How to get benefit of Pradhan Mantri Jan Arogya Yojana (PMJAY) ?

Medical Insurance is becoming popular now a days in India and COVID-19 has provided a big push for quantum jump in its popularity. However, those who need it most can afford it least. The weaker section of the society who is pulling on their daily life on stressed financial budget cannot, in spite of their best intentions, afford medical insurance. This is an irony of our society. An incident of a hospitalisation for a poor family pushes the family in a debt trap. If the breadwinner of the family has to be hospitalised, the financial wound becomes deeper, leaving long-lasting implications on the family. The aged people with no earning capacity and no savings have to suffer the pain – they are more vulnerable but less cared for. In order to provide universal free health care to all eligible citizens, the Government of India first announced the Ayushman Bharat Yojana as a universal health care plan in February 2018 in the Union budget of India. The Yojana has been touted as the world’s largest health care programme in the world. An important milestone under Ayushman Bharat is the Pradhan Mantri Jan Arogya Yojana (PMJAY) which was launched on 23/09/2018 by our Honourable Prime Minister Shri Narendra Modi.

The features of the PMJAY:

1. It is a means tested (eligibility based on the economic position of the family) scheme. The households included are based on the deprivation criteria of Socio-Economic Caste Census 2011 (SECC 2011) and occupation for rural and urban areas respectively.

2. It subsumed the old Rashtriya Swasthya Bima Yojana (RSBY) which was introduced in 2008. Hence, PM-JAY covers families that were covered in RSBY but are not present in the SECC 2011 list. The beneficiaries under Employee State Insurance Scheme (ESIS) are also covered.

3. PM-JAY is fully funded by the Government and cost of implementation is shared between the Central and State Governments. It is implemented under the aegis of National Health Authority.

4. Hospitalisation (in public and private empanelled hospitals in India) expenses to the extent of Rs. 5,00,000/- (Rs five lakh only) is provided to the family per year.

5. PM-JAY provides cashless access to health care services for the beneficiary at the point of service, that is, the hospital.

6.  It covers up to 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines.

7. There is no restriction on the family size, age or gender.

8. All pre–existing conditions are also covered from day one.

9. Beneficiary can avail the medical treatment from any empanelled public or private hospital across the country.

10. Services include approximately 1,393 procedures covering all the costs related to treatment, including but not limited to drugs, supplies, diagnostic services, physician's fees, room charges, surgeon charges, OT and ICU charges etc.

11. The cap on benefit of Rs. 5,00,000 per year is  on a family floater basis which means it can be used by one or more members of the family.

12. COVID-19 patients can avail free treatment at empanelled hospitals.

 

Who Is Not Eligible for PMJAY?

The people falling under one or more categories are not eligible for PMJAY:

• Those who have mechanised farming equipment.
• Who owns a two, three or four-wheeler.
• Those who hold a Kisan card.
• Government employees.
• Those who own a motorised fishing boat.
• Those who are earning more than Rs.10,000 per month.
• Those who are working in government-run non-agricultural enterprises.
• Those who own more than 5 acres of agricultural land.
• Those who own landline phones or refrigerators. 
• Those who live in decently built houses.

 

How to apply online for Ayushman Bharat Yojana?

Follow the following steps for applying online for PMJAY card (popularly known as a Gold Card):

-  Visit the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana official website at https://pmjay.gov.in/

- Click on ? mark (“Am I Eligible”) icon (on right hand top corner).

- Enter your contact details (mobile number), Captcha code and generate OTP.

- Select your state

- Select Category (Search your name by your name or mobile number (if registered in (SECC) Socio Economic and Caste Census 2011) or HHD (a 24 digit Household Id number given to each family in SECC 2011) or Ration Card number)

- If you search by Name, fill in your  name,  Father’s name, Mother’s name, Spouse’s name, your gender, age, district name, village name, area(Rural / Urban), PIN Code, etc. Care: if the details are not filled in properly, you might not find your name in the list even though you are in the eligible list.

- Click on 'Family Members' tab to find the family members listed in SECC database

- HHID is also available along with the details of the family members. Note down the HHID on a piece of paper for reference in future.

- Click on “GET DETAILS ON SMS” and fill up your mobile number and Captcha code and Click on submit button.

- A message will appear on the screen “SMS has been sent to your mobile number XXXX. Thank you”.

- With this SMS, visit a CSC (Common Service Centre) or Community Health Centre/ Empanelled Hospital in your vicinity.

