1. Rajiv Gandhi Jeevandayee Arogya Yojana

2. Agenda Objective of the scheme Beneficiaries. Benefits Health card
Family and Sum insured
Package Details
Cashless Transaction
Process at Health Cards by VLE
Aarogyamitra and its Process Flow (Arogyamitra)
Pre-Printed Stationary
Role of SCA’s VLE.
Role of Directorate of Health Services
Commercials for Health Cards Service
Business Potential for SCA’s
Contact us for Beneficiary

3. Objective of the Scheme
To improve access of Below Poverty Line (BPL) and Above Poverty Line (APL) families.
To provide Quality health care for identified specialty services requiring hospitalization for surgeries through Network hospitals.
Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) would be implemented throughout the state of Maharashtra in phased manner for a period of 3 years.The insurance policy/coverage under the RGJAY for the eligible beneficiary families

4. Beneficiaries Families holding - Yellow Ration cards (BPL Families)
- Orange Ration cards (APL Families)
- Antyodaya Anna Yojana card and
- Annapurna card
The families with white ration card holding would not be covered under the scheme.
The beneficiary families would be identified through the “ Rajiv Gandhi Jeevandayee Health Card ” issued by the Government of Maharashtra or based on the Yellow and Orange ration card issued by Civil Supplies Department.

5. Benefits
Scheme would provide 971 surgeries/therapies/procedures along with121 follow up packages in following 30 identified specialized categories
Sr. No.
Specialized Categories
Sr.No. 1
GENERAL SURGERY 16
POLY TRAUMA 2
ENT SURGERY 17
PROSTHESES 3
OPHTHALMOLOGY SURGERY 18
CRITICAL CARE 4
GYNAECOLOGY AND OBSTETRICS SURGERY 19
GENERAL MEDICINE 5
ORTHOPEDIC SURGERY AND PROCEDURES 20
INFECTIOUS DISEASES 6
SURGICAL GASTRO ENTEROLOGY 21
PEDIATRICS MEDICAL MANAGEMENT 7
CARDIAC AND CARDIOTHORACIC SURGERY 22
CARDIOLOGY 8
PEDIATRIC SURGERY 23
NEPHROLOGY 9
GENITOURINARY SYSTEM 24
NEUROLOGY 10
NEUROSURGERY 25
PULMONOLOGY 11
SURGICAL ONCOLOGY 26
DERMATOLOGY 12
MEDICAL ONCOLOGY 27
RHEUMATOLOGY 13
RADIATION ONCOLOGY 28
ENDOCRINOLOGY 14
PLASTIC SURGERY 29
GASTROENTEROLOGY 15
BURNS 30
INTERVENTIONAL RADIOLOGY

6. Health Cards
“ Rajiv Gandhi Jeevandayee Health Cards ” will be issued to families based on Yellow, Orange Ration cards, Antyodaya Anna Yojana , Annapurna cards.
Health Cards will be used for identification of Beneficiary in the family under the Scheme.
Family Health Cards will be prepared by using data from valid Yellow or orange ration cards coupled with Aadhaar numbers issued by UID authorities

7. Family and Sum Insured
Family means members as listed on the Rajiv Gandhi Jeevandayee Arogya Yojana Health Cards or holding valid Orange/Yellow Ration Card
The Scheme shall provide 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 through Health cards or valid Orange/Yellow Ration Card.
The benefit shall be available to each and every member of the family on floater basis i.e. the total annual coverage of Rs.1.5 lakh can be availed by one individual or collectively by all members of the family.
Coverage up to INR 2, 50,000/- (for renal transplants).

8. The package rates will include
Package details
The package rates will include
Bed charges in General ward,
Nursing and boarding charges,
Surgeons, Anesthetists,
Medical Practitioner, Consultants fees,
Anesthesia, Blood, Oxygen,
O.T. Charges,
Cost of Surgical Appliances,
Medicines and Drugs,
Cost of Prosthetic Devices, Implants, X-Ray and Diagnostic Tests,
Food to inpatient,
One time transport cost by State Transport or second class rail fare (from Hospital to residence of patient only)

9. Cashless Transaction
Transaction shall be cashless for covered procedures at Network hospitals.
Beneficiary will go to hospital and come out without making payment to the hospital.
When the beneficiary visits the selected Empanelled hospital and services of selected Empanelled hospital should be made available
The facility of cross referral to nearest another Empanelled hospital is to be made available
Aarogyamitra will also provide the beneficiary with the list of nearby Empanelled hospitals.

