiary care conditions. The cover under the scheme includes all expenses incurred on the following components of the treatment.

  • Medical examination, treatment and consultation
  • Pre-hospitalization
  • Medicine and medical consumables
  • Non-intensive and intensive care services
  • Diagnostic and laboratory investigations
  • Medical implantation services (where necessary)
  • Accommodation benefits
  • Food services
  • Complications arising during treatment
  • Post-hospitalization follow-up care up to 15 days

The benefits of INR 5,00,000 are on a family floater basis which means that it can be used by one or all members of the family. The RSBY had a family cap of five members. However, based on learnings from those schemes, PM-JAY has been designed in such a way that there is no cap on family size or age of members. In addition, pre-existing diseases are covered from the very first day. This means that any eligible person suffering from any medical condition before being covered by PM-JAY will now be able to get treatment for all those medical conditions as well under this scheme right from the day they are enrolled.


AB-PMJAY Card Issued Data

Year - 2020

Year - 2019

AB-PMJAY REG. Beneficiary Data

Year - 2020

Year - 2019

Sr. No. Month No. of beneficiary
1 January 190
2 February 148
3 March 229
4 April 280
5 May 316
6 June 316
7 July 398
8 Aug 323
9 September 206
10 October 265
11 November 410
12 December 411
Total 3492

Contact

Phone No.(Toll-Free) 14555/ 1800111565
Address7th & 9th Floor, Tower-l, Jeevan Bharati Building, Connaught Place, New Delhi – 110001
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