- Each member of the family has to give the biometrics (finger print) which will be verified with Aadhar database to confirm the identity of the beneficiary. The photo and other details are auto-populated from the Aadhar database and printed on the card.

- Each member is given a separate PMJAY Card (Gold Card). The card is required to avail the benefit under the AB-PMAJY.

- Family members can be added due to birth or addition due to marriage or name of a family member is left out due to some genuine error.

- Alternatively, you can approach any Empanelled Health Care Provider (EHCP) or dial the Ayushman Bharat Yojana call centre number: 14555 or 1800-111-565 to know whether you are eligible or not under PMJAY.

- To know the details of benefits under the PMJAY, just send Hi on WhatsApp Number

+91 98689 14555 (Just Ask Master Ayushman service).

Progress so far:

More than 12.58 crore cards (till March, 2021) have been issued under the PMJAY. It has been lauded as the largest universal health care initiative in the world. It has earned many accolades from the international organisations, including World Health Organisation. The scheme aims to cover 50 crores beneficiaries. By the end of June 2021, as many as 1,91,32,000 patients have availed the hospitalisation treatments worth Rs 13,412 crore through a network of 21,565 public and private empanelled hospitals. The National Health Authority has also prepared detailed guidelines to issue eCard to the beneficiaries.

Disclaimer: The information given in the blog is only for general awareness and must not be construed as a professional advice. Readers are advised to consult the professionals in any subject matter of the blog before acting on the information discussed in the blog. The readers who are acting otherwise are doing so at their own risk.

(The reader’s comments are welcome at gnpatel@gujaratinfotech.com)

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Work From Home - Advantages / Disadvantages for Employees & Employers

What is “Work From Home”?

Carrying out an economic activity at home is called Work From Home (also known as telecommuting).

Benefits from “Work from Home”

Benefits to the employers:

· Savings on cost of infrastructure, overhead expenses and office supplies/consumables  

. The facility could be swapped in place of other perks to reduce the pay roll cost, if employees agree

· A Non-financial perk to attract and retain the talented employees

·  Flexibility in rostering and scheduling the availability of services

·  Continuity of business in natural calamities

·  Reduction in Absenteeism

· Reduction in frequency of availing leave by the employees

· Reduction in frequency of availing unplanned leave (leave without prior request)

· More satisfied employees and better perception / Public Review of the Company

· Higher productivity if proper Project Management Tools, monitoring system, Carrot and Stick Policy, infrastructure, etc are in place

· More flexibility in duty hours with extended availability of services attracting more customers/clients

Benefits to the employees:

. Saving the cost, time and hassles of commuting

. Better Work-Life balance leading to better family life and positive perception about the job and the employer

. Higher Productivity if the employee takes the facility as a responsible employee and proper tools / HR Policy / monitoring system are in place

. More flexibility in duty hours to adjust with personal needs for free time

. Lesser need to avail leave, particularly for small work / errands outside duty hours

. More focus on work (due to less distractions / interruptions from colleagues, office gossip/chitchat, office formalities/etiquettes)

. Sounding the waters to know like what the home life would be after retirement (if the employee is approaching retirement age)

. Safe, healthy workplace during epidemic / infectious disease period

. More friendly to mother of infant, pregnant woman, persons with restricted mobility and working senior citizens

. Bigger bouquets of employers to choose from for better job as the distance from the employer becomes irrelevant

Benefits to the society:

.  Less air and noise pollution as more vehicles could be taken off the road

.  Saving the scarce petroleum products

. Less crowded public transport

.  Better road safety as less vehicles will be on the road

. Better availability of parking space

. Better inculcation of social values in children as they will be under the eyes of the parents for more days

A few concerns:

For the employers:

·        Apprehension of reduction in productivity

·        Risk of piracy / loss of data

·        Risk of leakages of data of the clients leading to “Breach of Privacy”

·        Erosion in Sense of Belonging to the organization

·        Less flexibility to deploy the employees to cope with absenteeism / work exigencies

·        Limited use of employees’ talent

·    Difficulty in reviewing the Annual Performance of senior employees (though their performance can be measured, the overall strength of employees is not “visible”)  

·       Prevalence of a haze of unfamiliarity between the employees and the monitoring official as face to face interactions are limited

·     Cost of providing the tools / Project Management Software / App for online work

·        Communication gap till the system gets stabilized

·        Difficulty in inculcating Company Culture and Values in the employees

·        Scope for misuse of latitude of flexi time inherent under the concept

·        Problems associated with withdrawal of facility once extended to the employee

·        Lack of bondage with colleagues resulting into poor team spirit

·     Difficulty in dovetailing the pieces of work done by the employees working at home into an integrated whole deliverable work to the client

·    Risk of divulgence of critical information pertaining to R&D, tenders, future plans, tricks of the trade, etc

·   Dilution of the efficacy of the seniors for mentoring and controlling the employees  

·        Poor co-ordination, particularly intra-department

·    Loss of importance of better location of office, ambience, in-office free amenities, etc in attracting and retaining the employees

·      Aversion of employees towards subjecting themselves to bit stricter monitoring tools and procedures of reporting.

