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Dear readers, the Ayushman (आयुष्मान) CAPF is a joint initiative by the Ministry of Home Affairs and the National Health Authority, which will provide cashless healthcare services to CAPF staff/personnel working from all seven forces, ie. Assam Rifles, BSF, CISF, CRPF, ITBP, NSG, SSB, and their families through the Ayushman Bharat PM-JAY IT platform.
Ayushman CAPF was launched on January 23, 2021, by the Honorable Minister of Home Affairs of the Federation from Guwahati, Assam. Health facilities under the scheme will be available in all CGHS and PM-JAY private hospitals in a phased manner.
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About Ayushman CAPF in Details
The scheme is a joint initiative between the Ministry of home affairs and the National Health Authority. The purpose of the scheme is to provide cashless health services to CAPF employees and their families using the Ayushman Bharat PM-JAY IT platform. The “Ayushman CAPF” scheme was launched on January 23, 2021, in Assam and will be implemented across the country in a phased manner.
The convergence of Ayushman Bharat and CAPF is the first initiative of its kind to capitalize on the strengths of the current robust IT framework, access to a network of various private hospitals, and the potential to move services across the country. This initiative will help move away from any manual, paper-based process of leveraging healthcare benefits by CAPF employees and their families to a paperless service on the NHA’s IT platform.
In addition, the 24/7 call center, online complaints management system, fraud, and abuse monitoring system, and real-time monitoring dashboards are other key features of the scheme.
Ayushman CAPF Eligibility
Service personnel and their families of Assam Rifles, Border Security Force (BSF), Sashastra Seema Bal (SSB), Central Reserve Police Force (CRPF), Central Industrial Security Force (CISF), National Security Guard (NSG), and Indo-Tibetan Border Police (ITBP) under the scheme.
Here’s everything you need to know about the Ayushman CAPF Scheme:
- The plan is a joint initiative between the Ministry of home affairs and the National Health Authority. The purpose of the scheme is to provide cashless health services to CAPF employees and their families using the Ayushman Bharat PM-JAY IT platform.
- A distinguishing feature of the scheme is that it will shift from the manual, paper-based process of leveraging healthcare benefits to a paperless service on MHA’s IT platform.
- There will also be a 24/7 call center, online complaints management system, fraud and abuse monitoring system, and real-time monitoring dashboards.
- Beneficiaries of the scheme or program can collect the Ayushman CAPF electronic card from the respective forces. This card will be activated in private hospitals that have been activated using a copy of the service ID and Aadhaar or any other photo ID approved by the government.
- The electronic card can also be obtained from Pradhan Mantri Aarogya Mitra (PMAM) stationed at Private PM-JAY Hospital using the same documents.
Key Features of Ayushman CAPF
- Onboarding all CGHS empaneled Health Care
- Organizations (HCOs) on the NHA IT platform
- Transfer of paper-based processes to online workflows
- Paperless verification of beneficiaries
- Referral mechanism
- Claim processing (intimation, submission, scrutiny, and approval/rejection of claims)
- Online transfer of payments
- One-time e-KYC authentication on Beneficiary Identification System (BIS)
- Seamless access for serving personnel and their dependents to healthcare services
- Cashless & paperless treatment and diagnostics facilities at the empaneled HCOs upon referral from the CAPF / government Hospitals / CGHS wellness center
- Health Benefits Packages (HBP) offer more than 1853 procedures across 45 specialties
- Less waiting time for availing healthcare services
How to Avail Cashless Benefits under Ayushman CAPF
Get the Ayushman CAPF Card
- Beneficiaries can collect the Ayushman CAPF e-card from the respective forces. The card may be activated in an empaneled private hospital, after authentication using a copy of the Force and Aadhaar ID or a government photo ID.
- Alternatively, the Ayushman CAPF e-card can be obtained from Pradhan Mantri Aarogya Mitra (PMAM) stationed at PM-JAY Empaneled Private Hospital upon submission of the above documents.
Benefit from cashless medical treatment
- A recipient may benefit from medical treatment at CAPF or government-owned facilities free of charge, as per current guidelines.
- CAPF or government-owned facilities may refer the beneficiary to CGHS and PM-JAY private hospitals where the recipient can benefit from cashless outpatient / IPD treatment, including diagnoses at CGHS or CAPF private hospitals. In addition, beneficiaries can provide cashless IPD treatment at PM-JAY’s other private hospitals. The beneficiary will be required to register with the hospital using an activated Ayushman CAPF / ID card.
Payment of self-pay medical treatment costs
- The beneficiary may receive payment in the following scenarios: (1) Self-paying services available at CAPF or government-owned facilities (diagnostics, implants, medications, etc.) (2) Self-paying services available in non-affiliated hospitals, in an emergency situation.
- To submit a claims reimbursement claim, the beneficiary can log into the website (https://tms.pmjay.gov.in/) using the Ayushman CAPF ID. The beneficiary will be required to provide the required details and upload relevant documents such as prescriptions, referrals, bills, etc. Upon approval, payment will be made to CAPF employees’ bank accounts through UPI, in accordance with the applicable rates.
