What diseases are covered under MJPJAY in 2025?

My family lives in Maharashtra and we are covered under the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY). I want to know which major diseases and treatments are covered by this scheme.

The Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) in Maharashtra is a very comprehensive health insurance scheme. As of 2025, it has been expanded to cover approximately 1,900 medical and surgical procedures. It is designed to cover almost all major secondary and tertiary care illnesses that require hospitalization.

Extensive Coverage for Critical Illnesses

My neighbor in Pune, whose father is an MJPJAY beneficiary, was recently able to get his father’s heart bypass surgery done completely cashless. I explained to him that the scheme has a strong focus on providing for critical illnesses. This includes most major cardiac surgeries, a wide range of cancer treatments (like chemotherapy and radiotherapy), neurosurgery, and kidney ailments.

Coverage for Planned Surgeries and Common Ailments

I was speaking to a hospital’s Aarogyamitra, who handles MJPJAY claims, and he mentioned that a large number of common planned surgeries are also covered. He said that his hospital regularly processes cashless claims for MJPJAY beneficiaries for procedures like knee and hip replacements, cataract surgeries, hernia repairs, and gallbladder removal.

Maternity and Child Health Coverage

My cousin, who lives in Nagpur, used her family’s MJPJAY card for her recent delivery. She was happy to confirm that the scheme fully covered her maternity and childbirth expenses, including her C-section. The Aarogyamitra also told me that the scheme has extensive packages dedicated to pediatric care, which covers a wide range of treatments for newborns and young children.

What is Generally Not Covered by MJPJAY

The Aarogyamitra did clarify that, similar to the national PM-JAY scheme, MJPJAY is for in-patient hospitalization. He confirmed that routine outpatient (OPD) consultations for common illnesses, standalone diagnostic tests that do not lead to an admission, and elective cosmetic surgeries are not covered under the scheme’s benefits.

1 Like