Mukhyamanrtri Amrutum Yojana: Eligibility, Coverage & Benefits

Posted on: Jun 6, 2024 | 3 mins | Written by: HDFC ERGO Team

Mukhyamanrtri Amrutum Yojana: Eligibility, Coverage & Benefits

Mukhyamantri Amrutum Yojana has been launched by the government with the principal target of helping the poor. Considering the steep medical inflation rate, it becomes extremely difficult for poor people to handle medical emergencies. To ensure sufficient medical care at affordable costs, this special health insurance scheme was introduced.

What is Mukhyamantri Amrutum Yojana?

Mukhyamantri Amrutum Yojana is a tertiary medical insurance scheme launched by the Gujarat government. It was introduced primarily for the benefit of the BPL families of Gujarat. However, eventually, its scope was enhanced by incorporating the lower middle-class families too. It allows them to access standard healthcare using a cashless facility.

What You Should Be Aware of about Mukhyamantri Amrutum Yojana?

Some of the special factors about the MA Yojana that you need to note include:

• The current eligibility criteria allow ASHAs from rural as well as urban populations to enrolment

• The claim settlement procedure is transparent and hassle-free

• You can complete the enrolment procedure both online and offline

• Apart from the primary beneficiary, you can obtain an additional add-on card

• This scheme offers add-on coverage up to INR 5 lakhs.

Eligibility Criteria

A. Eligibility for MA Yojana:

The eligibility criteria for the MA Yojana include:

a. The family must be listed in the BPL list as created by the respective state government.

b. The entire family and its members must be listed in the BPL list to complete the enrolment process.

B. MA Vatsalya Yojana Eligibility:

a. Families slightly above the BPL level can enrol under this scheme

b. The annual family income must be up to INR 4 lakhs

c. Accredited ASHA workers and authorised media personnel can be enrolled

d. State government-appointed employees with fixed pay and working in class 3 & 4 positions are allowed enrolment

e. U-Win cardholders are enrolled

f. Senior citizens from families with an average annual income of up to INR 6 lakhs are enrolled.

Features and Benefits of MA Yojana

Some of the significant features and benefits of Mukhyamantri Amrutum Yojana include:

• There is no need for premium or enrolment charges

• This is a 100% government-funded scheme

• The benefit amount is INR 3 lakhs/annum

• It is available for up to 5 family members/family

• For every registered BPL family, INR 100 is provided to ASHA workers

• The respective state government transfers the RTGS benefits

• General and mega health camps are conducted every month with empanelled hospitals at the district level

• Dedicated servers and data centres are efficiently managed by n(Code) Solutions

• Every procedure including claim settlement, is paperless

• There is no specified enrolment period, the beneficiaries can enrol throughout the year using Taluka Kiosks and Civic Centre kiosks

• There are no mediators involved

• It allows coverage of up to INR 5 lakhs for liver transplants, kidney transplants, pancreas+kidney transplant procedures

• MA Yojana covers renal ailments, cardiovascular diseases, and other 600 procedures

• Each beneficiary is issued a special QR-coded card containing biometric details, photos, taluka, and district name

• Up to INR 300 is for travel charges per hospitalisation

• The repatriation cost is limited to INR 6/km. from the hospital to the designated house of the beneficiary

What’s Covered and What’s Not Covered?

A. Inclusions:

a. Plastic surgery and burns treatment

b. Vascular and cardiothoracic surgery

c. Cardiology

d. Emergency room packages

e. General medicine and general surgery

f. Renal surgery

g. Interventional neuroradiology

h. Hip and knee replacement

i. Medical oncology

j. Packages for mental disorder

k. Neonatal packages, etc.

B. Exclusions:

a. Cosmetic procedures like plastic surgery for aesthetic purposes

b. Certain specific non-emergency processes remain excluded, etc.

How To Enrol in MA Yojana?