| # | HCO Type | Referral required? | Services (As available) | Mode | Guidelines/ Rates |
|---|---|---|---|---|---|
| 1 | Public HCOs, including MHA and CAPF-owned facilities | No | OPD / IPD | Free services | – |
| Other | Self-paid(later claim ‘Reimbursement’) | CGHS | |||
| 2 | Private HCOs empanelled under CGHS | Yes* | OPD/IPD/ Diagnostics | Cashless | CGHS |
| Other | Self-paid(later claim ‘Reimbursement’) | CGHS | |||
| 3 | Private HCOs NOT empanelled under CGHS or AB PM-JAY | Only in Emergency Cases | All | Self-paid(later claim ‘Reimbursement’) | CGHS |
CGHS & CAPF
LIST OF CGHS EMPANELED PRIVATE HCPs IN ASSAM
| Hospital Name | District | City/Town | Address | Pincode |
|---|---|---|---|---|
| ASG Eye Care | Kamrup Metro | Guwahati | Near Pantaloon Downtown, G.S Road | 781005 |
| Downtown Hospital | Kamrup Metro | Kamrup Metro | G.S Road Guwahati 781006 | 781006 |
| Hayat Hospital | Kamrup Metro | Kahilipara Road,Lalganesh, Odalbakra, Guwahati | 781034 | |
| Marwari Hospitals | Kamrup Metro | Guwahati | Sati Joymoti Road, Aathgaon | 781008 |
| Narayana Superspeciality Hospital | Kamrup Metro | Guwahati | Tularam Bafna, Civil Hospital Complex, Amingoan Guwahati, Assam | 781031 |
| Ultracare Diagnostic Centre | Kamrup | Guwahati | Beltola Branch,Survey,Guwahati | 781028 |
| SRL Diagnostics | Kamrup | Guwahati | SRL Limited, Near Ulubari Flyover, G.S.Road, Ulubari, Guwahati | 781007 |
| Ils Hospitals Agartala | West Tripura | Agartala | New Secretariat, Capital Complex | |
| Woodland Hospital | East Khasi Hills | Shillong | Woodland Hospital | |
| Bansara Eye Care Hospital | East Khasi Hills | Shillong | Lady Veronica Path, Laitumkhrah |
LIST OF CAPF EMPANELED PRIVATE HCPs IN ASSAM
| Hospital Name | District | City/Town | Address | Pincode |
|---|---|---|---|---|
| Aditya Diagnostic & Hospital | Dibrugarh | Dibrugarh | Amc Road Near Gautam Bazar, Dibrugarh | 781005 |
| J.J. Memorial Diagnostics & Hospitals Pvt Ltd | Dibrugarh | Dibrugarh | L.G.B Avenue Opposite Polo Ground, Dibrugarh | 786001 |
| Gnrc Dispur | Kamrup Metro | Guwahati | Rukminigaon Dispur Secretariat | 781006 |
| Lower Assam Hospital & Research Centre | Bongaigaon | Bongaigaon | North Bongaigaon | 783380 |
| Health City Hospital, Guwahati (A Unit Of North East Health City Pvt. Ltd) | Kamrup Metro | Guwahati | Uday Nagar Opp. Bodoland Guest House, Khanapara | 781022 |
| Dr. Damani Nursing Home | Dibrugarh | Dibrugarh | L.G.B Avenue Near Circuit House, Gangapara | 786001 |
| Sristhi Nursing Home (CISF/ Non-CGHS) | Dibrugarh | Dibrugarh | Paltan Bazaar, Dibrugarh, Assam | 786001 |
pmjay gov in login process please visit on the official website – https://tms.pmjay.gov.in/OneTMS/loginnew.htm
Status of Ayushman CAPFs Health Card Distribution 2023
| CAPF | Total number of Beneficiaries | Health Cards Distributed |
|---|---|---|
| NSG | 32972 | 13632 |
| Assam Rifles | 235132 | 233419 |
| ITBP | 333243 | 311827 |
| SSB | 254573 | 253430 |
| CISF | 466927 | 466775 |
| BSF | 1048928 | 1002979 |
| CRPF | 1186998 | 1159291 |
| Total | 3558773 | 3441353 |
Contact or Helpline from Ayushman CAPF
National Health Authority
- Address: 9th Floor, Tower-l, Jeevan Bharati Building, Connaught Place, New Delhi – 110001
- Phone Number: 14588
- Website: https://pmjay.gov.in/
Resources:
- Ayushman CAPF Brochure – English
- Ayushman CAPF Brochure – Hindi
- Ayushman CAPF – Manuals
- Ayushman CAPF Launch video
- CEO presentation on Ayushman CAPF
Quick Links:
Important Links
| Official Website | Click Here |
| AB PM-JAY | Click Here |
| Resources | Click Here |
| Hospitals | Click Here |
| Beneficiary View/Upload photo | Click Here |
| Transaction Management System/ Claim processing | Click Here |
| Transaction Management System/Reimbursement Portal | Click Here |
| Grievance Portal | Click Here |
| Ayushman CAPF FAQs | Click Here |
Frequently Asked Questions – Ayushman (आयुष्मान) CAPF Scheme
Ayushman CAPF is a convergence scheme that is implemented on the Ayushman Bharat PM-JAY IT platform. This scheme began to provide non-cash or reimbursable healthcare services to serve individuals from all seven CAPFs and their dependent family members.
Ayushman CAPF was launched in Assam on January 23, 2021. The scheme will be rolled out across the country in a phased manner. After the implementation of the program begins across India, the benefits provided in the scheme can be availed of in all CGHS and PM-JAY-equipped hospitals in the country.
All officials/working individuals and their families are from Seven Powers, viz. Assam Rifles, Border Security Force ( BSF), Sashastra Seema Bal (SSB), Central Reserve Police Force (CRPF), Central Industrial Security Force (CISF), National Security Guard (NSG), and Indo-Tibetan Border Police (ITBP) will be covered Under the scheme.
Ayushman CAPF Cards will be made available to all recipients in their forces/units. The card may be activated in a private hospital after authentication. Alternatively, the Ayushman CAPF electronic card can be obtained from an accredited private hospital. A copy of the force’s ID and Aadhaar card or government-approved photo ID is required for authentication.
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