Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) - Features and Benefits

Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) is a health scheme in Maharashtra providing cashless treatment for critical diseases, covering hospitalization, surgeries, and medical care through an extensive hospital network for eligible beneficiaries.
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3 min
08-April-2025

The Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) is a flagship health insurance scheme launched by the Government of Maharashtra with the objective of providing affordable, accessible, and quality healthcare to the state’s economically weaker sections.

Designed to bridge the gap between essential healthcare and financial limitations, MJPJAY offers comprehensive cashless treatment for a wide range of identified medical conditions. The scheme is implemented through an extensive network of empaneled public and private hospitals, enabling beneficiaries to receive timely treatment without any upfront payment.

Whether it's a routine procedure or a critical illness, beneficiaries under MJPJAY can access medical care without the stress of financial strain. By covering hospitalization, surgeries, and post-operative care, this initiative plays a crucial role in reducing out-of-pocket medical expenses and improving health outcomes for Maharashtra’s underserved communities.

In this article, we will discuss the benefits, coverage, eligibility, and more about Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY).

What is MJPJAY?

Previously known as the Rajiv Gandhi Jeevandayee Arogya Yojana, Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) began in eight districts on July 2, 2012, and expanded to 28 districts on November 21, 2013. The scheme's primary goal is to offer cashless access to quality medical care for beneficiaries dealing with catastrophic illnesses. This includes hospitalisation for surgeries and therapies within specified specialty services. This assistance is facilitated through a network of healthcare providers.

The Mahatma Phule Yojana covers all medical expenses incurred during hospitalisation, providing a sum insured of Rs. 1.5 lakh per family per policy annually. This coverage can be utilised by an individual or the entire family through cashless hospitalisation services.

MJPJAY (Mahatma Jyotiba Phule Yojana): Overview

Aspect Details
Scheme name Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY)
Objective Provide cashless healthcare services for identified diseases in Maharashtra
Coverage Extensive coverage for medical treatments, surgeries, and hospitalisation
Network providers Empaneled hospitals and healthcare facilities in public and private sectors
Eligibility Based on socio-economic factors, prioritizing economically disadvantaged
Benefits Financial protection, access to quality healthcare, and preventive services


MJPJAY: Features and benefits

Given below are the key features and benefits of Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY):

  • The scheme covers all hospitalisation expenses for the beneficiary, up to Rs. 1.5 lakh per family per policy each year.
  • For renal transplant, the limit for hospitalisation expenses has been enhanced upto Rs. 2.5 lakh per family, per policy annually.
  • The benefit is accessible to every family member on a floater basis. The total coverage of Rs. 1.5 lakh or Rs. 2.5 lakh, depending on the case, can be utilised by one person or shared among all family members during the policy year.
  • MJPJAY beneficiary gets benefit of 996 medical and surgical procedures with 121 follow up procedures.
  • The scheme provides coverage for surgeries, diagnostics, medications, and follow-up consultations and treatment.
  • Orthopaedic surgery and procedures, general surgery, ENT surgery, gynaecology and obstetrics surgery, cardiac and cardiothoracic surgery, ophthalmology surgery, pediatric surgery, radiation surgery, plastic surgery, etc.
  • Free health camps shall be conducted by network hospital.

Eligibility criteria for Mahatma Jyotiba Jan Arogya Yojana

To avail the benefits under MJPJAY, applicants must meet the following eligibility requirements:

  • The scheme is applicable to families residing in economically distressed districts of Maharashtra.
  • Beneficiaries must possess any of the following documents: an Annapurna Card, White/Yellow/Orange Ration Card, or an Antyodaya Anna Yojana (AAY) Card.
  • Farmers from agriculturally distressed districts are also eligible for coverage under this scheme.

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What is covered under Mahatma Jyotiba Phule Jan Arogya Yojana?

MJPJAY provid=es comprehensive health insurance coverage, ensuring that beneficiaries receive essential medical care without financial burden. The scheme covers a wide range of medical treatments and related expenses, including:

  • Coverage for 971 medical surgeries, therapies, and procedures, along with 121 follow-up packages.
  • A broad spectrum of specialties including General Surgery, ENT, Obstetrics, Gynecology, Cardiac and Cardiothoracic Surgery, Orthopedics, Plastic Surgery, Pediatrics, Ophthalmology, Radiation Therapy, and more.
  • Renal transplant surgeries with coverage up to a maximum of ₹2.5 lakh.
  • Post-hospitalization expenses, such as follow-up consultations and prescribed medications, for up to 10 days after discharge.