10. Process at Health Cards by VLE
Beneficiaries will visit CSC along with their valid and eligible Ration cards
CSC VLE will verify the details as per the ration card and asking the beneficiaries accordingly.
CSC VLE will search Health Card through MahaOnline Portal by any one method from four options.
VLE will print valid info on pre-printed stationary provided to VLE at free.

11. Aarogyamitra A friend and guide for patient Registration & Enrollment
Counseling the patient
Creating Awareness
Assuring patients interest
Help patient to avail the benefit of the scheme

12. Process Flow (Arogyamitra)

13. Pre-Printed Stationary
VLE will receive Pre-Printed stationary from RGJAY society absolutely free, in bunch of 500 Blank Health Cards.
These Pre-Printed stationary will be available to VLE at Taluka Health Officer(THO) at taluka level.
VLE will have to visit them with their VLE identity proof, and collect Pre-Printed stationary.

14. Role of SCA’s VLE
SCA’s VLE will receive Pre-Printed stationary from RGJAY society absolutely free.
SCA’s VLE will search the health cards through given 4 search option (Personal Details/Ration Card No/UID No/Village Data).
SCA’s VLE will have confirm the details with the beneficiary, along with the name of family manbers.
SCA’s VLE then print it on Pre-Printed stationary and handover it to beneficiary.
SCA’s VLE should provide this services absolutely free and should not charge any ₹ to beneficiary.
SCA’ VLE will be paid by Government of Maharashtra RGJAY for each card printing, hence should not charge to beneficiary.
SCA’s will generate INVOICE on No. of card printed and forward it to Maha-Online, and received amount in 10 working days.

15. Role of Directorate of Health Services
DHS- Directorate of Health Services will also ensuing printing of cards where connectivity is low or No-Connectivity through EXE file.
DHS- Directorate of Health Services will delivery the Pre-Printed Stationary via Taluka Health Officer to VLE.
DHS- Directorate of Health Services will distribute Health cards at the location where internet connectivity is low or no existence of any VLE.

16. Commercials for Health Cards Service

17. Business Potential for SCA’s
Name of SCA's
SCA's
Division Name
Sum of Imported Head of the Family Count
Total Count
Business Potential (₹)
CMS
Amravati
14,96,712
46,11,104
23,05,552
Aurangabad
31,14,392
SPANCO
Konkan
13,78,319
51,66,867
25,83,,433
Pune
37,88,548
MOL
Nagpur
19,42,325
Basix
Nashik
23,09,434
11,54,717
Grand Total
1,40,29,730

18. Imported Head of the Family Count
Business Potential for SCA’s
Sr.
Division
District
Imported Head of the Family Count 1
Amravati
Yavatmal (510)
4,87,260 15
Konkan
Thane (517)
7,43,974 2
Buldhana (500)
4,67,176 16
Ratnagari (528)
4,08,465 3
Washim (502)
2,76,842 17
Sindudurge (529)
2,25,880 4
Akola (501)
2,65,434 18
Pune
Pune (521)
16,88,508 5
Aurangabad
Aurangabad (515)
7,24,247 19
Kolhapur (530)
8,16,200 6
Beed (523)
6,46,092 20
Satara (527)
6,50,951 7
Latur (524)
4,37,039 21
Sangli (531)
6,32,889 8
Osmanabad (525)
3,80,042 22
Nagpur
Nagpur (505)
9,93,104 9
Parbhani (513)
3,40,628 23
Chandrapur (509)
4,52,391 10
Jalna (514)
3,37,492 24
Wardha (504)
2,59,260 11
Hingoli (512)
2,48,852 25
Gondia (507)
2,37,570 12
Nashik
Nashik (516)
11,07,229 13
Jalgaon (499)
8,83,144 14
Nandurbar (497)
3,19,061

19. Contact us for Beneficiary
For any assistance VLE should guide the beneficiary and it’s family members with below contact details.
Help-Line No:
155388
website :

20. THanks