In India, health is a state subject. Although the central government contributes substantially towards developing the healthcare infrastructure, each state determines its priorities and allocates funds for healthcare for its population. However, lack of focus often makes quality healthcare for the poor and the masses a distant dream.
Due to inadequate facilities in government-run hospitals and the high cost of treatments in private hospitals, poor people neglect healthcare for themselves and their family members and suffer the most when emergencies occur.
Devendra Fadnavis grew up in his political career fighting for the causes of common people, seeing the hardships and miseries of the poor in the rural and urban, how limited resources bar a family from getting proper health services for their loved ones, and how people are pushed into poverty due to high cost of treatment for a major illness.
Arrival of the MJPJAY Health Insurance scheme to reduce the burden of treatment
When he took over as the CM, the state was reeling under successive droughts, crop damage, and a shattered rural economy as a fallout, which required immediate attention. On the public health front, there was a health scheme from the previous government for the people who belonged to the BPL category. In 2016, when this old scheme reached expiry, the Fadnavis government proposed to implement the Mahatma Jotiba Phule Jan Arogya Yojana (MJPJAY Scheme) on the eve of the 125th birthday of Mahatma Jotiba Phule.
In this, the government proposed upgrading some features from the old scheme and adding many new ones to increase its capacity and coverage. The modified health insurance scheme had an increased number of medical procedures, increased coverage on the cost of treatment, and an increased number of accredited hospitals. 1100 medical conditions were included in the MJPJAY scheme, including old age issues, hip and knee replacement, sickle cell, and anemia treatment, among others. The coverage amount under this scheme became Rs 2 lakh, which could go up to Rs 3 lakh in case of kidney transplantation. Ashramiks, orphanages, old-age homes, and reporters were also made beneficiaries of this scheme, along with farmers from 14 distressed districts. The scheme also appointed health friends and introduced the services of call centers to provide proper guidance to the patient’s relatives. As decided by the Cabinet, the Public Health Department announced the Government Decision on 4th August 2016 and implemented the Mahatma Jotiba Phule Jan Arogya Yojana in the state.
Including retired police personnel as beneficiaries
The decision to include the retired assistant sub-inspectors of police, constables, police naiks, and police constables in the MJPJAY scheme was taken in the state cabinet meeting held on January 22, 2019, under the chairmanship of the then Chief Minister Devendra Fadnavis. The cabinet decided to include the retired police personnel below the sub-inspectors level in this scheme. Due to the stress on police personnel and their irregular working hours, they face various health problems. This decision was taken to give them relief.
Integrating MJPJAY to AB_PMJAY to make It cashless for all with high coverage amount
In 2020, during the period of Covid, Devendra Fadnavis, then Leader of the Opposition of the state, became vocal about clubbing the MJPJAY scheme with AB-PMJAY (Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana) and took initiatives towards it. This resulted in the integration of the MJPJAY yojana with the central scheme, extending its earlier limit to meet the expensive COVID treatment costs in private hospitals for the general public.
Devendra Fadnavis returned to power as the Dy. CM and Finance Minister in the Eknath Shinde-led coalition government, which took charge from the MVA government in mid-2022. The success of the integrated MJPJAY and AB-PMJAY encouraged Fadnavis to implement the same for all populations domiciled in Maharashtra and to expand the scope of the scheme. In the first budget of the Shinde-Fadnavis government in 2023, Devendraji made the historic announcement of making the MJPJAY scheme a cashless medical insurance scheme for all families in Maharashtra, with the coverage limit increased from the earlier 2 lakhs to the current 5 lakhs. Also, the scope of the scheme was expanded to include advanced surgeries, therapies, and other treatments in over 1000 government-empanelled hospitals.
Key Features of Integrated Scheme
- Universal Health Coverage for all citizens of Maharashtra
- Cashless secondary and tertiary healthcare procedures in network hospitals
- Provides health coverage of Rs. 5 lakhs per year on a family floater basis, which means that it can be used by one or all members of the family
- Medical services of surgeries/treatments requiring hospitalization under 34 Specialties
- All pre-existing conditions are covered from day one.
- An MJPJAY yojana beneficiary can avail cashless treatment in any Govt/Pvt network hospital in the state.
- Benefits of the MJPJAY scheme are portable across the country
- Dedicated call center for the scheme where beneficiaries can get information about the scheme or raise grievances about its services.
- The scheme is fully paperless and runs on a dedicated portal.
- Arogyamitras at every network hospital to help with facilities for the beneficiaries.
- Patients can avail treatment in case of emergency through intimation by telephone or email.
Beneficiaries under the AB-PMJAY
- Households recorded in the Social, Economic and Caste Census, 2011 (SECC)
- Antyodaya Anna Yojana (AAY) and Priority House Holder (PHH) families under the National Food Security Act (NFSA)
Beneficiaries under the MJPJAY scheme
Category – A
- Families holding Yellow, Antyodaya Anna Yojana (AAY), Annapurna Yojna, and Orange Ration Card.
Category – B
- White ration card holder families (including Govt./Semi Gov employees).
- A family without having any kind of ration card but having domicile certificate of Maharashtra.
Category – C
- Students in Govt. and Govt. recognized Ashram School
- Children in Govt. and Govt. recognized Orphanages
- Women in Govt. and Govt. recognized Women’s Ashram
- Sr. citizens in Govt. and Govt. recognized old age homes
- Reporters and their dependent family members as stipulated under the Directorate General of Information and Public Relations Office.
- Migrant construction workers and their families registered with the Maharashtra Building and Other Construction Workers Board.
Category – D
- Road traffic accident victims from outside Maharashtra and outside India who met with an accident on roads in Maharashtra.
Category – E
- Families living in 865 villages of Belgaum, Karwar, Kalburgi, and Bidar Districts, close to the Maharashtra-Karnataka border, who are holding below-mentioned ration cards
- Antyodaya Anna Yojana (AAY)
- Priority House Holder (PHH)
- Annapurna Yojana
Government Decisions and GR’s
Cabinet Decisions
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