About Gujarat Mukhyamantri Arogya Artham Yojana
Access to quality healthcare is a basic human right. However, many people in India, especially those belonging to lower-income groups, struggle to afford medical treatment due to financial constraints. To address this issue, the Government of Gujarat has launched the Mukhyamantri Arogya Artham Yojana, this scheme is a health insurance scheme that aims to provide financial assistance to eligible families for medical treatment.
Objectives
- Providing cashless health insurance cover up to Rs 5 lakh per family per year.
- To Cover all medical expenses related to hospitalization, including room charges, surgeon fees, anaesthesia charges, and other medical expenses.
- To Cover the cost of transportation to and from the hospital for eligible beneficiaries.
- Offering cashless treatment to eligible beneficiaries at empanelled hospitals and healthcare centers.
- Ensuring that all family members, including newborns, are covered under the scheme.
Eligibility Criteria
To enroll in the Mukhyamantri Arogya Artham Yojana, the applicant must meet the following eligibility criteria:
- Residence: The applicant must be a resident of Gujarat state.
- Socio-economic criteria: The scheme targets vulnerable families belonging to lower-income groups, including:
- Families having an annual income of up to Rs. 2.5 lakhs.
- Families holding a yellow ration card or Antyodaya Anna Yojana (AAY) card.
- Families who have availed of benefits under the National Food Security Act (NFSA), or any other state-level food security scheme.
- Families belonging to Scheduled Castes (SC), Scheduled Tribes (ST), and Other Backward Classes (OBC).
- Family size: The scheme covers families with up to five members. In the case of larger families, the coverage is extended to a maximum of seven members.
- No existing insurance cover: The applicant should not have any existing health insurance coverage under any scheme or program.
- Enrollment: The applicant must enrol themselves in the scheme by filling out the enrollment form and submitting the necessary documents.
Benefits
The Mukhyamantri Arogya Artham Yojana offers the following benefits:
- Cashless health insurance cover: Eligible families can receive cashless health insurance cover of up to Rs 5 lakh per family per year.
- Cashless treatment: The scheme offers cashless treatment to eligible beneficiaries at empanelled hospitals and healthcare centers, meaning that they don’t need to pay out-of-pocket expenses for medical treatment.
- Coverage of medical expenses: The scheme covers all medical expenses related to hospitalization, including room charges, surgeon fees, anaesthesia charges, and other medical expenses, making it easier for families to access quality healthcare without worrying about the financial burden.
- No age limit: There is no age limit for enrollment in the scheme, meaning that it covers all family members, including newborns, and ensures that everyone can access healthcare services without discrimination based on age.
- Transportation expenses: The scheme covers the cost of transportation to and from the hospital for eligible beneficiaries, which can be a major financial burden for families living in rural or remote areas. This ensures that everyone has access to healthcare services without worrying about the cost of transportation.
| Coverage | Scheme Benefits |
|---|---|
| Medical Treatment | Cashless quality medical and surgical treatment for Primary, Secondary and Tertiary care services covering 1805 defined procedures along with their follow-ups. |
| Health Benefit Cover | Rs 5,00,000 (Rupees Five Lakh only) per family per annum covering all pre-existing conditions. |
| Pre & Post Hospitalization Expenses | Covers expenses incurred for consultation, diagnostic tests & medicines before admission of the patient in the same hospital and cost of diagnostic tests & medicines up to 15 days of discharge from the hospital for the same ailment or surgery. |
| Family Size and Age | No cap on family size and age. |
| Empanelled Hospitals | Both Private, Government /Trust/Grant-In-Aid hospitals and Medical college hospitals are empanelled under the scheme. Currently, more than 3,000 hospitals are empanelled under the scheme. |
| Travel Cost | Rs 300/- is paid to the beneficiary as a travel cost during every hospitalization. |
Disease & Medical Treatment Inclusion & Exclusion
the list of inclusions and exclusions under the MA Amrutam Yojana:
| Inclusions | Exclusions |
|---|---|
| Burns and plastic surgery | Cosmetic treatments like plastic surgery for enhancing aesthetics |
| Cardiothoracic & vascular surgery | Certain non-emergency procedures might not be covered |
| Cardiology | |
| Emergency room packages | |
| General medicine | |
| General surgery | |
| Genitourinary surgery (renal) | |
| Interventional neuroradiology | |
| Knee & hip replacement | |
| Medical oncology | |
| Mental disorder packages | |
| Neonatal packages | |
| Nephrology | |
| Neurosurgery neurology | |
| Obstetrics and gynaecology | |
| Ophthalmology | |
| Oral and maxillofacial surgery | |
| Organ transplant packages | |
| Orthopaedics and polytrauma | |
| Otorhinolaryngology | |
| Paediatric surgery | |
| Paediatric medical management | |
| Radiation oncology | |
| Surgical oncology |
Additional Information
| Topic | Details |
|---|---|
| MA Yojana Health Card Application | To apply for the MA Yojana health card, one can obtain the application form from the enrolment centre or KIOSK CENTRE. The application form Must filled with the required details and submitted at the centre along with other necessary documents. After the verification process, the applicant will receive the MA health card, a list of empanelled hospitals, and a pamphlet about the scheme. |
| Renewal of MA Yojana Health Card | Renewal can be done by calling customer care or visiting the kiosk with income certificate and previous MA card. Renewal required after expiry of the card. |
| Mukhyamantri Amrutum App | App can be downloaded from Play Store. The App Provides information on hospital list, contact details, and features of the scheme. |
| Download Application Form | Application form can be obtained from the nearest kiosk. |
| Claim Process of MA Yojana | Submit QR card to network hospital, no need for additional documents. Claims are cashless. After treatment, hospital sends details to insurance company for direct settlement. |
Required Documents
To apply for the Mukhyamantri Arogya Artham Yojana, the applicant must submit the following documents:
- Identity proof: Aadhaar card, Voter ID card, Passport, Driving license, PAN card, etc.
- Address proof: Aadhaar card, Voter ID card, Passport, Driving license, Utility bill, etc.
- Income certificate: Proof of income for the family, such as salary slips, income certificate, BPL ration card, etc.
- Bank account details: A copy of the bank passbook or a canceled cheque for the bank account in which the benefits will be transferred.
- Family photograph: A recent photograph of the family to be enrolled in the scheme
- Medical documents: Any medical documents related to pre-existing conditions or illnesses that the family members may have.
How to Apply
To apply for the Mukhyamantri Arogya Artham Yojana, follow these simple steps:
The process for enrolling in the MA/MAV Yojana is designed to be convenient and accessible for all eligible families. Kiosks are set up at Taluka and Civic Centers, equipped with the necessary technology to capture biometric information, photographs of family members, and to print the MA/MAV cards.
To ensure that only eligible families are enrolled in the scheme, the designated Government Officer, the Taluka Verifying Authority, carefully verifies all documents before approving enrollment. Upon approval, the beneficiary family is provided with the MA/MAV card, along with an information pamphlet detailing the benefits of the scheme and a list of empaneled hospitals.