MJPJAY to expand coverage, increase benefits

According to health officials, it is also set to increase the insurance amount from ₹1.5 lakh per annum to ₹5 lakh. “We had constituted a committee of 107 experts under the chairmanship of the National Urban Health Mission commissioner early this year

Mumbai: The Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY), the state’s flagship health insurance scheme, is set to increase its ambit as it decided to cover more than 1,300 ailments against the existing 996. In comparison, the Pradhan Mantri Jan Arogya Yojana – the national public health insurance scheme of the central government – includes 1,209 ailments.

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According to health officials, it is also set to increase the insurance amount from ₹1.5 lakh per annum to ₹5 lakh. “We had constituted a committee of 107 experts under the chairmanship of the National Urban Health Mission commissioner early this year. After a lot of deliberation, it was felt that more ailments should be added to the existing scheme,” said Vinod Bondre, acting CEO of MJPJAY. “Our new plan includes more ailments from orthopaedic, urology, cardiac, oncology and even psychiatry section.”

MJPJAY was rolled out on July 2, 2012, and since then has covered 54 lakh patients and spent ₹10,550 crore. In Mumbai, 57 public and private hospitals are empanelled with the scheme. Maharashtra pays an annual premium of ₹1,700 crore to cover 2.2 crore families.

Bondre said in the new plan, they have proposed to increase the number of hospitals for empanelment across the state.

“At present, only 1,000 hospitals across Maharashtra can be empanelled out, of which 195 are public hospitals and the remaining are private hospitals. There are reputed private hospitals even from Mumbai who have filed the online applications and are waiting to get empanelled for MJPJAY,” said Bondre.

While health experts welcome the increase in coverage up to ₹5 lakh, concerns have been raised about the limited number of empanelled hospitals and the uneven distribution of facilities across Maharashtra. Individuals residing in rural or tribal areas often face the challenge of travelling long distances, sometimes hundreds of kilometres, to avail of the scheme’s benefits. Experts have recommended an increase in public awareness about the MJPJAY scheme and suggest that the government appoint consultants in each empanelled hospital to assist economically disadvantaged patients in navigating the cashless scheme, which covers a wide range of critical illnesses.

Ravi Duggal, a public health researcher and activist, emphasised the importance of raising awareness about the MJPJAY scheme, as many individuals still encounter difficulties in covering additional expenses despite the scheme’s cashless nature. Duggal proposed the appointment of consultants in every empanelled hospital to guide indigent patients and ensure they can avail of the scheme’s comprehensive coverage for essential diseases.