List of diseases and treatments covered under MJPJAY

There are over 30 specialised diseases and treatments which are covered under MJPJAY scheme:

Burns

Medical Oncology

Cardiology

Neonatal and Pediatric Medical Management

Cardiovascular and Thoracic surgery

Nephrology

Critical Care

Neurology

Dermatology

Neurosurgery

Endocrinology

Obstretrics and Gynecology

ENT surgery

Ophthalmology

General Medicine

Orthopedics

General Surgery

Pediatric Surgery

Haematology

Pediatric Cancer

Infectious diseases

Plastic Surgery

Interventional Radiology

Polytrauma

Medical Gastroenterology

Prosthesis and Orthosis

Pulmonology

Surgical Oncology

Radiation Oncology

Urology (Genitourinary Surgery)

Rheumatology

Mental disorders

Surgical Gastroenterology

Oral and Maxillofacial Surgery


List of documents required for Mahatma Jyotiba Jan Arogya Yojana

Apart from the yellow/orange/white cards, there are other documents required for MJPJAY. Given below is the list of the same:

  • Aadhaar card
  • PAN card
  • Voter Id
  • Driving license
  • School/College Id
  • Passport
  • Freedom Fighter ID card
  • Health card of RGJAY / MJPJAY
  • Handicap certificate
  • Nationalised bank passbook with photo
  • Senior citizen card issued by Central Government or State Government
  • Defense ex-servicemen card issued by Sainik Board
  • Marine Fishery Identity card
  • Any photo ID proof issued by Government of Maharashtra/ Government of India

Read more: Ayushman Bharat Yojana – Registration, eligibility and apply

How can you apply for a MJPJAY Card?

  • Visit the nearest Government Health Insurance Help Desk at an empaneled hospital.
  • Carry valid documents such as Ration Card, Aadhaar Card, and residence proof.
  • Submit a duly filled application form along with required documents.
  • The Aarogya Mitra at the help desk will assist with the enrollment process.
  • Once verified, your MJPJAY health card will be issued for availing scheme benefits.

How to register for Mahatma Jyotiba Jan Arogya Yojana (MJPJAY)?

The registration process for MJPJAY scheme is simple. You can follow the steps given below to enrol for Mahatma Jyotiba Jan Arogya Yojana:

  • Beneficiaries can visit nearby empanelled network hospital or attend health camps. Arogyamitras at hospitals assist beneficiaries and provide referral letters based on diagnosis.
  • Arogyamitras at network hospitals enroll patients, examining valid ration cards and Photo ID. Medical Coordinator captures admission notes and test results in the dedicated database.
  • Hospital raises e-preauthorisation request for eligible procedures under MJPJAY (996).
  • Insurer's medical specialists review and approve pre-authorisation. Rejected requests are referred to a technical committee for review. ADHS-SHAS makes the final decision on approval or rejection.
  • The procedure must be performed within specified timelines, with a turnaround time of 12 hours for decisions. Emergency Telephonic Intimation (ETI) is used for urgent approvals.
  • Network hospital provides cashless medical/surgical treatment. The medical coordinator updates daily treatment notes on the portal.
  • Network hospital uploads diagnostic reports, discharge summary, and payment acknowledgements. Follow-up procedures are communicated to patients at the time of discharge.
  • Free follow-up consultation, diagnostics, and medicines are provided up to 10 days post-discharge.
  • Insurer scrutinises bills and pays claims within 15 working days. Claim settlement module is part of SHAS portal, operated by the Insurer.

Also, the reports will be available for scrutiny on the State Health Assurance Society (SHAS) login.

List of empanelled hospitals

Given below is the list of government and private hospitals empanelled under MJPJAY:

Name of district Location Name of hospital Private/Government
Akola Murtijapur Awghate Bal Rugnaly Private
Akola Akola B.L. Chandak research foundation
(kidney dialysis unit)		 Private
Akola Akola City Hospital, Akola Private
Akola Akola District women hospital
akola		 Government
Akola Akola Goverment Medical College And
Hospital Akola		 Government
Akola Akola Icon Hospital Private
Akola Akola Joshi ortho hospital Private
Akola Akola K S Patil Hospital Private
Akola Akola Mauli Hospital Private
Akola Akola Murarka Hospital Private
Akola Akola Ozone Multispeciality Hospital &
Critical Care Centre ( Unit Of VNRN
Health Services PVT.LTD. Akola		 Private
Akola Akola Raut Hospital Maternity & Surgical,
Akola (B1 grade)		 Private
Akola Akola Sant Tukaram Hospital and
Medical Research Centre		 Private
Akola Akola Vidarbha Hospital Private
Akola Akola Vitthal Hospital Private


.For detailed list of empanelled hospitals, you can visit the official website
(https://www.jeevandayee.gov.in/RGJAYDocuments/Empanelled_Hospitals_Under_MJPJAY.pdf)

How to file a claim for MJPJAY?