For the employees:

·        Lack of socialization with colleagues

·        Poor availability of help from peers/seniors

·        Poor availability of hardware in case of breakdown

·        Lack of opportunity to face to face interact with the seniors

·        Non-availability of proper space/highspeed internet/reliable source of electricity at home

·        Social distractors at home

·        Additional cost on electricity, tea/coffee/cold drinks, snacks, etc

·        Non-availability of free amenities which are otherwise available in the office

·        Role confined to limited subject matter which might hamper the progress in career, particularly for managerial role

·        Breeds aloofness and monotony in daily life

·        Difficulty in justifying the reduction in productivity to the monitoring officer even though the employee is not at fault

·        Risk of marginalization by the seniors for meetings, consultations, training, presentations, demo, etc as the employee is not in the office, hampering the growth of the employee.

·        Developing a habit of wasting time on internet for non-official matters.

·        Increasing tendency of working till late night.

How old is the concept?

It is generally perceived that the concept is of recent origin but it is not so. If you sift through the history of civilization and economic development of mankind, you would find that the concept is as old as the beginning of human being’s settled habitat in the form of a village. In olden days, and in developing countries even today, the artisans and professionals operate from their home only – front portion of the home is “work area” (front office!) and the rear portion of the home is residential area. The carpenters, the blacksmiths, the goldsmiths, the barbers, the weavers, the tailors, the cobblers, the doctors, the astrologers, the grocers, the money lenders, etc still “Work From Home”, if at all, they are not wiped out by the modern economy. The Industrial Revolution (1760 – 1840 AD) has changed the method of manufacturing and later, the further economic development has changed the method of delivering the services resulting into “Go to Work” rather than “Work From Home”. The self-employed individual has now become an employee of a Business House or such organization. As such, the concept is very old and only new thing about it is that the monstrous COVID-19 pandemic has brought it in limelight and sadly enough, spread the concept along with its own spatial spread.

The scope:

The concept can be adopted by many business verticals – particularly in Information Technology and Service Sector. With the advent of Information Technology, standardization, productization, online banking, Corporatization of Public Services, HR Policy, etc, the scope is expanding day by day. At present the concept is self-driven out of necessity or compulsion of circumstances. The Govt Policy, in the form of incentives, could certainly provide impetus for furtherance of the concept. It is reported that in 2019, the facility of “Work From Home” was being availed by 4.70 million employees (3.40 % of the work force) of which, (1) 44% were availing the facility full time and (2) 52% were female. On the employer side, 7% employers have extended the facility to their employees during the corresponding period. During last 5 years the growth rate of employers extending the facility has increased at the rate of 40%. Understandably, post COVID-19 pandemic, growth rate of employees availing “Work From Home” would be exponential and would help the concept stand in good stead. Typically, following sectors are much inclined to adopt the concept:

·        Information Technology

·        Data Entry, Digitization

·        Marketing, e-Commerce, Social Media

·        Travel and Hospitality

·        Education, Tutoring, Training

·        Mobile Telephony

·        Accounting and Taxation

·        Financing and Debt Collection

·        Consulting

·        Sourcing, shortlisting and interview for fresh recruitment

·        Post-sale customer services in retail

·        Consumer Services under Public Utilities (Electricity, Gas, Water, Telecom, etc)

·        E-Governance

·        Audiobooks and e-books

·        Capital Market

·        Streaming Media

·        Content Writing, Proofreading, Translation.

The future:

Though there are limitations of the concept of “Work From Home”, it has a bright future and a long way to go. Perception gap between the employers and the employees about the concept are narrowing down which is paving the road for breaking new grounds. The emerging technology in the field of IT, Communication, Artificial Intelligence, Robotics, Data Analytics, IOT (Internet of things), eCommerce, Business Methodology, increasing cost of office space, demands for more perks from employees, etc would strengthen the concept in future as the present scenario has proved that “Work Form Home” works and it pays to all stakeholders.

(Comments are welcome.

The blogger can be reached at gnpatel@gujaratinfotech.com)

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