How much health insurance coverage under Pradhan Mantri Ayushman Bharat Jan Arogya Yojana (PM-JAY)?

Appeared in: NORCET 9 Mains - 2025

Explanation

The Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a government health insurance scheme.
It provides a health coverage of ₹5 Lakh per family per year.
This coverage is for secondary and tertiary care hospitalization and is based on a family floater model.
The scheme aims to protect poor and vulnerable families from high medical expenses.

Option A: ₹10 Lakh is not the standard coverage amount provided under the PM-JAY scheme. This amount is double the actual benefit.
Option C: ₹8 Lakh is an incorrect amount. The scheme has a clearly defined benefit of ₹5 Lakh.
Option D: ₹15 Lakh is significantly higher than the actual coverage provided by PM-JAY. This amount is three times the correct benefit.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pradhan Mantri Jan Arogya Yojana (PM-JAY) Coverage as background academic context rather than a clinical decision trigger.
Nurses need to be aware of PM-JAY to assist patients and their families in understanding and availing the benefits, especially during admission and discharge planning.
Knowledge of the scheme helps in guiding patients to empanelled hospitals, ensuring they receive cashless treatment and reducing their financial burden.
What if? If a patient's required treatment cost exceeds the ₹5 Lakh limit within a year, the family would have to bear the additional expenses out-of-pocket, or seek support from other state-specific schemes or NGOs. The PM-JAY cover does not automatically renew or increase within the same policy year.

How to Approach the Question

Identify the core subject of the question, which is the 'Pradhan Mantri Ayushman Bharat Jan Arogya Yojana (PM-JAY)'.
Recognize that the question asks for a specific factual detail: the 'health insurance coverage' amount.
Recall or look up the key features of the PM-JAY scheme.
Compare the recalled amount with the given options (10 Lakh, 5 Lakh, 8 Lakh, 15 Lakh).
Select the option that matches the correct coverage amount as per the scheme's guidelines.

Concept Tested & Keywords

Concept Tested: Pradhan Mantri Jan Arogya Yojana (PM-JAY) Coverage
Stem keywords: health insurance coverage, Pradhan Mantri Ayushman Bharat Jan Arogya Yojana, PM-JAY
Lead-in keywords: How much

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Practise the full NORCET 9 Mains - 2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.