The treatment and claim process under the Mahatma Jyotirao Phule Jan Arogya Yojana is simple and streamlined:

  • If diagnosed at an empaneled hospital, the hospital coordinates with the insurance company to send a pre-authorization request for treatment approval.
  • If diagnosed at a non-empaneled hospital, an Aarogyamitra will issue a referral card, allowing you to begin treatment at a network hospital.
  • Upon receiving approval from the insurer, the treatment or surgery is initiated at the empaneled facility.
  • After completion of the procedure, the hospital submits all necessary documents—medical records, bills, diagnostic reports, and discharge summary—to the insurer.
  • Once verified, the claim is approved, and you are eligible to receive post-hospitalization services for up to 10 days.

Significance of health insurance policies

Health insurance policies play a crucial role in providing financial protection and access to quality healthcare services. They mitigate the risk of high medical expenses during emergencies, ensuring individuals and families can afford necessary treatments without facing financial hardship. Additionally, health insurance promotes preventive care, early detection, and management of health issues, leading to improved health outcomes. By covering a range of medical services and treatments, these policies contribute to the overall well-being and economic stability of individuals, families, and society.

Government and private health insurance policies both hold significance in providing essential healthcare coverage. Government policies like the MJPJAY scheme ensure access to healthcare for vulnerable populations, promoting social equity and public health. They often cover basic medical needs and preventive services. Private health insurance policies offer more comprehensive coverage, providing choices and additional benefits for individuals and families willing to pay premiums.

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Frequently asked questions

Do I need to make any additional payments for treatment?

Under the scheme, you are not required to provide any extra funds to the hospital for services covered within the approved packages.

Is ambulance charge covered under the scheme package?

No, ambulance charges are not covered under the scheme package.

Where can I avail the MJPJAY scheme services?

The MJPJAY scheme is empaneled with more than 4000 hospitals across Maharashtra. The beneficiary can avail cashless treatment in any of these empaneled hospitals.

When was the Mahatma Phule Jan Arogya Yojana launched?

On April 1, 2020, the state introduced the Integrated Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) and Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Formerly known as the Rajiv Gandhi Jeevandayee Arogya Yojana, the program commenced on July 2, 2012, in eight districts. Subsequently, it was extended to 28 districts in Maharashtra starting from November 21, 2013.

How much assistance is available under MJPJAY Yojana?

Under the MJPJAY scheme, eligible beneficiaries receive cashless treatment coverage up to ₹1.5 lakh per family per year for select medical and surgical procedures. For certain life-threatening diseases like cancer, kidney failure, and cardiac surgeries, this limit can be extended to ₹2.5 lakh per family per year. The scheme covers hospitalisation, surgeries, follow-up consultations, and medicines as per the approved package list.

Who is eligible for receiving Maintenance Haemodialysis treatment under MJPJAY?

To be eligible for Maintenance Haemodialysis under MJPJAY, the patient must:

  • Be a resident of Maharashtra and possess any of the valid government-issued yellow, orange, white ration cards with an annual income up to ₹1 lakh, or be a farmer from 14 distressed districts.
  • Be diagnosed with End-Stage Renal Disease (ESRD) and require regular dialysis treatment.
  • Be registered under the MJPJAY scheme and avail treatment at an empanelled network hospital that provides dialysis services.
Which services are provided under the package of Maintenance Haemodialysis under MJPJAY for the patient?

The Maintenance Haemodialysis package under MJPJAY includes the following services:

  • Dialysis sessions (typically up to 3 sessions per week as per medical need)
  • Consumables and dialysers used during the procedure
  • Consultation charges, nursing care, and medical management during dialysis
  • Lab investigations necessary for dialysis treatment (like serum creatinine, electrolytes, etc.)
  • Drugs and injections administered during or immediately after the dialysis
  • Access catheter care if required
  • Hospital stay (if any) during the treatment sessions

All of these are provided cashless at the empanelled hospitals under the scheme.

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