Mukhyamantri Amrutum Yojana is a comprehensive plan that combines family health insurance and senior citizen health insurance. The enrolment procedure is simple:

• Civic centres and taluka-like government authorities maintain the list of families with an annual income of less than INR 4 lakhs.

• To ensure enrolment under MA Vatsalya and MA schemes, the actual beneficiary family members must visit the respective talukas or civic centres.

• The civic centres, taluk office, mobile kiosks, etc. are all completely equipped with hardware to ensure a smooth enrolment process

• After the enrolment procedure is completed, the documents are verified and the beneficiary is issued an MA card, a scheme pamphlet and a complete list of empanelled network hospitals. This completes the enrolment process.

What are the documents needed to apply for the MA Yojana?

The list of documents essential for MA Yojana are:

• Address proof such as the ration card, utility bills, etc.

• Identification proof like PAN card, Voter’s ID, etc.

• Income proof and the

• BPL certificate.

MA Yojana Health Card Details

To ensure the verification details are completed, the beneficiary must be physically present at the designated kiosk. During any medical emergency, he/she must submit the MA card in Gujarati.

On reaching the enrolment centre, the beneficiary will receive the MA Vatsalya card application either in hardcopy or PDF. You can always choose to revisit the particular kiosk to ensure Mukhyamantri Amrutum Vatsalya card checks for the current status. You can also log in to the official website of MA Yojana to get a better picture of the scheme and check several details.

What is the process of renewing your MA Yojana Smart Health Card?

The beneficiary needs to renew the MA card benefits to ensure uninterrupted coverage. The validity of this card is for 3 years. You can either call customer care or visit the respective kiosk for renewal. You will need to produce your income certificate and the previous MA card.

Mukhyamantri Amrutum Yojana App

You can easily download and install this app on your Android device from the Play Store. Some apps provide details about the hospital list which are very handy during any medical emergency.

What is the process to download the MA Yojana Application Form?

You can visit the official Mukhyamantri Amrutum website to receive guidance about the nearest kiosk. You can easily get an application form there. Once this is done, you can proceed accordingly.

How To Claim Mukhyamantri Amrutum Yojana?

MA claim settlement process is very simple. You do not need any special documents for claiming. You should submit your designated MA card to a network hospital to initiate the short and quick verification process. You can continue with the treatment. You must note that this is a cashless claim.

Once the treatment process is complete, the hospital will then send the relevant details to the insurance provider. The hospital and the insurer will directly settle the claims by themselves without any involvement of the beneficiary.

MA Yojana Hospital List

Some of the significant network hospitals that are included in the MA Yojana scheme include:

• B. T. Savannah Kidney Hospital

• HJ Doshi Hospital

• Adani Institute of Medical Sciences

• Himalaya Cancer Hospital

• Muni-Seva Ashram

• Lifeline Hospital

• Hanuman Hospital-Bhavnagar

• DDMM Heart Institute

• Civil Hospital Surat

• Medistar Hospital Pvt. Ltd.

Conclusion

Mukhyamantri Amrutum Yojana stands as a highlighting introduction of the Gujarat Government covering a wide range of ailments. This is a very user-friendly initiative benefitting several BPL families.

FAQs

1. How many family members are covered under the MA Yojana?

Mukhyamantri Amrutum Yojana allows coverage for five family members. In the case of a newborn addition, it will be considered as a 6th member.

2. Is there any waiting period for PEDs?

No, all sorts of PEDs are covered under the MA scheme.

3. What is the procedure for including new family members under an existing MA Yojana?

During the yearly renewal time, new family members can be added. For newborns, a birth certificate is essential.

Disclaimer The above information is for illustrative purposes only. For more details, please refer to policy wordings and prospectus before concluding the sales.

Which is Better: Government Health Insurance Plans or Private Medical Insurance Policy?

What Is Karunya Health Insurance Scheme? How To Apply

Secure Your Health with HDFC ERGO’s Affordable Health Suraksha Plan

How Does Critical Illness Insurance Works?

Best Family Health Insurance Plans in India