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Maharashtra

Profile


Overview
Name of the Scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY);
Mahatma Jyotiba Phule Jan Arogya Yojana (MPJAY)
Date of roll-out 23-09-2018
Mode of Implemetation Hybrid
Number of PM-JAY eligible families as per SECC/RSBY data 83,72,870
Number of PM-JAY additional families covered by the State -
Number of Non-PM-JAY families covered by the State scheme 1,39,17,739
Insurance
Name of the insurance company (if applicable) National Insurance Company
Name of the ISA/TPA MD India, Medi Assist and Paramount
Health Services and Insurance TPA Pvt. Ltd
Health Packages
Number of Health Benefit Packages (HBP 1.0) 1,913
Number of packages reserved for government hospitals 460
Description of the State Scheme
The State Government of Maharashtra launched its flagship health insurance scheme, Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) on 2nd July 2012 in 8 districts of Maharashtra (Phase 1) and later on introduced it to remaining 28 districts of Maharashtra (Phase 2). The scheme is renamed as Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) from 1st April 2017.Beneficiaries under this scheme are the families belonging to any of the 36 districts of Maharashtra and holding Yellow Ration Card, Antyodaya Anna Yojana Card (AAY), Annapurna Card and Orange Ration Card along with Farmers from 14 agriculturally distressed districts of Maharashtra. The Scheme provides coverage for meeting all expenses relating to hospitalization of beneficiary up to Rs. 1,50,000 per family per year in any of the Empanelled Hospital subject to Package Rates on cashless basis.
Contact Details of the State Team
Name of State Health Agency (SHA) State Health Assurance Agency
Address Jeevandayee Bhavan, ESIS Hospital Compound,
Ganpat Jadhav Marg, Worli  Naka, Worli, Mumbai-400018
Contact No. 022-24912291
Email Id ceo@jeevandayee.gov.in
Name of CEO Dr.Sudhakar Shinde (IRS)
Toll Free no 1800-233-2200  & 155388
Note:   Data as on 14 April 2020

Maharashtra Factsheet


Name of the State MAHARASHTRA Mode of implementation Mixed (Cover of Rs.1.5Lakhs through insurance) Date of data download 03-Feb-20
I. Demographic Details
1 Name of the scheme in the State Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY); Mahatma Jyotiba Phule Jan Arogya Yojana (MPJAY)
2 Number of PM-JAY eligible families as per SECC/RSBY data 83,72,870
3 Number of Additional PM-JAY families covered by the State 0
4 Number of non-PM-JAY families covered under the State scheme 1,39,17,739
5 Percentage of families covered under PM-JAY 31%
6 Percentage of non-PM-JAY families covered under the State scheme 52%
II. Hospital Emapanelment
Till Date
Public Private Total
7 Number of empaneled hospitals
90 404 494
III. Beneficary Identifcation
Till Date
8 E-cards generated 62,73,326
III. Transaction Management
Jan-20 Till Jan 2020
9 Hospital Admissions Authorized Numbers
21,868 2,90,944
Amount (In Rs.)
55,84,14,384 746,55,38,828
IV. Claims
Jan-20 Till Jan 2020
10 Claims submitted Numbers
21,084 2,50,000
Amount (In Rs.)
50,93,65,916 600,85,98,992
V.Portability
Total Outgoing
Jan-20 Till Jan 2020
Total Incoming
Jan-20 Till Jan 2020
11 No. of hospital admissions authorized
190 1,673
686 6,633
12 No. of claims submitted
109 1,183
674 4,829
maharashtra Factsheet
Note:
1.     Non-PM-JAY families covered under State health scheme-Mahatma Jyotiba Phule Jan Arogya Yojana with healthcare cover of Rs. 1.5 Lakhs; and special provision of Rs.2.5 lakhs for renal transplant
2.   State cards have been generated using State own IT system

District Profile


 
 
Note:
1. Map not to scale

2. Data as on 01st Jan 2020

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